{"id":4870,"date":"2025-11-22T17:42:44","date_gmt":"2025-11-22T22:42:44","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/?post_type=chapter&#038;p=4870"},"modified":"2026-06-02T22:09:36","modified_gmt":"2026-06-03T02:09:36","slug":"incontinence","status":"web-only","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/chapter\/incontinence\/","title":{"raw":"8p4 Incontinence \u2013 Types, Causes, and Treatments","rendered":"8p4 Incontinence \u2013 Types, Causes, and Treatments"},"content":{"raw":"<strong>Incontinence \u2013 Types, Causes, and Treatments<\/strong>\r\n<h1><strong>Incontinence<\/strong>:<\/h1>\r\nLoss of voluntary control over the bladder, leading to accidental peeing.\r\n<h1><strong>5 Types of Incontinence<\/strong><\/h1>\r\n<h1><strong style=\"font-size: 1em\">1. Enuresis (Bedwetting):<\/strong><\/h1>\r\n<ul>\r\n \t<li>Involuntary urination in children\u00a0<strong>older than four<\/strong>.<\/li>\r\n \t<li>In children\u00a0<strong>under four<\/strong>, it\u2019s considered normal due to immature nervous system development. The\u00a0<strong>nervous system<\/strong>\u00a0continues to mature into early adulthood (up to ~30 years).<\/li>\r\n \t<li><strong>Causes of enuresis:<\/strong>\r\n<ul>\r\n \t<li><strong>Delayed neural maturation<\/strong>.<\/li>\r\n \t<li><strong>Psychosocial stressors<\/strong>\u00a0or disturbances.<\/li>\r\n \t<li>Usually\u00a0<strong>outgrown<\/strong> with age.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong style=\"font-size: 1em\">2. Stress Incontinence:<\/strong><\/h1>\r\n<ul>\r\n \t<li>Caused by\u00a0<strong>increased intra-abdominal pressure<\/strong>\u00a0(coughing, sneezing, heavy lifting, laughing).\u00a0\u00a0 This pressure\u00a0<strong>forces urine out<\/strong>\u00a0through weakened sphincters or pelvic muscles.<\/li>\r\n \t<li><strong>Pelvic Floor Muscle weakness:<\/strong>\u00a0Often due to\u00a0<strong>multiple pregnancies<\/strong>, aging, or hormonal changes. More common in\u00a0<strong>women<\/strong>.<\/li>\r\n \t<li><strong>Treatment Strategies:<\/strong><\/li>\r\n<\/ul>\r\n<ul>\r\n \t<li style=\"list-style-type: none\">\r\n<ul>\r\n \t<li><strong>Pelvic Floor Exercises: Kegel exercises<\/strong>\u00a0strengthen\u00a0<strong>pelvic floor muscles<\/strong>\u00a0and\u00a0<strong>urethral sphincters<\/strong>.\r\n<ul>\r\n \t<li>Improves urinary control by enhancing muscle tone around the bladder outlet.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Alpha-adrenergic agonists:<\/strong> Mimic\u00a0<strong>norepinephrine\/epinephrine<\/strong>.\r\n<ul>\r\n \t<li>Bind to <strong>alpha-adrenergic receptors <\/strong>on internal sphincter smooth muscles.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<ul>\r\n \t<li style=\"list-style-type: none\">\r\n<ul>\r\n \t<li style=\"list-style-type: none\">\r\n<ul>\r\n \t<li>Stimulate internal sphincters to\u00a0<strong>contract and close<\/strong>, reducing leakage.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>3. Urge Incontinence:\u00a0<\/strong><\/h1>\r\n<ul>\r\n \t<li>Characterized by an\u00a0<strong>abrupt, strong urge to urinate<\/strong>.<\/li>\r\n \t<li>Most common with\u00a0<strong>aging<\/strong>.<\/li>\r\n \t<li>The person\u00a0<strong>must rush to the bathroom<\/strong>\u00a0and\u00a0<strong>can\u2019t hold it<\/strong>\u00a0for long, leading to frequent urination.<\/li>\r\n \t<li><strong>Cause:<\/strong>\r\n<ul>\r\n \t<li>Overactivity of the\u00a0<strong>detrusor muscle<\/strong>\u00a0(the bladder muscle), leading to involuntary contractions.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Treatment:<\/strong>\r\n<ul>\r\n \t<li>Bladder training (timed bathroom trips), lifestyle adjustments (adopting healthy diet with fiber, fewer caffeinated beverages), stop smoking, building up pelvic floor muscles.<strong style=\"text-align: initial;font-size: 1em\">\u00a0<\/strong><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>4. Overflow Incontinence and Retention:\u00a0<\/strong><\/h1>\r\n<ul>\r\n \t<li>Occurs when the\u00a0<strong>bladder becomes overfilled<\/strong>.