Types of Urinary Incontinence

What are the types of urinary incontinence?

Q: What are the types of incontinence? 

A: There are four types of urinary incontinence:

- stress incontinence

- urge incontinence 

- overflow incontinence

- functional incontinence 

Each type of incontinence is defined by the triggers that cause that type of urinary incontinence, and how large a volume of urine loss one is experiencing. One’s experience with incontinence is not limited to these four types of incontinence, as it is also possible to experience symptoms of both stress and urge urinary incontinence. Experiencing both stress and urge incontinence is called mixed incontinence. 

Q: What is stress incontinence? What are the causes of stress incontinence? What is female stress incontinence?

A:  Stress incontinence (also called female stress incontinence - in women) means that one one will experience urine leakage when your body places some form of physical ‘stressor’ or pressure on your body or bladder. More simply put, stress incontinence is urinary incontinence one experiences during physical activity. It is worth noting that stress incontinence refers only to physical stressors on the bladder that trigger leakage and not emotional or psychological stress. 

Common causes of female stress incontinence are activities like coughing, jumping, sneezing, laughing, exercising, engaging in penetrative sexual activity, participating in sexual intercourse, or heavy lifting. Stress incontinence varies from person to person;  triggers for one person may not trigger leakage in another. Stress incontinence can also vary individually, just because an activity might cause stress incontinence sometimes, does not mean it will cause stress incontinence every time one engages in the activity. Oftentimes, the amount of urine loss one experiences during stress incontinence depends on how full one’s bladder is. 

Q: What is urge incontinence? 

A:  Urge incontinence happens when one has a sudden urge to urinate that one is unable to, or has difficulty, delaying. 

Urge incontinence happens because the muscles in the bladder that control the flow and retention of urine contract or squeeze at the wrong time. There are a variety of causes for urge incontinence, including infections, inflammations, or anything that is a cause of, or symptom of, bladder irritation. 

The term ‘overactive bladder’ or OAB is also sometimes referred to as urge incontinence, however this is not totally accurate. Overactive bladder is defined as urinary urgency and frequency with or without leakage, in the absence of other conditions like a UTI or kidney stone. Urge incontinence is, however, a component over overactive bladder.

Q:  What is functional incontinence?

A:  Functional incontinence is when, though someone’s bladder is acting normally, they are unable to reach a toilet before urinating. This may be due to the fact that the given person does not realize they need to go to the bathroom, or, due to their physical condition, are unable to reach the bathroom or disrobe in time. Functional incontinence can also be known as disability associated urinary incontinence due to the fact that it is generally caused by the mobility or cognitive impairments that come along with disability. Common physical impairments associated with functional incontinence are Multiple sclerosis (MS), back pain, or arthritis. Common cognitive impairments associated with functional incontinence are Alzheimer’s disease or other forms of dementia. Dementia or Alzheimer’s patients might render patients unable to locate the bathroom, or not realize they need to use one.

Q: What is overflow incontinence?

A: Overflow incontinence is when the bladder doesn’t empty completely or properly, and thus excess urine, the ‘overflow,’ leaks out later on due to the bladder becoming overfull. Overflow incontinence can also be marked by either not sensing that the bladder is full, due to conditions that affect the bladder nerves like MS or diabetes. Or those experiencing overflow incontinence may be unable to completely empty. Lastly, it can be caused by some form of blockage preventing complete emptying of the bladder, like bladder or uterine prolapse.

Q: What is transient urinary incontinence?

A:Transient urinary incontinence is urinary incontinence that is temporarily caused by some form of sickness or medical ailment. It later goes away when the underlying issue is addressed, and is not permanent. 

Some causes of transient incontinence include UTIs, weakened pelvic floor muscles (which can be strengthened by exercises including kegels), pregnancy, depression, pelvic surgery and so forth. 

It is worth noting that ‘transient urinary incontinence’ is not a term found in medical literature or used in the medical community. Nor is ‘transient urinary incontinence’ a medical condition that urologists treat. UTIs are generally associated with urgency incontinence, and weakened pelvic floor muscles and pregnancy are associated with stress incontinence. 

Q:  What is nocturia incontinence?

A:  “Nocturia incontinence” is actually not a medical term; doctors refer to this condition simply as “nocturia.” Nocturia is defined by getting up during the night to relieve your bladder, interrupting your sleep. Various medical conditions can contribute to nocturia. Those experiencing nocturnal polyuria may produce extra urine during their sleep. Various medical conditions, including sleep apnea and diabetes, can cause this deviation in urine production. Bladder storage issues commonly associated with overactive bladder can also lead to this problem. With bladder storage problems, either the bladder is unable to store sufficient amounts of urine to get one through the night, or the bladder isn't completely empty. When the bladder doesn’t empty completely, it fills up faster, resulting in the need to empty more frequently.  

Q: What is coital incontinence?

A: Urine loss with sexual activity (penetration and/or orgasm) is called coital incontinence. More specifically coital incontinence is the “complaint of involuntary loss of urine during coitus”. Though urine loss with penetrative sexual activity is thought to have similar underlying pathophysiology to stress incontinence, it is still technically a distinct condition. Women often don’t report experiencing coital incontinence due to shame and stigma, and thus it has limited the level information and research available on the topic. 

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