The unintentional loss of urine happens once in a while to most women. It is much more frequent after the menopause. When it does occur, it is usually in a small amount and doesn't occur so often as to be a hygiene or activity-limiting problem. If urine loss becomes more frequent or larger in amount, it results in inability to leave the house or maintain much in the way of physical activity.
Incontinence is somewhat expensive because of having to buy perineal pads continuously.
The etiology of the incontinence determines therapy so it is critical to separate between anatomical and functional causes. Anatomically incontinence can be stress incontinence due to detachments of the pelvic structures that support the urethra and bladder, as well as the unusual occurrence of fistulas between the urinary tract and vagina which produce continuous incontinence. Functionally, the detrusor muscle of the bladder may contract spontaneously or there may be impairment anywhere along the neurological reflex arc that controls voiding functions. These disturbances can be from the central nervous system, spine or in the local nerve innervation pathway. A thorough physical exam looking for pelvic support defects, as well as a neurologic exam and urodynamic studies are key in differentiating the causes of urinary incontinence.