Medically reviewed by Dr. Temitope Rude, MD
If you struggle with urinary incontinence (UI), you are not alone. Over half of adults over 65 experience urinary incontinence and understand what it’s like to live with UI. In addition to being aware of what products and exercises are available, it’s important to be aware of the different types of incontinence, their causes, and their symptoms. When you understand urinary incontinence, you can learn how to combat it and regain control of your life.
Are There Different Types of Incontinence?
There are numerous types of urinary incontinence, and each has its own set of causes, symptoms, and treatment options. Read more below to understand what types of incontinence you or your loved ones may be experiencing.
Types of Urinary Incontinence
Functional Incontinence
What is Functional Urinary Incontinence?
Functional Incontinence happens when your urinary system can function, but other physical or cognitive impairments are causing bladder leaks. This can be caused by a mental health condition, certain medications that may affect your sense of reality or brain damage incurred in an accident or surgery.
Functional Incontinence is also sometimes present in those who have a difficult time physically getting to the restroom. If you are downstairs and your bathroom is upstairs, you may experience trouble getting up the stairs to use the bathroom, and this can cause incontinence.
Signs and Symptoms of Functional Incontinence
- You have difficulty moving to the bathroom and undressing in time
- You have an illness that makes you unconcerned about staying dry
- You are taking medications that decrease awareness of the need to find a toilet
Reflex Urinary Incontinence
What is Reflex Incontinence?
Reflex Incontinence is characterized by the release of urine with no warning or urge. Typically, reflex incontinence is due to nerve damage to the nerves responsible for signaling bladder fullness or emptiness. The most common appearance of this form of urinary incontinence is in people with severe brain damage or spinal cord injury, those with multiple sclerosis, or those who have undergone radiation treatments or specific surgeries.
Signs and Symptoms of Reflex Incontinence
- You do not feel the need to urinate
- You may not realize you’re leaking until you feel wet
Stress Incontinence
What is Stress Incontinence?
According to Harvard Health, stress incontinence is characterized by urine leaks caused by movement. The term “stress” refers to physical stress placed on the bladder during sudden movements. These movements can include jumping, coughing, laughing, or sneezing. The pelvic floor muscles are the muscles that control the bladder and contract the urethral sphincter.
If you experience stress incontinence, these muscles have been weakened or damaged, and can no longer contract the way they are supposed to hold urine.
There are two subgroups of stress incontinence. The first is known as urethral hypermobility. This subtype is characterized by movement. In urethral hypermobility, the urethra and bladder shift downward when abdominal pressure rises (due to a cough or sneeze) so the pelvic floor muscles cannot support the bladder or urethra.
The second form of stress incontinence is intrinsic sphincter deficiency. This subtype of stress incontinence happens when there are problems in the urinary sphincter that inhibit the full closure of the urinary sphincter. These problems could also allow the sphincter to “pop” under enough pressure, so if you cough hard enough or jump high enough, these muscles “pop” open and your bladder can empty.
One of the most common causes of stress incontinence is childbirth. For mothers who gave birth vaginally, damage to the pelvic floor muscles and nerves is very likely. If your child was over average size, there’s also a greater risk of nerve and pelvic floor muscle damage.
Another cause of this form of incontinence is age. As we age, our muscles generally weaken. Unfortunately, this includes our pelvic floor muscles and the urethral sphincter. In women, this can be due to an imbalance of estrogen levels, which can lead to bone and muscle loss. For men, stress incontinence is most often caused by urinary sphincter damage from prostate surgery or injury.
In addition, there are other contributing factors to developing stress incontinence such as obesity and high-impact exercise. Lung conditions or respiratory issues caused by smoking or disease can also lead to stress incontinence as they may cause an increase in coughing.
Signs and Symptoms of Stress Incontinence
- You will not feel the urge to urinate
- You urinate when you cough or sneeze
- You urinate when you laugh, bend over, or lift something heavy
- You urinate during exercise or sex
Urge Incontinence
What is Urge Incontinence?
Also known as Overactive Bladder (OAB) or Latchkey Incontinence, this form of incontinence is characterized by the urge to urinate, even if your bladder isn’t full. A muscle called the detrusor muscle is responsible for signaling to the brain that you have to urinate.
This overactivity occurs when the detrusor muscle contracts and signals urgency even when your bladder is not full. The signal for urgency is often very short-lived and your bladder muscles may release before you can make it to the restroom.
The causes of urge incontinence are less identifiable than those of stress incontinence. Urge incontinence could be caused by brain damage, which could prevent you from being able to counteract the signals sent to your brain to release your bladder. Similarly, if you’ve suffered from nerve damage or spine damage, these could result in an inability to stop a signal. A urinary infection could also cause urge incontinence and increase the urge to go, but these often go away when your infection does. Other causes include: constipation, bladder infections, diabetes, and bladder irritants.
When women go through menopause, their pelvic floor muscles also often get weaker. This is due to a few factors. Their body produces significantly less estrogen, the hormone responsible for the menstrual cycle, pregnancy changes, and puberty. When the body stops making this hormone, women stop going through these changes, and as a result, the vaginal tissue becomes less elastic, the urethra lining may begin to thin, and the pelvic floor muscles weaken.
In addition, if you have myofascial pelvic pain syndrome, you may experience urge incontinence as a result. If you experience burning when urinating, pain, or feelings of heaviness in your bladder, speak to your physician.
In men, urge incontinence is most commonly caused by surgeries or damage to the prostate. This can include benign prostatic hyperplasia (BPH) which is an enlargement of the prostate, prostate cancer surgeries, or other prostate cancer procedures and treatments.