<\/li>\r\n \t<li>Results from weakened bladder muscles failing to empty properly, leading to dribbling and frequent urination.<\/li>\r\n \t<li>The <strong>detrusor muscle <\/strong>becomes\u00a0<strong>weak or insufficiently contractile<\/strong>.\u00a0 The\u00a0<strong>bladder<\/strong>\u00a0gradually\u00a0<strong>distends<\/strong>\u00a0and\u00a0<strong>overfills<\/strong>.<\/li>\r\n \t<li>The increase in stretch <strong>weakens<\/strong> the detrusor muscle further, creating a\u00a0<strong>vicious cycle<\/strong>.<\/li>\r\n \t<li>When the muscle cannot fully contract, urine <strong>remains <\/strong>in the bladder (residual urine).\u00a0 The residual volume causes the bladder to\u00a0<strong>fill up again faster<\/strong>, leading to frequency of urination.<\/li>\r\n \t<li>As the bladder <strong>overflows<\/strong>, the pressure pushes urine through the\u00a0<strong>urethral sphincters<\/strong>, leading to\u00a0<strong>dribbling <\/strong>or involuntary leakage.<\/li>\r\n \t<li><strong>Risk factors<\/strong> include urethral blockages (e.g., <strong>prostate<\/strong> <strong>enlargement<\/strong>, <strong>renal calculi<\/strong>), in which case treatment should address the cause. <strong>Urethral strictures or scarring<\/strong> due to frequent infections or Trauma can also lead to <strong>Retention<\/strong> and then Overflow Incontinence.\u00a0 As can <strong>nerve<\/strong> <strong>damage<\/strong> (eg. spinal cord injury <strong>below T12<\/strong>), or medications (e.g., <strong>anesthesia<\/strong>) that impair nerve signalling.<\/li>\r\n \t<li><strong>Treatments<\/strong>:\r\n<ul>\r\n \t<li>Catheters, possibly adult absorption underwear, bladder training, surgical removal of obstruction, or nerve repair. Retention needs immediate treatment to prevent bladder damage.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Note:\u00a0 Both Urge and Overflow Incontinence <\/strong>have common risk factors that include: <strong>aging<\/strong>, or nerve\/muscle dysfunction.<strong style=\"font-family: 'Cormorant Garamond', serif;font-size: 1.80225em\">\u00a0<\/strong><\/li>\r\n<\/ul>\r\n[caption id=\"attachment_6516\" align=\"alignnone\" width=\"300\"]<a href=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2026\/06\/Closed_Urinary_Drainage.png\" target=\"_blank\" rel=\"noopener\"><img class=\"wp-image-6516 size-medium\" src=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2026\/06\/Closed_Urinary_Drainage-300x300.png\" alt=\"Urinary Catheterization\" width=\"300\" height=\"300\" \/><\/a> Urinary Catheterization[\/caption]\r\n<h1><strong>5. Spinal Cord Injury &amp; Neurogenic Bladder Types:<\/strong><\/h1>\r\n<h1><strong>Above T12 and brain injuries\/disease:<\/strong><\/h1>\r\n<ul>\r\n \t<li style=\"list-style-type: none\">\r\n<ul>\r\n \t<li><strong>Bladder contracts involuntarily<\/strong>\u00a0\u2014\u00a0<strong>spastic<\/strong> bladder <strong>(spastic, overactive, or hyperreflexic bladder)<\/strong>.<\/li>\r\n \t<li>Causes\u00a0<strong>frequent, involuntary urination<\/strong>\u00a0(incontinence).<\/li>\r\n \t<li><strong>Treatment:<\/strong>\r\n<ul>\r\n \t<li>Usually\u00a0<strong>treated<\/strong>\u00a0with\u00a0<strong>anticholinergic drugs<\/strong>\u00a0to\u00a0<strong>relax<\/strong>\u00a0the detrusor muscle.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Risk factors<\/strong> include:\r\n<ul>\r\n \t<li>Brain damage (e.g., <strong>stroke<\/strong>), Neurological diseases (<strong>Multiple Sclerosis, Parkinson\u2019s Disease, Cerebral Palsy, Alzheimer\u2019s Disease, Encephalitis (viral or bacterial brain infection), Syphilis, Diabetes, Alcoholism (can cause neural damage)<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n&nbsp;\r\n<h1><strong>Below T12:<\/strong><\/h1>\r\n<ul>\r\n \t<li style=\"list-style-type: none\">\r\n<ul>\r\n \t<li><strong>Muscle is inappropriately relaxed<\/strong>\u2014<strong>flaccid<\/strong>\u00a0bladder<strong> (flaccid, underactive, or hyporeflexic bladder)<\/strong>.