Text size:

Urinary Incontinence

Urinary incontinence is the involuntary release of urine due to the inability to control the bladder. Incontinence is not a disease, but it may be a sign that something is wrong. While many consider incontinence an inevitable consequence of aging, it is a medical problem that can be treated and alleviated.

According to the National Association for Continence, 25 million Americans experience some form of urinary incontinence and 1 in 4 women age 18 and older report they have had some form of involuntary bladder leakage. Prevalence may be greater, as cases are underreported due to a social stigma about the problem.

Urinary Incontinence More Common in Women

Women are far more likely than adult men to experience urinary incontinence because of anatomical differences in the pelvic region and the changes induced by pregnancy and childbirth. Women age 50 and older are the most likely to experience urinary incontinence.

In men, urinary incontinence is usually associated with prostate problems, prostate surgery, or neurologic conditions. Prostate dysfunction is indicated by problems with urination, such as a hesitant, interrupted, weak stream; urgency and leaking or dribbling; more frequent urination, especially at night; and urge incontinence.

Several body systems must work together to control the bladder, and problems can start when any one of these features is not working properly.

  • Pelvic floor muscles hold the bladder in place.
  • Sphincter muscles keep the urethra closed.
  • The bladder muscle relaxes when it fills with urine and squeezes when it's time to urinate.
  • Nerves carry signals from the bladder to let the brain know when the bladder is full.
  • Nerves also carry signals from the brain to tell the bladder when it's time to urinate.
  • Hormones help keep the lining of the bladder and urethra healthy.

Types of Urinary Incontinence

There are four major types of urinary incontinence:

  • Stress incontinence happens when urine leaks as pressure is put on the bladder, for example, during exercise, coughing, sneezing, laughing or lifting heavy objects. It's the most common type of bladder control problem in younger and middle-age women. It may also begin around the time of menopause. Men who have undergone prostate surgery or radiation treatment may also develop stress urinary incontinence.
  • Urge incontinence, often related to an overactive bladder (OAB), happens when people have a sudden need to urinate and are not able to hold their urine long enough to get to a toilet.
  • Overflow incontinence happens when small amounts of urine leak from a bladder that always feels full. Overflow incontinence is the constant dribbling of urine usually associated with urinating frequently and in small amounts. The bladder may never feel empty.
  • Functional incontinence is untimely urination that happens in many disabled or older people who have normal bladder control. They have a problem getting to the toilet because of physical disabilities or obstacles that make it hard to move quickly.

Stress and urge incontinence often occur together in women. Combinations of incontinence 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 in women. Transient incontinence is a temporary condition caused by infection or medication.

Symptoms of Urinary Incontinence

  • Involuntary leakage of urine
  • Sudden and urgent need to urinate resulting in urinary leakage

Testing for Urinary Incontinence

  • Urinalysis or urine culture
  • Cystoscopy
  • Pad test
  • Pelvic or abdominal ultrasound
  • Urinary stress test
  • Urodynamic studies

Treatment for Urinary Incontinence

Treatment for urinary incontinence depends on the causes and severity of the condition and the patient's health and personal preferences.

  • Diet modification
  • Medication modification
  • Bladder retraining
  • Biofeedback –for incontinence
  • Physical therapy – Kegel exercises for all forms of incontinence
  • Neuromodulation (nerve stimulation) for overactive bladder
  • Medication for overactive bladder
  • Injections of bulking agents for stress incontinence
  • Botox® injections for urge incontinence
  • Vaginal devices (pessary, urethral plugs)
  • Artificial urinary sphincter for stress incontinence in men and women
  • Surgical sling procedures for stress incontinence in men and women


Medical Disclaimer: The information provided in the Bladder Health Program of South Florida website should be used solely for educational purposes. It is not intended to replace the independent judgment of a healthcare provider. The appropriateness of a course of treatment for a patient may vary from the medical information provided herein due to individual conditions and/or complications. Always ask your physician about all treatment options, as well as the risks and benefits.

Share