[Incontinence and voiding disorders]

Urinary continence and micturition are functions which require the integrity of the organs (bladder, urethra, voluntary and involuntary sphincters) and the neural pathways responsible for micturition (parasympathetic), continence (sympathetic), and their control and coordination. Save the incontinence associated with vesico-vaginal fistulae in women, or overflow incontinence associated with a distended bladder in chronic retention, the three principal clinical forms of incontinence are: stress incontinence, urge incontinence and mixed incontinence, combining the two mechanisms. Voiding difficulties causing discomfort on urination, or even retention (chronic or acute), are the reflection of an imbalance between bladder contraction (reduction) and urethral resistance (augmentation). The management of a voiding disorder systematically requires an understanding of the pathophysiological mechanism involved and the search for the aetiology (often multifactorial), so as to adapt the appropriate medical and/or surgical management.