<\/li>\r\n \t<li>The\u00a0<strong>bladder overfills<\/strong>\u00a0because it\u00a0<strong>fails to contract<\/strong>\u00a0properly.<\/li>\r\n \t<li>Leads to <strong>overflow incontinence<\/strong>,\u00a0<strong>urinary retention<\/strong>\u00a0and\u00a0<strong>dribbling<\/strong>.<\/li>\r\n \t<li><strong>Treatment:<\/strong>\r\n<ul>\r\n \t<li>Relax the\u00a0<strong>sphincters<\/strong>\u00a0by\u00a0<strong>blocking<\/strong>\u00a0<strong>norepinephrine\/epinephrine<\/strong>\u00a0receptors, allowing the sphincter to\u00a0<strong>relax<\/strong>\u00a0when appropriate and <strong>enable voiding<\/strong>.\u00a0 Use <strong>alpha-adrenergic blockers<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<ul>\r\n \t<li style=\"list-style-type: none\">\r\n<ul>\r\n \t<li style=\"list-style-type: none\">\r\n<ul>\r\n \t<li><strong>Bladder management<\/strong>\u00a0involves controlling\u00a0<strong>urination timing<\/strong>\u00a0to prevent\u00a0<strong>bladder<\/strong> <strong>distention<\/strong>\u00a0and\u00a0<strong>detrusor<\/strong> <strong>muscle weakening<\/strong>.\u00a0 Catheter use may be required.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>","rendered":"<p><strong>Incontinence \u2013 Types, Causes, and Treatments<\/strong><\/p>\n<h1><strong>Incontinence<\/strong>:<\/h1>\n<p>Loss of voluntary control over the bladder, leading to accidental peeing.<\/p>\n<h1><strong>5 Types of Incontinence<\/strong><\/h1>\n<h1><strong style=\"font-size: 1em\">1. Enuresis (Bedwetting):<\/strong><\/h1>\n<ul>\n<li>Involuntary urination in children\u00a0<strong>older than four<\/strong>.<\/li>\n<li>In children\u00a0<strong>under four<\/strong>, it\u2019s considered normal due to immature nervous system development. The\u00a0<strong>nervous system<\/strong>\u00a0continues to mature into early adulthood (up to ~30 years).<\/li>\n<li><strong>Causes of enuresis:<\/strong>\n<ul>\n<li><strong>Delayed neural maturation<\/strong>.<\/li>\n<li><strong>Psychosocial stressors<\/strong>\u00a0or disturbances.<\/li>\n<li>Usually\u00a0<strong>outgrown<\/strong> with age.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong style=\"font-size: 1em\">2. Stress Incontinence:<\/strong><\/h1>\n<ul>\n<li>Caused by\u00a0<strong>increased intra-abdominal pressure<\/strong>\u00a0(coughing, sneezing, heavy lifting, laughing).\u00a0\u00a0 This pressure\u00a0<strong>forces urine out<\/strong>\u00a0through weakened sphincters or pelvic muscles.<\/li>\n<li><strong>Pelvic Floor Muscle weakness:<\/strong>\u00a0Often due to\u00a0<strong>multiple pregnancies<\/strong>, aging, or hormonal changes. More common in\u00a0<strong>women<\/strong>.<\/li>\n<li><strong>Treatment Strategies:<\/strong><\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li><strong>Pelvic Floor Exercises: Kegel exercises<\/strong>\u00a0strengthen\u00a0<strong>pelvic floor muscles<\/strong>\u00a0and\u00a0<strong>urethral sphincters<\/strong>.\n<ul>\n<li>Improves urinary control by enhancing muscle tone around the bladder outlet.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Alpha-adrenergic agonists:<\/strong> Mimic\u00a0<strong>norepinephrine\/epinephrine<\/strong>.\n<ul>\n<li>Bind to <strong>alpha-adrenergic receptors <\/strong>on internal sphincter smooth muscles.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Stimulate internal sphincters to\u00a0<strong>contract and close<\/strong>, reducing leakage.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>3. Urge Incontinence:\u00a0<\/strong><\/h1>\n<ul>\n<li>Characterized by an\u00a0<strong>abrupt, strong urge to urinate<\/strong>.<\/li>\n<li>Most common with\u00a0<strong>aging<\/strong>.<\/li>\n<li>The person\u00a0<strong>must rush to the bathroom<\/strong>\u00a0and\u00a0<strong>can\u2019t hold it<\/strong>\u00a0for long, leading to frequent urination.<\/li>\n<li><strong>Cause:<\/strong>\n<ul>\n<li>Overactivity of the\u00a0<strong>detrusor muscle<\/strong>\u00a0(the bladder muscle), leading to involuntary contractions.