Urinary Incontinence Types

Urinary incontinence is the condition when urine is involuntarily discharged from the body. It can be caused by a variety of reasons and the amount of urine that leaks can vary depending on the type. Urinary incontinence is now categorized into 6 types based on the cause, and it can occur in both men and women. Types of incontinence:

1. Stress Incontinence
2. Urge Incontinence (Overactive bladder)
3. Mixed Incontinence
4. Overflow Incontinence
5. Functional Incontinence
6. Reflex Incontinence

This article mostly covers the causal and physical aspects of urinary incontinence, but that’s just one aspect of incontinence. There’s another important area that we don’t want to ignore. The emotional and quality of life impacts that incontinence can have, if it isn't addressed. We wanted to cover this here because it’s often overlooked in articles, yet these impacts can become debilitating to life.

Emotional and Quality of Life Impacts of Urinary Incontinence

Incontinence always brings some level of anxiety about leaking, and often also worry about where the nearest bathroom is whenever you are away from home. These 2 factors can negatively impact many aspects of life. For example:

• Day-to-day living. If you’re constantly worrying about leaking, even a trip to the drug store can be a huge stress, and feel like an insurmountable task.
  
• Work. Worry about leakage becoming apparent while working, volunteering or anywhere in public, can lead to issues like not going to meetings, being distracted while at meetings etc.
• Social life. If you start to turn down social invitations, dinner at a friend’s house, or a night out on the town, you can become isolated because of your symptoms.
• Activities. Not going to the gym because exercise causes leaks? Hikes and long walks out because there’s uncertain/no access to a bathroom? This means that you are no longer participating in the things you enjoy.
• Relationships. Incontinence can stress a marriage if your spouse doesn’t know what’s going on. He/she may feel alienated, or wonder what secret you are keeping from them.
• Sex Life. A fear of leaking during sex can put a strain on, or even end to, intimacy.
• Sleep. If you are getting up to use the bathroom frequently at night, or lying awake worrying about leaking in bed, you won’t be getting the rest you need.

While the issues covered here can occur similarly for either males or females, the following articles give more details and provide information for men, and for women.

What you can do about incontinence symptoms

If you are experiencing any of these emotional impacts, know that you can and should do something about it. That's because in most cases incontinence is treatable and manageable. Once your incontinence symptoms are treated, that also removes or relieves many of the quality of life stresses. Here's what to do.

If you haven’t already done so, seek professional medical help. Be honest about both your physical symptoms, as well as how they are impacting your life. That way your doctor can address both aspects of your situation.

Yes, you’ll have to get past any embarrassment you may feel about your symptoms. Something that might help with this is to keep in mind that urinary incontinence is a common symptom that may occur in any individual. There is no shame in talking about it with trusted and supportive people in your life, like your doctor, spouse or other trusted family members.

The reward you’ll get by overcoming any embarrassment is huge; there are treatments and options to relieve, resolve or manage your incontinence symptoms. You’ll find information on treatment options, as well as other important reasons to consult your doctor, in our article Dribbling After Urination and What You Can Do About It.

What are the 4 Types of Urinary Incontinence?

So now let’s get into more detail on the 4 types of urinary incontinence. Many experts now consider that there are 6 types, and we’ll cover all 6 here.

 

1. Stress Incontinence

If urine leaks out during sneezing, coughing, laughing, jumping, or any form of physical exertion or pressure/stress on your bladder, then you may have stress incontinence. The root cause of stress incontinence is when the muscles around your pelvic region become weakened or damaged. This hinders the muscles from properly holding the urine. Men are quite likely to experience stress incontinence after prostate surgery, or a pelvic fracture. In women, estrogen may affect incontinence but the extent to which it does is still unclear. Certain lung conditions attributed by frequent coughing, like cystic fibrosis, can also have an impact.

2. Urge Incontinence (Overactive bladder)

You may have urge incontinence if you frequently feel the need to go to the bathroom, despite not having a full bladder. An overactive bladder signifies that your bladder muscles are contracting involuntarily.

As with most other types of incontinence, urge incontinence also becomes more common with aging. However, primary causes of this condition may include one or more of a variety of reasons, such as:

• Post-menopause in women
• Neurological diseases
• Infections in the pelvic region
• Infections
• Prostate surgery

3. Mixed Incontinence

Having symptoms of both stress incontinence and urge incontinences means that you may have mixed incontinence. Due to its nature this condition can be difficult to diagnose. Incontinence in women is particularly challenging since, more often than not, they tend to have symptoms of both types of incontinence. In men, mixed incontinence may occur as a result of prostate removal surgery.

4. Overflow Incontinence

Overflow incontinence occurs when your bladder does not empty completely, causing urine leakage later on. Urine may leak even when you don’t feel the need to go. Not to be confused with after-dribble, which happens immediately afterwards, this can occur any time after you’ve used the restroom.

Contrary to urge incontinence, overflow incontinence is caused due to an underactive bladder, which is why you don’t feel the need to urinate. Spasms in the bladder muscles may also cause excess urine to be pushed out – a symptom that can be related to cardiovascular disease or diabetes.

Overflow incontinence is typically caused by prostate-related conditions such as an enlarged prostate, which is why it’s more common among men. An enlarged prostate causes the urine to be blocked, which may leak at a later time. Urine blockage may also be caused by kidney stones or a tumor, resulting in symptoms of overflow incontinence.

There are also certain medications that prevent proper bladder contractions or reduce your urge to urinate, causing this condition to occur as a result.

5. Functional Incontinence

In functional incontinence, your urinary tract is functioning properly but dribbling still occurs due to disabilities or illnesses. Accidental leakage of urine occurs when you are unaware of the need to use a toilet. This can be caused by medications, dementia or some mental illness.

If you are in a condition that makes it difficult for you to access a toilet in time you may be in a functional incontinence situation. For example, if you have low mobility. Bed-wetting in your sleep can also be a symptom of functional incontinence.

6. Reflex Incontinence

Reflex incontinence is caused by the leakage of urine without any urge. This happens when the nerves that warn the brain when the bladder is filling get damaged. Additionally, damage to the spinal cord may also cause this condition. Reflex incontinence occurs due to severe neurological impairment.

Summary of the 4 types of Incontinence

• Urinary incontinence can be caused by several different reasons, and the amount of urine that leaks can vary depending on the cause.

• Urinary incontinence is now often categorized into 6 types:

1. Stress Incontinence
2. Urge Incontinence (Overactive bladder)
3. Mixed Incontinence
4. Overflow Incontinence
5. Functional Incontinence
6. Reflex Incontinence

• Incontinence has both physical and emotional/quality of life impacts.
• The physical impacts relate to coping with involuntary leakage in daily life - how to contain leaks, keep clothing dry, get to a bathroom in time
• The quality of life impacts relate to the compromises and adjustments people make to their lives – like not going to the gym, declining social invitations that involve leaving the house -- because of worry over leaking, or not being close enough to a bathroom. These impacts can become debilitating to life if not addressed.

• In most cases incontinence is treatable, or manageable. Consult your doctor, and be honest both about your physical incontinence symptoms as well as how they are impacting your quality of life

• In most cases treatment can relieve, resolve or help you better manage both the physical and emotional impacts of urinary incontinence to help improve your quality of life
  

 

References:
Harvard Health: https://www.health.harvard.edu/bladder-and-bowel/types-of-urinary-incontinence
Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/urinary-incontinence/symptoms-causes/syc-20352808

Bio: Anna Williams is a former senior care support worker, and has spent many years advocating for better mental and physical health care within the senior care community. She volunteers locally, enjoys long walks on her weekends and spending time with her two pups, Tommy and Zadie.