Signs and Symptoms of Urge Incontinence
- An increased urge to urinate, even if you have just emptied your bladder
- An inability to control these urges or wait
- Being unable to make it to the bathroom in time
Overflow Incontinence
What is Overflow Incontinence?
Overflow incontinence is most often experienced in men. It can be caused by a blockage of complete urine passage, which prohibits the bladder to empty completely, thus causing leaks without the urge to urinate.
If you have had a urine drainage bag, you may experience overflow incontinence due to the inactivity of your bladder. In addition, diabetes and multiple sclerosis can damage the nerves responsible for signaling fullness and emptiness, which can result in overflow incontinence. Some medicines can even result in overflow incontinence.
If you notice a change in your urinary habits after starting medicine, speak to your doctor.
Signs and Symptoms of Overflow Incontinence
- Releasing urine suddenly without the urge to go
- Feeling like your bladder is full even after urination
- Urination leakage while sleeping
- Sudden stopping and starting of your urine stream while you’re urinating
- Difficulty urinating even when you feel the urge to go
Mixed Incontinence
What is Mixed Incontinence?Some people experience both stress incontinence and urge incontinence, and this is referred to as mixed incontinence. Mixed incontinence is most common in women due to menopause and childbirth. Men can experience mixed incontinence if they have had surgeries or damage to the prostate as well.
Your chances of experiencing mixed incontinence also increase as you age, so understanding the signs of each type of UI and learning how to deal with it can be a determining factor in your journey.
Signs and Symptoms of Mixed Incontinence
- You have symptoms of both stress and urge incontinence
Living with Urinary Incontinence
Living with urinary incontinence can cause emotional distress, loss of sleep, lack of nutrition, and skin rash and irritation. Despite how common UI is among older adults, the stigma around UI can make it difficult for you to find the products you need and exercises to best help you.
If you live with urinary incontinence, you deserve products that fit into your life seamlessly. From protective underwear that fits your lifestyle, to skincare products you can integrate effortlessly into your busy life to protect you from rash and irritation, we know how important it is to be prepared.
Additionally, pelvic floor exercises (kegel exercises) can help you regain some control of your UI and your life. Kegels are easy to perform, require little effort, and can be done while watching TV, brushing your teeth, or even washing the dishes!
FAQs About Different Types of Incontinence
Living with urinary incontinence can be a challenge, but having the right information and products can help you or your loved ones continue to live their lives to the fullest. Read below for some commonly asked questions about managing incontinence.
What Type of Urinary Incontinence Occurs With Coughing?
If you find yourself leaking when you cough, sneeze, or laugh, stress incontinence is responsible for these leaks. When you laugh, cough, or sneeze, additional pressure is put on your bladder, which can force urine to leak.
What Type of Urinary Incontinence is Most Common in Women?
Many experts believe that women who have given birth vaginally are most likely to develop stress incontinence. The process of childbirth can stretch and sometimes damage pelvic floor muscles and nerves, which can result in stress incontinence. Stress incontinence can vary in severity depending on the size of the baby, the age of the mother, the length of the labor, and the number of births.
What Types of Urinary Incontinence Are Common in the Elderly?
The prevalence of incontinence is much greater among the elderly than in younger adults. Due to the natural weakening of the bladder muscles with age, stress incontinence is common among people over 65. However, older adults who experience Dementia or Alzheimer’s may be more prone to functional incontinence. In men, overflow incontinence is much more common due to prostate-related conditions. Lastly, neurological diseases like Parkinson’s or Multiple Sclerosis can be responsible for urge incontinence, however it is most commonly idiopathic.
Summary
Being aware of the signs, symptoms, and causes of urinary incontinence will help you understand which form you experience or may be susceptible to. Thankfully, there are a wealth of resources and tools to help you comfortably live with UI. If you notice a change in symptoms, always speak with your doctor to identify the right treatment plan.
Interested in learning about the different treatment options available for incontinence? Check out our blog: Medical Treatment for Incontinence: An All-Encompassing Look at Managing Leaks
Do you or a loved one experience urinary incontinence? Take our bladder protection quiz and get a starter pack to try.
If you're struggling with incontinence, join one of our private support groups today!
Women's Incontinence Support Group
Men's Incontinence Support Group
Sources:
Harvard Health Publishing. (n.d.). Types of Urinary Incontinence. Harvard Health Publishing. https://www.health.harvard.edu/bladder-and-bowel/types-of-urinary-incontinence
Mayo Clinic. (n.d.). Stress Incontinence - Symptoms and Causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/stress-incontinence/symptoms-causes/syc-20355727WebMD. (n.d.). Bladder Control and Menopause: What You Need to Know. WebMD. https://www.webmd.com/urinary-incontinence-oab/womens-guide/bladder-control-menopause#1
Thompson, W. K., Charo, L., Vahia, I. V., Depp, C., Allison, M., Jeste, D. V., & Eyler, L. T. (2013). Association between higher levels of sexual function, activity, and satisfaction and self-rated successful aging in older postmenopausal women. The Journal of Sexual Medicine, 10(6), 1549–1557. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3492521/
Michigan Medicine. (n.d.). Urinary Incontinence. University of Michigan Health. https://www.uofmhealth.org/health-library/uh1227
Minino, A. M., & Smith, B. L. (2001). Deaths: Preliminary Data for 2000. National Vital Statistics Reports, 49(12), 1–40. https://www.cdc.gov/nchs/data/series/sr_03/sr03_036.pdf
