====== Idiopathic normal pressure hydrocephalus urinary incontinence ======

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The bladder symptoms of iNPH are directly caused by [[detrusor]] [[overactivity]], which can result in [[urinary frequency]], urgency, or frank [[incontinence]]. 
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Urinary incontinence is one of the classic symptoms associated with iNPH. In this context, urinary incontinence refers to the involuntary leakage of urine, meaning a person may experience episodes of urine leakage without being able to control it properly. This symptom often develops due to the disruption of the normal neurological control mechanisms involved in bladder function.

Here's how urinary incontinence can be related to iNPH:

Neurological Impact: The increased pressure from the accumulated CSF in the brain can affect the nerves that control bladder function. This can lead to issues such as overactivity of the bladder muscles, causing frequent urges to urinate and potential leakage.

Coordination Issues: The communication between the brain, spinal cord, and the muscles controlling the bladder can be disrupted in iNPH. This can result in a lack of coordination between the muscles that keep the bladder closed (sphincters) and those that allow it to empty (detrusor muscle), leading to urinary incontinence.

Other Symptoms: Along with urinary incontinence, individuals with iNPH may also experience gait disturbances (difficulty walking), cognitive changes, and problems with cognitive flexibility.

It's important to note that while urinary incontinence is a common symptom of iNPH, it can also have other underlying causes. 
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Sakakibara et al. found that 95% of 41 patients with possible iNPH had urodynamic evidence of detrusor overactivity.