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Published on: August 28, 2020
Urinary and faecal incontinence: psychological factors and management recommendations
Kenley Lj Kuoch1, Geoffrey S Hebbard2, Helen E O'Connell3
1PhD (Psychology) Candidate, Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia.
Background:
Urinary and faecal incontinence substantially impacts upon physical health and is associated with significant psychological distress and reduced quality of life. Due to stigma and embarrassment, many patients do not present for management of their incontinence.
Aim:
The objective of this article is to summarise the forms and causes of urinary and faecal incontinence, highlight the psychological mechanisms and psychopathology associated with incontinence, and provide management recommendations.
Conclusion:
Urinary and faecal incontinence can have a significant impact on an individual's psychological wellbeing and quality of life. Psychological factors may either contribute to or arise from incontinence and should be addressed as part of the overall management plan.
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The Micturition Reflex
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating...

