Types of Urinary Incontinence

TEAM KNIX / YOUR BODY

Urinary incontinence is a broad term that covers a lot of different types of incontinence. They all share one thing in common; they manifest in the involuntary release or leakage of urine. 

This can be a stressful thing to experience. Those suffering from urinary incontinence often fear the embarrassment of an “accident” and may even withdraw from company and social situations to minimize the chances of this happening.

But it doesn’t need to be this way.

Asides from the many medical options you have once you’ve received a proper diagnosis of the actual type of urinary incontinence you’re experiencing, there are also lifestyle options to manage the day-to-day.

What We’ll Cover: Female Urinary Incontinence

Incontinence is something that can affect all ages, genders and ethnicities. While it is often seen (and portrayed) as a problem for “older” people, this isn’t necessarily always the case. So, if you’re younger and experiencing urinary incontinence don’t be shocked!

In this article, we’re going to focus on female urinary incontinence. Women are statistically more likely to experience urinary incontinence than men are (though as we noted it can affect both men and women). 

Of the 25 million adult Americans suffering from some form of urinary incontinence, 75-80% of those are women (source). Pregnancy, childbirth, and menopause are major reasons for the increased prevalence of urinary incontinence in women as compared to men. 

The 5 Types of Urinary Incontinence

At a high level, there are 5 different types of urinary incontinence that can be experienced by women. While the outcome is the same (involuntary release of urine), each one has subtle differences. That said, there are also overlaps between the different kinds of urinary incontinence. Plus, it’s possible to experience more than one kind, as you’ll see.

1. Urge Incontinence

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Urge Incontinence At-a-Glance

How / When it Manifests

Some Possible Causes

Treatment May Include

An impossible-to-ignore feeling that you need to go right this second or you’ll burst, even if you just went or felt fine just minutes before.

  • Neurological conditions like Parkinson’s or MS
  • Overactive bladder (OAB)
  • Pregnancy
  • Childbirth
  • Menopause
  • Trauma to the bladder and urethra from surgery
  • Weak bladder muscles
  • Weak pelvic floor muscles 
  • Biofeedback therapy
  • Pelvic floor exercises (Kegel exercises) to strengthen the pelvic floor muscles
  • Surgery

For some people, though, a strong urge to urinate comes seemingly out of nowhere. It can happen even if they’ve urinated recently and or felt completely normal just a minute ago. And if they can’t get to a bathroom in time, an accident may happen. This is urge incontinence.

Urge incontinence may be caused by a miscommunication between your brain and your bladder. There can be false messages that the bladder is full and needs emptying. Or “too late” nerve signals that you need to urinate.

Because it also involves the brain, urge incontinence can sometimes be linked to neurological conditions like Parkinson’s Disease and multiple sclerosis (MS). But it can also be caused by pregnancy (which puts pressure on the bladder), childbirth, menopause or trauma from surgery.

Urge incontinence can also be caused by an overactive bladder (OAB) - though it’s important to note that an overactive bladder does not always cause incontinence and is not itself considered a disease. OAB can be caused when the muscles in your bladder are too active.

2. Stress Incontinence

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Stress Incontinence At-a-Glance

How / When it Manifests

Some Possible Causes

Treatment May Include

Urine leakage during physical exertion, whether it be exercise or more physical reactions like coughing, sneezing, laughing etc.

  • Childbirth
  • Trauma from surgery (e.g. hysterectomy)
  • Weak pelvic floor 
  • Menopause
  • Pelvic floor exercises (Kegel exercises) to strengthen the pelvic floor 
  • Surgery

Stress urinary incontinence (SUI) has nothing to do with emotional stress, but is about physical exertion. This can be the obvious physical exertion of doing exercise. But it can also include bodily functions and involuntary reactions like coughing, sneezing, even laughing and having sex.

When any of those exertions cause an involuntary loss of bladder control resulting in leakage of urine, it’s called stress incontinence. And the cause of stress incontinence is usually weakened muscles that become weaker when the body is experiencing the ‘stress’ of those exertions, so fails to hold in your pee.

3. Mixed Incontinence

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Mixed Incontinence At-a-Glance

How / When it Manifests

Some Possible Causes

Treatment May Include

A combination of stress and urge incontinence.

  • The same causes as stress and urge incontinence
  • Medication
  • Bladder botox injections

Mixed incontinence is when a person experiences both urge and stress incontinence. It’s not uncommon to experience both issues with bladder control. It is, in fact, the second most common form of incontinence in women. If you have mixed incontinence, you likely have weakened pelvic muscles in combination with other possible health concerns. 

