Psychological and Physical Environmental Factors in the Development of Incontinence in Adults and Children: A Comprehensive Review.

The aim of this review was to identify etiological environmental factors related to incontinence in children and adults. A variety of etiological environmental factors for the development of incontinence were identified. In children, these encompass stressful life events and trauma, family dysfunction, parental psychopathology, school-related stressors, toilet or "potty" training, fluid consumption habits, housing conditions, and the availability of toilets. In adults, physical exercise, obesity, working conditions, fluid intake, and the availability of toilets play a role. Intervening variables such as hormonal variations due to work shifts have also been identified as influencing the likelihood of incontinence. Current research suggests that environmental factors influence the development of incontinence in children and adults. The interactions between biological factors, the immediate environment, and intervening variables need to be explored in greater detail. Practical solutions to reduce barriers to adequate fluid intake and healthy toileting habits should be implemented in school and work settings.

Cues to urinary urgency and urge incontinence: how those diagnosed with overactive bladder syndrome differ from undiagnosed persons.

PURPOSE: To investigate the extent to which cues are reported to be associated with urinary urgency incontinence and urinary urgency. DESIGN: Descriptive and correlational study comparing 2 groups. METHODS: An online questionnaire assessing the extent to which 19 environmental, 3 mood, 3 cognitive, 3 stress incontinence, 1 bladder volume cue, and 3 unlikely cues were associated with episodes of urinary urgency incontinence and urgency was administered. PARTICIPANTS: Three hundred six participants were randomly drawn from a panel of respondents maintained by Zoomerang, Inc. Approximately half (n = 150) had self-reported diagnoses of overactive bladder syndrome (OAB) and half did not. Cue ratings were compared between persons with and without OAB and between likely and unlikely cues. RESULTS: The most frequently reported environmental cues were "On the way to the bathroom" and "Arrival at home/opening front door"; these cues were reported by both groups. Respondents with and without OAB showed significant differences in the mean number of cues associated with urinary urgency incontinence and with urinary urgency; persons with OAB were always higher. Significant differences between persons with and without OAB were found for 28 of 32 cues associated with incontinence and 25 of 32 cues associated with urinary urgency. To investigate response bias, within-subjects analyses compared mean responses to the 3 unlikely cues to means of all other cues. Analyses revealed that scores for unlikely cues were significantly lower than scores for likely cues. CONCLUSION: Cues associated with urgency incontinence and urgency were frequently reported by both groups. However, responding to cues was significantly more frequent among those who had been diagnosed with OAB. These findings may have implications for the diagnosis and treatment of urinary urgency incontinence.