What Are the Different Types of Incontinence?

Urinary incontinence is a topic that doesn't get talked about enough, yet it affects millions of people around the world⁽¹⁾. Whether it's an occasional leak or a more frequent issue, incontinence can feel frustrating and inconvenient. However, understanding the different types of incontinence can help you manage your symptoms and find the best solution for you. 

There are several types of urinary incontinence, and each with its own causes and characteristics. By learning more about the different types of incontinence, you can take the first step toward managing your symptoms and regaining control.

The Uqora science team created this resource to support you in navigating your urinary health journey. Keep reading to learn more about the different types of urinary incontinence. 

What is Urinary Incontinence? 

Urinary incontinence is when you experience an involuntary leakage of urine⁽²⁾. It's more common than many people might think, affecting over 423 million people 20 years and older worldwide, with approximately 25% to 45% of females reporting some degree of it⁽¹⁾. That's a significant number of people who are dealing with this issue daily!

Understanding the different types of urinary incontinence can support you in making informed decisions for your urinary health. Each type has its own causes and treatment methods, and knowing which type of incontinence you're dealing with can help you manage your symptoms and find a solution that feels good to you. 

Plus, we hope this can help reduce the stigma around incontinence by promoting awareness and understanding about every aspect of the condition. 

How is Urinary Incontinence Diagnosed?

The only way to diagnose any type of urinary incontinence is to visit your doctor and generally they will follow this protocol to understand: 

• Medical history: Your doctor will need to know your symptoms, medical history, and lifestyle.
• Physical exam: They will likely conduct a physical exam that may also include a pelvic exam to check the strength of your pelvic floor muscles.
• Urine tests: Urine tests help rule out infections or other conditions.
• Bladder diary: Some doctors may recommend a bladder diary which consists of tracking your urination patterns and any episodes of leakage⁽³⁾. This can help identify any patterns or triggers that may help indicate the cause.
• Post-void residual measurement: Your doctor may also measure the amount of urine left in your bladder after you urinate to check for possible obstructions or issues with bladder nerves or muscles⁽³⁾.

Stress Incontinence

Stress incontinence is one of the most common types of urinary incontinence. It happens when physical movements or activities, like coughing, sneezing, laughing, or exercising, put pressure on your bladder, causing a leak⁽³⁾. 

Causes

The main causes of stress incontinence include: 

• Weak pelvic floor muscles & urinary sphincter: Stress incontinence occurs when weakened pelvic floor and urinary sphincter muscles can’t support or control urine flow properly⁽⁴⁾. 
• Childbirth: Childbirth can weaken the pelvic floor muscles or urinary sphincter due to tissue or nerve damage, potentially causing stress incontinence immediately after delivery or even years later⁽⁴⁾.
• Aging: As you age, weakening muscles can increase your risk of stress incontinence, although it can occur at any age⁽⁴⁾.
• Surgery: Procedures like a hysterectomy or a prostatectomy can sometimes damage and leave an impact on how the pelvic floor muscles function⁽⁵⁾. 

Urge Incontinence

Urge incontinence is when you experience a sudden, immediate urge to urinate and involuntarily urinate. If you find yourself needing to rush to the bathroom frequently and sometimes not making it in time, you might be dealing with urge incontinence⁽³⁾. 

Causes

Several factors can contribute to urge incontinence, including: 

• Bladder irritation: Conditions like infections and UTIs, bladder stones, or inflammation can trigger sudden urges⁽⁶⁾. 
• Neurological disorders: Diseases like Parkinson's, multiple sclerosis, or stroke can affect the nerves that control the bladder muscles⁽⁶⁾. 
• Certain medications: Diuretics and other medications can increase urine production or interrupt the normal process of storing and passing urine^(7,8).
• Drinking too much alcohol or caffeine: Alcohol and caffeine can interfere with nerve signals to the brain, leading to bladder overflow^(9,10).

Overflow Incontinence

Imagine trying to pour water into a full glass—it spills over because there's no more room. Overflow incontinence works the same way and occurs when the bladder doesn't empty properly, causing it to overflow and leak urine⁽³⁾. 