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Treatment:<\/strong>\n<ul>\n<li>Bladder training (timed bathroom trips), lifestyle adjustments (adopting healthy diet with fiber, fewer caffeinated beverages), stop smoking, building up pelvic floor muscles.<strong style=\"text-align: initial;font-size: 1em\">\u00a0<\/strong><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>4. Overflow Incontinence and Retention:\u00a0<\/strong><\/h1>\n<ul>\n<li>Occurs when the\u00a0<strong>bladder becomes overfilled<\/strong>.<\/li>\n<li>Results from weakened bladder muscles failing to empty properly, leading to dribbling and frequent urination.<\/li>\n<li>The <strong>detrusor muscle <\/strong>becomes\u00a0<strong>weak or insufficiently contractile<\/strong>.\u00a0 The\u00a0<strong>bladder<\/strong>\u00a0gradually\u00a0<strong>distends<\/strong>\u00a0and\u00a0<strong>overfills<\/strong>.<\/li>\n<li>The increase in stretch <strong>weakens<\/strong> the detrusor muscle further, creating a\u00a0<strong>vicious cycle<\/strong>.<\/li>\n<li>When the muscle cannot fully contract, urine <strong>remains <\/strong>in the bladder (residual urine).\u00a0 The residual volume causes the bladder to\u00a0<strong>fill up again faster<\/strong>, leading to frequency of urination.<\/li>\n<li>As the bladder <strong>overflows<\/strong>, the pressure pushes urine through the\u00a0<strong>urethral sphincters<\/strong>, leading to\u00a0<strong>dribbling <\/strong>or involuntary leakage.<\/li>\n<li><strong>Risk factors<\/strong> include urethral blockages (e.g., <strong>prostate<\/strong> <strong>enlargement<\/strong>, <strong>renal calculi<\/strong>), in which case treatment should address the cause. <strong>Urethral strictures or scarring<\/strong> due to frequent infections or Trauma can also lead to <strong>Retention<\/strong> and then Overflow Incontinence.\u00a0 As can <strong>nerve<\/strong> <strong>damage<\/strong> (eg. spinal cord injury <strong>below T12<\/strong>), or medications (e.g., <strong>anesthesia<\/strong>) that impair nerve signalling.<\/li>\n<li><strong>Treatments<\/strong>:\n<ul>\n<li>Catheters, possibly adult absorption underwear, bladder training, surgical removal of obstruction, or nerve repair. Retention needs immediate treatment to prevent bladder damage.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Note:\u00a0 Both Urge and Overflow Incontinence <\/strong>have common risk factors that include: <strong>aging<\/strong>, or nerve\/muscle dysfunction.<strong style=\"font-family: 'Cormorant Garamond', serif;font-size: 1.80225em\">\u00a0<\/strong><\/li>\n<\/ul>\n<figure id=\"attachment_6516\" aria-describedby=\"caption-attachment-6516\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2026\/06\/Closed_Urinary_Drainage.png\" target=\"_blank\" rel=\"noopener\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-6516 size-medium\" src=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2026\/06\/Closed_Urinary_Drainage-300x300.png\" alt=\"Urinary Catheterization\" width=\"300\" height=\"300\" srcset=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2026\/06\/Closed_Urinary_Drainage-300x300.png 300w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2026\/06\/Closed_Urinary_Drainage-1024x1024.png 1024w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2026\/06\/Closed_Urinary_Drainage-150x150.png 150w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2026\/06\/Closed_Urinary_Drainage-768x768.png 768w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2026\/06\/Closed_Urinary_Drainage-65x65.png 65w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2026\/06\/Closed_Urinary_Drainage-225x225.png 225w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2026\/06\/Closed_Urinary_Drainage-350x350.png 350w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2026\/06\/Closed_Urinary_Drainage.png 1500w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-6516\" class=\"wp-caption-text\">Urinary Catheterization<\/figcaption><\/figure>\n<h1><strong>5. Spinal Cord Injury &amp; Neurogenic Bladder Types:<\/strong><\/h1>\n<h1><strong>Above T12 and brain injuries\/disease:<\/strong><\/h1>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li><strong>Bladder contracts involuntarily<\/strong>\u00a0\u2014\u00a0<strong>spastic<\/strong> bladder <strong>(spastic, overactive, or hyperreflexic bladder)<\/strong>.