What Types of Incontinence Are There?

When, where, and how it happens can tell you which type of incontinence you may be experiencing.

Approximately one out of every four individuals could experience urinary incontinence, or the leaking of urine, according to a 2021 review and meta-analysis published in Aging Clinical and Experimental Research.

Several health conditions can cause you to leak urine, including stress incontinence, overactive bladder, and urge incontinence. Paying attention to when and where you have problems can help figure out which type you have.

"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."

Here are explanations of the different types of incontinence, what may contribute to them, and what you can do about it.

Stress Incontinence

If you leak urine after simply standing up from a sitting position, you may have stress incontinence.

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, according to MedlinePlus.

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

Urine leakage when you laugh, sneeze, or cough is a common symptom of stress incontinence. Additionally, another sign of stress incontinence is leaking urine when lifting weights or performing other exercises. Women with stress incontinence can also experience urine leakage while having sex, said Dr. Shah.

Stress incontinence is more common in women than in men. It is typically caused by factors that weaken the bladder muscles, such as aging, childbirth, excess weight, and surgery, particularly hysterectomy (in which the womb is removed) and prostate surgery.

Urge Incontinence

In situations where people can't delay urination, they may be dealing with urge incontinence, according to MedlinePlus.

"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. Bladder contractions can be the result of 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 unidentifiable.

Overactive Bladder

If you feel the need to urinate frequently and that need is sudden, urgent, and uncontrollable, you may have overactive bladder, which can cause you to have 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 the sound of running water or other noises when engaging in daily rituals.

"Running water or thoughts of approaching home—as one waits for the garage door to open or unlocks the door—can actually 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.

"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, according to a December 2018 International Urogynecology Journal article. Because of that, you'll want to seek medical 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, according to MedlinePlus.

Overflow incontinence happens when you have too much urine in your bladder. Functional incontinence occurs when urine leaks as a result of disabilities or other physical problems. Transient incontinence occurs when something (e.g., medicines) causes the incontinence but disappears when the cause is eliminated. Bedwetting happens exclusively when someone leaks urine while asleep.

What Else to Know About Urinary Incontinence

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.

You can make changes to help you manage the condition. For example, you can reduce your chance of leakage by going to the restroom and avoiding fluids before engaging in physical activity.

Additionally, doing Kegel exercises can help you tone the pelvic floor muscles, which hold in urine. You can also try a more discreet option, like disposable underwear, to keep you protected in the moments when you're caught off-guard.

However, if your experiences with urinary incontinence are still problematic, you'll want to talk with your healthcare provider, who can help determine the best treatment plan for your individual case.

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