Causes

There are several reasons why overflow incontinence may happen:

• Blockage: Something blocking the urethra, like a tumor or enlarged prostate gland, can prevent urine from flowing freely.
• Weak bladder muscles: If the bladder muscles are not strong enough to contract effectively, the bladder can't empty completely.
• Nerve damage: Conditions like diabetes, spinal cord injuries, and neurological diseases can affect nerve signals to the bladder and prevent it from contracting normally⁽¹¹⁾. 
• Medications: Certain medications, especially those that affect bladder function or increase urine volume, can contribute to overflow incontinence^(11,12).

Functional Incontinence

Functional incontinence is when someone has difficulty making it to the bathroom in time due to physical or cognitive impairments rather than bladder function itself⁽³⁾. Mobility issues, arthritis, or dementia, can all prevent us from reaching the bathroom in time.

Causes

Several factors can contribute to functional incontinence:

• Variance in mobility function: Difficulty walking or getting around due to arthritis or joint pain. 
• Cognitive impairment: Conditions like dementia or delirium can affect brain function making it hard to recognize the need to use the bathroom.
• Physical barriers: Physical barriers like stairs, poor lighting that hinders visibility, and large crowds can make it difficult to reach the bathroom in time, leading to functional incontinence⁽¹³⁾. 
• Medications: Certain medications can affect mobility, cognitive function, or bladder control, contributing to functional incontinence^(11,13).

Mixed Incontinence

Mixed incontinence is just what it sounds like; it's a combination of different types of urinary incontinence, most commonly it refers to stress and urge incontinence occurring together. This means experiencing leaks from both physical movements that put pressure on the bladder (like coughing or laughing) and sudden urges to urinate that are difficult to control⁽³⁾.

Causes

Mixed urinary incontinence often happens when both stress and urge incontinence are present. Stress incontinence is caused by weak pelvic muscles or problems with the urinary sphincter, while urge incontinence involves sudden, uncontrollable bladder contractions due to factors like nerve issues or bladder sensitivity⁽¹⁴⁾.

How Is Urinary Incontinence Treated?

When it comes to managing symptoms of urinary incontinence, the treatment your doctor recommends will depend on the type of incontinence you're experiencing.

In order to find the best treatment option for you, you’ll need to be diagnosed by a medical professional. Here are some common treatments they might suggest:

• Behavioral techniques: These include bladder training, where you schedule bathroom visits at regular intervals and gradually increase the time between trips. Your doctor can work with you to come up with a plan that works for you.
• Pelvic floor exercises: Pelvic floor therapy, which includes exercises like Kegel exercises, can also strengthen the muscles that control urination.
• Lifestyle changes: Simple adjustments like managing fluid intake, limiting or avoiding caffeine and alcohol consumption, and maintaining a healthy weight can possibly make a difference in reducing symptoms.
• Medications: Depending on the type of incontinence you’re experiencing, your doctor may prescribe medications. For example, anticholinergics can help calm an overactive bladder, while topical estrogen might be recommended for women experiencing urinary symptoms due to hormonal changes.
• Medical devices: In some cases, devices like pessaries (inserted into the vagina to support the bladder) or urethral inserts (that block leakage) can be helpful.
• Surgery: For more severe cases or when other treatments haven't been effective, surgical options like sling procedures to support the urethra or artificial sphincter implants may be considered.
• Interventional therapies: These include procedures like botox injections into the bladder muscles to help control overactive bladder symptoms and urge incontinence⁽³⁾.

Overactive Bladder vs. Urinary Incontinence

Urinary incontinence and overactive bladder (OAB) might seem like similar experiences, but they're actually different when it comes to how they present. Incontinence is the involuntary loss of urine, which can happen throughout the day for various reasons. On the other hand, OAB is characterized by feelings of urgency and frequent urination even if your bladder isn't completely full.

OAB can sometimes be accompanied with urinary incontinence, but not always. So, while they both affect your bladder, knowing the difference can help you and your doctor figure out the best way to treat whichever you're experiencing.

If you're experiencing either of these, chatting with your healthcare provider can help you sort out the best plan to keep your symptoms under control. 

Learn more about the difference between overactive bladder, urinary incontinence, and UTI. 

Manage Incontinence and Enhance Your Comfort

Figuring out how to manage incontinence means understanding the different types and causes of incontinence. 

Remember, everyone's experience with incontinence is different, so teaming up with a healthcare provider you feel comfortable with can help ensure you get the support you need to feel your best.