What Are The 4 Types Of Incontinence?

Types Of Incontinence

You’ve probably heard of urinary incontinence or the phrase bladder leaks, but what exactly is it and how do the types of incontinence differ? In this post, we’re going to look at the four main types of urinary incontinence. We'll then also explore three other less common types of urinary incontinence.

But first, what is urinary incontinence? The NHS defines urinary incontinence as the unintentional passing of urine. There are several different types of incontinence and it affects millions of people (1). Knowing which type of incontinence you have is important so you’re able to get the right advice, support, and treatment.

Signs of urinary incontinence

Knowing the symptoms that you’re experiencing can help your doctor pinpoint which type of urinary incontinence you have and then offer you the right treatment.

The common symptoms people have are (2):

  • Minor leaks
  • Losing small to moderate amounts of urine on a regular basis
  • Urine leaks when you cough, sneeze, laugh, exercise, or lift a heavy object
  • Feeling a sudden urge to go to the toilet
  • Weeing more often
  • Dribbling urine

What are the 4 main types of urinary incontinence?

Stress incontinence

Stress incontinence is when the pressure in your bladder is greater than the strength of your urethra’s ability to stay closed. So when your bladder experiences pressure, such as when you laugh or cough, it pushes urine out. This often happens because the pelvic muscles are weak or damaged, or the urethral sphincter is damaged. Stress incontinence can affect men, but is more common in women, with 1 in 3 women experiencing bladder leaks in the UK (3).

Symptoms of stress incontinence can include leaking urine when you:

  • Laugh
  • Cough
  • Exercise
  • Lift a heavy object
  • Sneeze

The possible causes of stress incontinence are:

  • Weak or damaged pelvic floor muscles during pregnancy or childbirth
  • Obesity
  • Damage to bladder or the nearby area during surgery. For example, a hysterectomy or the removal of the prostate gland.
  • Neurological conditions or damage to the spinal cord, such as Parkinson’s Disease or multiple sclerosis.
  • Certain types of medicines
  • Menopause

Urge incontinence

Urge incontinence (also known as an overactive bladder) happens when the detrusor muscles in the wall of the bladder contract too often. This causes the bladder to go into a spasm and makes you want to wee. Urge incontinence can affect anyone, yet women and older adults are at a higher risk (4).

Symptoms of urge incontinence include:

  • A sudden and intense need to urinate
  • Regular trips to the toilet throughout the night

The causes of urge incontinence include:

  • Too much alcohol or caffeine
  • Not drinking enough fluids. The urine then becomes concentrated and can irritate the bladder.
  • Constipation
  • Neurological condition e.g. stroke
  • Trauma to the spinal cord
  • Diabetes
  • Urinary Tract Infection
  • Tumours or stones in the bladder
  • Certain medicines
  • Enlarged prostate

Overflow incontinence

Overflow incontinence happens when the bladder fills up as normal, however, a blockage in the bladder means it can’t empty properly. Because of the blockage, urine is building up inside the bladder. This then causes pressure to build and can cause leaks to happen (5).

Symptoms of overflow incontinence are:

  • A sudden need to pee
  • Feeling as though the bladder is full, even after you’ve been to the toilet
  • Leaking urine while sleeping
  • The flow of urine stops and starts as you wee
  • Find it difficult to wee, even when you need to go

There is a handful of causes for overflow incontinence, these include:

  • The urethra can become narrow
  • Blockage in the urinary tract
  • Bladder stones
  • Tumour
  • Enlarged prostate
  • Certain medicines
  • Constipation
  • Weakness in the muscles inside the bladder

Mixed incontinence

Mixed incontinence is when someone experiences more than one type of incontinence. Typically, this is a mix of stress and urge incontinence. It’s common to have a mixture of symptoms and there is often more than one cause (6).

For some people, one symptom is causing more of a problem than another. The various symptoms are:

  • An urgent need for the loo only to leak a little
  • Needing a wee after only drinking a small amount of water
  • Accidentally leaking urine when laughing, coughing, sneezing, or doing physical activity
  • A need to wee throughout the night
  • Dribbling urine after you’ve finished going to the toilet
  • Needing to wee after hearing or touching water

The causes of mixed incontinence reflect the causes of stress and urge incontinence.

Other types of incontinence

Functional incontinence

Functional incontinence (disability associated incontinence) is a physical or mental impairment that keeps someone from getting to the toilet on time (2). For example, someone isn’t able to recognise that they need the toilet or aren’t able to undress.

The causes of functional incontinence are either physical, intellectual, or due to an environmental issue, such as:

  • Arthritis
  • Cerebral palsy
  • Problems with memory or learning
  • Dementia

Reflex incontinence

Reflex incontinence is caused by a bladder spasm. The spasm can happen even when the bladder isn’t full. This causes the person to lose a large amount of urine (7). There are two types of reflex incontinence:

  • Supraspinal reflex incontinence: The brain and bladder don’t communicate. For example, someone who has had a stroke or has Parkinson’s Disease or dementia.
  • Spinal reflex incontinence: Connection from the spine to the brain is disrupted due to a disease or injury to the spinal cord.

Total Incontinence

Total incontinence happens when someone isn’t able to hold their urine at all. They may pass large amounts of urine all the time or leak often (8). There are various causes, including:

  • Problems since birth
  • Injury to the spinal cord
  • Bladder fistula
  • Diabetes
  • Certain medicines

When to see a doctor

Bladder leaks can be life-changing, uncomfortable, and let’s not forget embarrassing. Urinary incontinence isn’t a disease, something is causing it. If you’re worried about incontinence it’s important to see your doctor, as they'll be able to offer you the right advice, treatment, and management techniques.

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