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What are the types of urinary incontinence?
If coughing, laughing, sneezing, or other movements that put pressure on the
bladder cause you to leak urine, you may have stress incontinence. Physical
changes resulting from pregnancy, childbirth, and menopause often cause stress
incontinence. This type of incontinence is common in women and, in many cases,
can be treated.
Childbirth and other events can injure the scaffolding that helps support the
bladder in women. Pelvic floor muscles, the vagina, and ligaments support your
bladder (see figure 2). If these structures weaken, your bladder can move
downward, pushing slightly out of the bottom of the pelvis toward the vagina.
This prevents muscles that ordinarily force the urethra shut from squeezing as
tightly as they should. As a result, urine can leak into the urethra during
moments of physical stress. Stress incontinence also occurs if the squeezing
Stress incontinence can worsen during the week before your menstrual period.
At that time, lowered estrogen levels might lead to lower muscular pressure
around the urethra, increasing chances of leakage. The incidence of stress
incontinence increases following menopause.
If you lose urine for no apparent reason after suddenly feeling the need or
urge to urinate, you may have urge incontinence. A common cause of urge
incontinence is inappropriate bladder contractions. Abnormal nerve signals might
be the cause of these bladder spasms.
Urge incontinence can mean that your bladder empties during sleep, after
drinking a small amount of water, or when you touch water or hear it running (as
when washing dishes or hearing someone else taking a shower). Certain fluids and
medications such as diuretics or emotional states such as anxiety can worsen
this condition. Some medical conditions, such as hyperthyroidism and
uncontrolled diabetes, can also lead to or worsen urge incontinence.
Involuntary actions of bladder muscles can occur because of damage to the
nerves of the bladder, to the nervous system (spinal cord and brain), or to the
muscles themselves. Multiple sclerosis, Parkinson's disease, Alzheimer's
disease, stroke, and injury-including injury that occurs during surgery-all can
harm bladder nerves or muscles.
Overactive bladder occurs when abnormal nerves send signals to the bladder at
the wrong time, causing its muscles to squeeze without warning. Voiding up to
seven times a day is normal for many women, but women with overactive bladder
may find that they must urinate even more frequently.
Specifically, the symptoms of overactive bladder include
urinary frequency -- bothersome urination eight or more times a day or two or
more times at night
urinary urgency -- the sudden, strong need to urinate
urge incontinence -- leakage or gushing of urine that follows a sudden,
nocturia -- awaking at night to urinate
People with medical problems that interfere with thinking, moving, or
communicating may have trouble reaching a toilet. A person with Alzheimer's
disease, for example, may not think well enough to plan a timely trip to a
restroom. A person in a wheelchair may have a hard time getting to a toilet in
time. Functional incontinence is the result of these physical and medical
conditions. Conditions such as arthritis often develop with age and account for
some of the incontinence of elderly women in nursing homes.
Overflow incontinence happens when the bladder doesn't empty properly,
causing it to spill over. Your doctor can check for this problem. Weak bladder
muscles or a blocked urethra can cause this type of incontinence. Nerve damage
from diabetes or other diseases can lead to weak bladder muscles; tumors and
urinary stones can block the urethra. Overflow incontinence is rare in women.
Other Types of Incontinence
Stress and urge incontinence often occur together in women. Combinations of
incontinence-and this combination in particular-are sometimes referred to as
mixed incontinence. Most women don't have pure stress or urge incontinence, and
many studies show that mixed incontinence is the most common type of urine loss
Transient incontinence is a temporary version of incontinence. Medications,
urinary tract infections, mental impairment, and restricted mobility can all
trigger transient incontinence. Severe constipation can cause transient
incontinence when the impacted stool pushes against the urinary tract and
obstructs outflow. A cold can trigger incontinence, which resolves once the
coughing spells cease.
The Types of Urinary Incontinence
The Types of Urinary Incontinence
Leakage of small amounts of urine during physical movement
(coughing, sneezing, exercising).
Leakage of large amounts of urine at unexpected times, including
Urinary frequency and urgency, with or without urge incontinence.
Untimely urination because of physical disability, external
obstacles, or problems in thinking or communicating that prevent a
person from reaching a toilet.
Unexpected leakage of small amounts of urine because of a full
Usually the occurrence of stress and urge incontinence together.
Leakage that occurs temporarily because of a situation that will pass
(infection, taking a new medication, colds with coughing).