What Types of Incontinence Are There?

Approximately one in every four individuals could experience urinary incontinence, or the leaking of urine.

Several health conditions can cause leaking urine, including stress incontinence, overactive bladder, and urge incontinence. Paying attention to when and where you have problems can help you determine your type.

"The problem is, sometimes it's difficult for patients to pay attention to their voiding habits," said Sovrin M. Shah, MD, attending physician in the Department of Urology, Icahn School of Medicine at Mount Sinai in New York City. "A good, detailed history and physical examination can help you tell if you have stress or urge incontinence."

If you're wondering what type of incontinence you have, here are explanations of the different types of incontinence, what may contribute to them, and what you can do about it.

Stress Incontinence

You may have stress incontinence if you leak urine after standing up from a sitting position.

This type of incontinence isn't due to emotional stress but rather physical stress—meaning increased pressure in the body or straining can force urine past the neck of the bladder and out through the urethra.

"Anytime you exert yourself, increase pressure on the abdomen, and leak urine, that would be considered stress incontinence," Dr. Shah said.

Urine leakage can happen when you:

• Laugh
• Sneeze
• Cough
• Exercise
• Lift weights or heavy objects
• Have sex

Stress incontinence is more common in women than in men. It is typically caused by factors that weaken the bladder muscles, such as:

• Pregnancy
• Childbirth
• Menopause
• Excess weight
• Some medicines
• Injury to the urethra
• Surgery in the pelvic area and prostate (in men)

There are several ways to treat stress incontinence, including:

• Try pelvic floor muscle exercises, also called Kegel exercises. Talk to a healthcare provider to understand if Kegels are safe for you and how to do them properly.
• Avoid caffeine and alcohol.
• Maintain a healthy weight.
• Stop smoking.
• Ask a healthcare provider about medications.
• Speak to a healthcare provider about surgery.

Urge Incontinence

When people have a strong need to urinate and can't delay it, they may be dealing with urge incontinence.

"They know they have to go but feel they don't have enough time to get there," said Dr. Shah. "They can't stop the bladder, and their underwear is wet before they get to the bathroom, or they are dripping on the floor."

Urge incontinence typically occurs when the bladder contracts at inappropriate times and these bladder spasms result in incontinence. This type of incontinence is more common in older women and can happen at times when you don't expect it:

• During sleep
• After drinking water
• When you hear or touch running water
  

Bladder contractions can result from damage to the nerves or muscles of the bladder. Although urge incontinence may happen following conditions such as bladder cancer, bladder inflammation, or infections, the cause of urge incontinence is often not identifiable.

Treatment options for urge incontinence include:

• Trying pelvic floor muscle exercises
• Avoiding caffeine and alcohol
• Maintaining a healthy weight
• Stopping smoking
• Using biofeedback
• Using medications to relax the bladder muscle
• Getting Botox bladder injections to relax the muscle
• Using nerve stimulation to relax and regulate bladder spasms
  

Overactive Bladder

If you feel the need to urinate frequently and that need is sudden, urgent, and uncontrollable, you may have an overactive bladder, which can cause urge incontinence. The feeling can occur even when the bladder contains only a small amount of urine.

Some people have an increased urinary urgency—which can trigger incontinence—when they hear running water or other noises when performing daily rituals.

"Running water or thoughts of approaching home—as one waits for the garage door to open or unlocks the door—can exacerbate the symptoms of overactive bladder," said Dr. Shah.

Mixed Incontinence

Mixed incontinence is common and, in most cases, involves both stress and urge incontinence. Studies have estimated that mixed incontinence occurs in 16% to 19% of women in the U.S.

"Sometimes it's clear-cut, but it's not uncommon for patients to have both components," said Dr. Shah. However, one type of incontinence is usually more pronounced than the other.

Mixed incontinence usually does not respond well to treatment. Because of that, you'll want to talk with a healthcare provider for advice. "One should see an expert to determine which conditions are present and then decide which therapy would be best," Dr. Shah said.

Other Types of Incontinence

Overflow, functional, and transient incontinence, as well as bedwetting, are other types of incontinence.

• Overflow incontinence happens when you have too much urine in your bladder.
• Functional incontinence occurs when urine leaks due to disabilities or other physical conditions.
• Transient incontinence occurs when something (like medicines) causes the incontinence but disappears when you remove the cause.
• Bedwetting happens exclusively when someone leaks urine while asleep.

What Else To Know About Urinary Incontinence

The volume of leakage alone doesn't necessarily tell you what type of incontinence you have, said Dr. Shah. The amount leaked completely depends on the severity of the condition. Although people with stress incontinence are thought to leak less than people with urge incontinence, they can still release quite a bit if their condition is severe.

Tips To Reduce Urinary Incontinence

You can make changes to help you manage the condition. For example, you can reduce your chance of leakage by:

• Urinating regularly
• Avoiding fluids before engaging in physical activity or going to bed
• Doing Kegel exercises to help tone the pelvic floor muscles
• Maintaining a healthy weight
• Managing diabetes
• Preventing constipation
• Drinking less caffeinated and carbonated beverages

However, if you continue to experience urinary incontinence, talk with a healthcare provider who can help determine the best treatment plan for you and, if necessary, refer you to a specialist.

A Quick Review

There are several types of urinary incontinence, with stress incontinence being the most common. Although the causes of incontinence differ depending on the type, it's not something you should just have to live with because there are treatment methods worth trying. If the prevention and treatment methods you can do on your own aren't enough to solve the incontinence, talk with a healthcare provider to find the best treatment plan.