<\/li>\n<li>Causes\u00a0<strong>frequent, involuntary urination<\/strong>\u00a0(incontinence).<\/li>\n<li><strong>Treatment:<\/strong>\n<ul>\n<li>Usually\u00a0<strong>treated<\/strong>\u00a0with\u00a0<strong>anticholinergic drugs<\/strong>\u00a0to\u00a0<strong>relax<\/strong>\u00a0the detrusor muscle.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Risk factors<\/strong> include:\n<ul>\n<li>Brain damage (e.g., <strong>stroke<\/strong>), Neurological diseases (<strong>Multiple Sclerosis, Parkinson\u2019s Disease, Cerebral Palsy, Alzheimer\u2019s Disease, Encephalitis (viral or bacterial brain infection), Syphilis, Diabetes, Alcoholism (can cause neural damage)<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h1><strong>Below T12:<\/strong><\/h1>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li><strong>Muscle is inappropriately relaxed<\/strong>\u2014<strong>flaccid<\/strong>\u00a0bladder<strong> (flaccid, underactive, or hyporeflexic bladder)<\/strong>.<\/li>\n<li>The\u00a0<strong>bladder overfills<\/strong>\u00a0because it\u00a0<strong>fails to contract<\/strong>\u00a0properly.<\/li>\n<li>Leads to <strong>overflow incontinence<\/strong>,\u00a0<strong>urinary retention<\/strong>\u00a0and\u00a0<strong>dribbling<\/strong>.<\/li>\n<li><strong>Treatment:<\/strong>\n<ul>\n<li>Relax the\u00a0<strong>sphincters<\/strong>\u00a0by\u00a0<strong>blocking<\/strong>\u00a0<strong>norepinephrine\/epinephrine<\/strong>\u00a0receptors, allowing the sphincter to\u00a0<strong>relax<\/strong>\u00a0when appropriate and <strong>enable voiding<\/strong>.\u00a0 Use <strong>alpha-adrenergic blockers<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li><strong>Bladder management<\/strong>\u00a0involves controlling\u00a0<strong>urination timing<\/strong>\u00a0to prevent\u00a0<strong>bladder<\/strong> <strong>distention<\/strong>\u00a0and\u00a0<strong>detrusor<\/strong> <strong>muscle weakening<\/strong>.\u00a0 Catheter use may be required.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<div class=\"media-attributions clear\" prefix:cc=\"http:\/\/creativecommons.org\/ns#\" prefix:dc=\"http:\/\/purl.org\/dc\/terms\/\"><h2>Media Attributions<\/h2><ul><li about=\"https:\/\/commons.wikimedia.org\/wiki\/File:Closed_Urinary_Drainage.png#\/media\/File:Closed_Urinary_Drainage.png\"><a rel=\"cc:attributionURL\" href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Closed_Urinary_Drainage.png#\/media\/File:Closed_Urinary_Drainage.png\" property=\"dc:title\">Closed_Urinary_Drainage<\/a>  &copy;  Bruce Blaus    is licensed under a  <a rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA (Attribution ShareAlike)<\/a> license<\/li><\/ul><\/div>","protected":false},"author":1370,"menu_order":7,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":["zoe-soon"],"pb_section_license":"cc-by-nc-sa"},"chapter-type":[],"contributor":[60],"license":[57],"class_list":["post-4870","chapter","type-chapter","status-web-only","hentry","contributor-zoe-soon","license-cc-by-nc-sa"],"part":59,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/4870","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/users\/1370"}],"version-history":[{"count":22,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/4870\/revisions"}],"predecessor-version":[{"id":6517,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/4870\/revisions\/6517"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/parts\/59"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/4870\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/media?parent=4870"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapter-type?post=4870"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/contributor?post=4870"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/license?post=4870"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}