Support structures to the bladder and bladder neck become damaged and pressure cannot be transmitted to the proximal urethra and leakage will occur. This results in pouching of the top wall of the vagina which can almost bulge outside the vagina. The bladder drops down with it and it becomes difficult to empty the bladder. Chronic bladder infections can also cause urgency and sometimes urgency incontinence. There are medications available to correct these problems, e.g. for urgency, hypo estrogenism.
Muscular sclerosis is also a disease that results in incontinence.
Parkinsonism also results in incontinence. During the first visit a complete history and physical is performed. Catheters measure the pressure in the bladder and urethra at the same time measuring the muscle activity of the lower pelvis. In this way, it is determined whether there are urgency symptoms or an overactive bladder. Urinalysis is routinely performed.