4. Overflow Incontinence

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Overflow Incontinence At-a-Glance

How / When it Manifests

Some Possible Causes

Treatment May Include

If the flow of urine “dribbles” or is unsteady, you may have overflow incontinence. The inability to completely empty your bladder can lead it to overflow and cause unexpected urine leaks.

  • Weak bladder muscles
  • Underactive bladder
  • Blockages in the urinary tract
  • Lifestyle changes
  • Surgery to remove blockages
  • Use of catheter

If you pee frequently but it has an unsteady, dribble-like flow of urine, this could point to overflow incontinence. With this type of incontinence, the bladder cannot empty when you pee and the amount of urine you eliminate may be small. And because your kidneys continually produce urine, this can lead your bladder to overflow later, without warning.

In addition to the stress this kind of sudden incontinence can cause, it also puts you at risk for urinary tract infections (UTI). This is because urine should be expelled from the body, but if the bladder isn’t emptying, the urine that remains can become a breeding ground for bacteria.

In many women, overflow incontinence can be caused by weak bladder muscles, an underactive bladder or a blockage in the urinary tract. An underactive bladder can be caused by certain medications, diabetes, alcoholism and other medical conditions. Blockages in the urinary tract are sometimes caused by other surgeries or unusual growths.

5. Functional Incontinence

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Functional Incontinence At-a-Glance

How / When it Manifests

Some Possible Causes

Treatment May Include

This is when you experience urine loss, but the cause is not associated with any problems with the urinary system.

  • Neurological or psychological causes
  • Physical impairments like spinal cord injuries
  • Nursing assistance
  • Changing physical settings
  • Medications and therapies to address underlying medical condition

Functional incontinence is probably the easiest form of incontinence to understand, because it isn’t caused by any damage to the urinary system but usually by another medical condition.

This kind of incontinence can have neurological or psychological causes. It might be a mental health issue that causes a person to ignore their urge to pee, or a disease like Alzheimer’s disease that can impact a person’s self-awareness or judgement. 

But it can also be caused by physical impairments which prevent a person from acting on their need to urinate. These can include physical obstacles, such as spinal cord injuries and mobility issues.

Seeking Medical Advice and Making Lifestyle Changes

Incontinence is definitely something we recommend speaking to a medical professional about. Even if you have an inkling of the kind of incontinence you are experiencing, they will be able to diagnose and confirm for you.

As we’ve seen, different forms of incontinence overlap… it would be easy to assume you have stress or urge incontinence and actually discover you have mixed incontinence, for example.

Your healthcare provider will also be able to discuss treatment options with you. And, yes, there are treatment options. Remarkably, half of people who experience incontinence don’t discuss it with their doctor. This is presumably either because they’re embarrassed (pfft! your doctor has seen it all!) or because they assume there’s nothing to be done.

Whether it's temporary or persistent, there are changes you can make to manage, and have excellent quality of life, while living with incontinence, including:

1. Reduce Your Risk Factors

Factors that increase your risk of urinary incontinence include:

  • Age
  • Being overweight
  • Smoking
  • Family history
  • Other diseases (e.g. diabetes, MS, Parkinson’s Disease)
  • Having been through pregnancy and childbirth
  • Having undergone certain pelvic surgeries (e.g. hysterectomy)
  • Dementia 

While some of these cannot be easily changed, others can be addressed or improved by making some  changes to your levels of physical activity and diet choices.

2. Do Kegel / Pelvic Floor Exercises

These exercises strengthen the pelvic muscles, which support the uterus, bladder, small intestine and rectum. 

Good news: Kegel exercises can be done any time, either sitting or lying down. You can even do them when you are eating, sitting at your desk, or when you are resting or binging The Crown on Netflix!

If you’re unsure how to do Kegel exercises, your doctor or physiotherapist can help you. But basically it’s like pretending you have to urinate and then holding it. You relax and tighten the muscles that control urine flow. 

One way to learn the muscles you should activate is to pay attention when you pee: Start to pee and then stop. You should feel the muscles in your vagina (for women), bladder, and anus get tight and move up. These are the pelvic floor muscles.  

If you feel them tighten, you have done the exercise right. Your thighs, buttock muscles, and abdomen should remain relaxed.

Try Products Like Leakproof Underwear 

While you explore treatment options with your doctor, you can also explore products to help you stay active and social. Leakproof underwear comes with different absorbency levels, that can hold up to 8 tsp of pee. 

Super absorbent Knix leakproof underwear can hold up to 8 tsp of liquid (whether that’s sweat, blood or urine). Products like these can be a game changer for those experiencing urinary incontinence, allowing them to remain active and social while exploring treatment options.