Urinary Incontinence

Types

Urinary incontinence has seven types:

Pressure on bladder causes leaking.

Stress incontinence

People with stress incontinence involuntarily leak urine while exercising, coughing, sneezing, laughing or lifting. During these activities, sudden pressure to the bladder causes urine to leak. Stress incontinence is the most common type of incontinence among women. It may be due to weakened pelvic muscles, weakening in the wall between the bladder and vagina, or a change in the position of the bladder. In many cases, the condition develops as a result of pregnancy and childbirth. Other causes of stress incontinence include:

• Weakening of muscles that hold the bladder in place, or weakening of the bladder itself
• Weakening of the urethral sphincter muscles
• Damage to the nerves controlling the bladder from diseases such as diabetes, stroke, Parkinson's disease and/or multiple sclerosis, or from treatment of gynecologic or pelvic cancers with surgery, radiation or chemotherapy
• In women, a hormone imbalance or a decrease in estrogen following menopause, which can weaken the sphincter muscle
• In men, benign prostatic hyperplasia (a noncancerous overgrowth of the prostate gland), prostate cancer or prostate surgery

Urge incontinence

Problems caused by oversensitive bladder.

A frequent, sudden urge to urinate along with little control of the bladder (especially when sleeping, drinking, or listening to running water) is known as urge incontinence. This condition is also known as spastic bladder, overactive bladder or reflex incontinence. Urge incontinence is marked by a need to urinate more than seven times daily or more than twice nightly. It is most common in older adults. It also may be a symptom of a urinary infection in the bladder or kidneys, or may result from injury, illness or surgery. Among the possible causes are:

• Stroke
• Diseases of the nervous system, such as multiple sclerosis, Alzheimer's or Parkinson's
• Tumors or cancer in the uterus, bladder or prostate
• Interstitial cystitis (inflamed bladder wall)
• Prostatitis (inflamed prostate)
• Prostate removal, cesarean section, hysterectomy, or surgery involving the lower intestine or rectum

Overflow incontinence

Bladder doesn't empty completely, leading to frequent urination or dribbling.

People with overflow incontinence cannot completely empty their bladders. A constantly full bladder triggers frequent urination or a constant dribbling of urine, or both. This type of incontinence is often caused by bladder muscles weakened as a result of nerve damage from diabetes or other diseases. It can also occur when the urethra is blocked due to kidney or urinary stones, tumors, an enlarged prostate in men, female bladder surgery that is too tight, or a birth defect.

Functional incontinence

Functional incontinence is the most common type among older adults with arthritis, Parkinson's disease or Alzheimer's disease. These people are often unable to control their bladder before reaching the bathroom due to limitations in moving, thinking or communicating.

Mixed incontinence

Some people experience two types of incontinence simultaneously, typically stress incontinence and urge incontinence. Mixed incontinence is most commonly found in women. What causes the two forms may or may not be related.

Anatomic or developmental abnormalities

Incontinence is sometimes caused by an anatomic (physical) or neurologic abnormality. An abnormal opening between the bladder and another structure (called a fistula) can cause incontinence, as can a leak in the urinary system.

Loss of normal bladder function may also result from damage to part of the nervous system due to trauma, disease or injury. This dysfunction, called neurogenic bladder, can cause the bladder to be underactive (unable to contract and empty completely) or overactive (contracting too quickly or frequently).

Temporary incontinence

Sometimes incontinence comes and goes with specific conditions or as a side effect of a treatment for other chronic or acute diseases. Temporary incontinence may be caused by:

• Severe constipation
• Infections in the urinary tract or vagina
• Certain medications such as diuretics (water pills); sleeping pills or muscle relaxants; narcotics, such as morphine; antihistamines; antidepressants; antipsychotic drugs; or calcium channel blockers

Bed-wetting

In addition, some children have nocturnal enuresis (wetting the bed at night). Bed-wetting is normal until the age of 5 years. It is often an inherited disorder with a delay in neurological control of the bladder. Treatment is usually delayed to age 6 and may involve either medication or an alarm device that will awaken the child at the first sign of wetness.

Read more about bed-wetting and stress incontinence on MayoClinic.com.