What Is Incontinence?

This common problem may limit quality of life but is treatable

The door to a bathroom with a male and female figures holding their abdominal area.

 Peter Dazeley / The Image Bank / Getty Images

Incontinence is when there is an unintentional loss of control in releasing urine (pee) from the urinary bladder. Having urinary incontinence leads to urine leaking out of the body. This problem can be caused by a variety of factors that affect the muscles and nerves of the bladder.

Having urinary incontinence could mean anything from a small leak when coughing or sneezing to a complete lack of control that causes more urine to leave the body. People of any sex can experience incontinence.

Some of the types of incontinence are stress incontinence, urge incontinence, overflow incontinence, functional incontinence, and mixed incontinence.

Urinary Bladder

The urinary bladder is where urine is stored until it is released from the body. The bladder is located in the pelvis. It is an organ that is somewhat like a balloon. This is because it is hollow inside and it expands as it fills with urine. An adult bladder might be able to hold anywhere between 1.5 and 2 cups of urine.

Urine leaves the body through a tube called the urethra. The urethra goes between the bladder and the outside of the body. When the bladder is full, there’s a signal sent to the brain that it is time to urinate.

We don’t have any control over the production of urine and how the bladder fills up. There are two sets of muscles, called sphincters, that help control the flow of urine. These sphincters are shaped like a ring and are located in the neck of the bladder and the urethra.

When the sphincters are closed, they hold the urine in the bladder. When they are relaxed because it’s time to urinate, the urine is sent down the urethra and out of the body.

People do have control over these muscles and can clench them or relax them. Not having that control over being able to stop and start the body from urinating, either in part or totally, can result in urinary incontinence.

Types of Incontinence

There are several types of urinary incontinence and each has different potential causes.

Stress Incontinence

This is incontinence that occurs when urine leaks from the body with certain activities like coughing, sneezing, laughing, bending over, exercising, having sex, or lifting something heavy. Stress incontinence is more common in females than it is in males. 

This type of incontinence is caused by the muscles of the urinary sphincter or the urethra becoming weaker. When there is force upon the muscles in the abdomen, it can cause pressure on the bladder and lead to leaking urine.

Stress incontinence may develop when the muscles are weakened by childbirth, and it can occur anytime from during pregnancy to years after delivery. It can also occur after having surgery on the prostate. This is because the muscles of the sphincter can become weakened by this surgery.

Treatment of stress incontinence may start by exercising the pelvic floor muscles. Bladder training might also be used to learn how and when to void on a schedule to avoid symptoms of stress incontinence.

A more invasive treatment is the use of specialized devices, one which needs to be implanted by a healthcare professional (a vaginal pessary) or one that can be inserted and removed as needed (urethral insert) by the patient. Surgery that helps support the muscles in the urethra and the neck of the bladder may also be used to prevent leakage.

Urge Incontinence

This type of incontinence is when there is a feeling of a sudden need to urinate that is followed by a loss of muscle control and leaking urine. Some people who experience urge incontinence also find that they need to go to the bathroom more often, and sometimes get up during the night.

This condition is caused by abnormal contractions in the bladder. The muscles contract and cause urine to be voided out of the body.

There are several risk factors for urge incontinence including having abdominal surgery (including cesarean section or prostate surgery), obesity, cancer of the bladder or prostate, urinary tract infections, and being older.

The treatment for urge incontinence may start with biofeedback, which is type of training to learn how and when to empty the bladder to avoid leaks. Exercises called Kegels, which involve contracting certain muscles of the pelvic floor, might also be helpful.

Medications, nerve stimulation therapy, and surgery might also be used for incontinence that doesn’t respond to more conservative methods.

Overflow Incontinence

This type of incontinence happens because the bladder is not emptying fully after urinating. The feeling of needing to empty the bladder when it is full might not occur. That leads to urine staying in the bladder, which eventually causes an overflow of the retained urine.

This type of incontinence is often more common for the male urinary tract than the female urinary tract. Some of the causes of overflow incontinence include a blocked urethra, nerve damage in the bladder, weakened muscles in the bladder, and certain medications.

Treating overflow incontinence may start with a practice called “double voiding,” which means going to the bathroom to urinate twice a few minutes apart. This may help to completely empty the bladder. Other management techniques might include careful timing of fluid intake and using the bathroom right away when feeling an urge to do so.

Treating any underlying related conditions, for instance, a problem with the prostate, may also be recommended to help treat overflow incontinence. 

Functional incontinence

This type of incontinence may occur for various reasons when a person can not get to a bathroom in time to urinate, which can result in leaks. It can also occur as an adverse effect of certain medications. Functional incontinence is more common in people with a female urinary tract than people with a male urinary tract.

In some cases, part of the cause is a condition such as a problem with the spine, arthritis, or nerve damage from conditions such as Parkinson's disease or multiple sclerosis.

With conditions that restrict movement, it may take too long to get to a bathroom to urinate, especially when there are not accessible bathrooms. It might also occur with intellectual disabilities, where a person may not recognize the need to use the bathroom to urinate. 

For those that experience functional incontinence as a result of another condition, bladder training and scheduled bathroom trips may help. Treating this type of incontinence for those who have altered mobility may involve addressing societal issues such as bathroom access.

Mixed Incontinence

This type of incontinence is a combination of both stress and urge incontinence. The treatment might include those that are used for either or both of those types of incontinence.

Coping

Urinary incontinence is common but it is also upsetting and can impair quality of life. However, there are many treatments available for the various types of incontinence. In some cases, the problem may be managed through the use of non-invasive measures such as pelvic floor exercises or biofeedback.

For leakage that is preventing the ability to work or attend social events, using urinary pads or underwear can help. This should be a temporary solution until a healthcare provider can help to find a more long-term treatment plan.

It is important to speak with a healthcare professional about urinary incontinence, even though it is an uncomfortable topic. Some other lifestyle measures that may be recommended by a healthcare professional and can help in coping with urinary incontinence include:

  • Avoiding drinking a few hours before bedtime if waking to urinate is a problem
  • Avoiding alcoholic drinks, caffeine, and spicy foods if they cause irritation
  • Pelvic floor exercises such as Kegels to strengthen the muscles in that area
  • Reducing or changing the dosage or dose schedule of medications that may be associated with incontinence
  • Scheduling trips to the toilet every few hours
  • Training the bladder to urinate on a more regular schedule through delaying urination (as directed by a physician)

A Word From Verywell

Even though many adults experience urinary incontinence, it is not always easy to discuss the problem with a healthcare provider. A primary care physician, internal medicine physician, urogynecologist, or urologist are some of the physicians that can help with diagnosing and treating urinary incontinence.

In some cases, making some lifestyle changes can be helpful in reducing the symptoms. For more chronic types of incontinence, there are treatments that go from medications to implants to surgery.

The most important point to remember is that if urinary incontinence is having a significant negative effect on quality of life, treatments are available and they may help in getting back to regular activity.

Was this page helpful?
Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Institute of Diabetes and Digestive and Kidney Diseases. The urinary tract & how it works. June 2020.

  2. Urology Care Foundation, American Urological Society. What is stress urinary incontinence? Updated September 2020.

  3. McIntosh L, Andersen E, Reekie M. Conservative treatment of stress urinary incontinence in women: A 10-year (2004-2013) scoping review of the literature. Urol Nurs. 2015;35:179-203. 

  4. Urology Care Foundation, American Urological Association. It's time to talk about OAB.

  5. Hersh L, Salzman B. Clinical management of urinary incontinence in women. Am Fam Physician. 2013;87:634-640. 

  6. Michigan Medicine, University of Michigan. Overflow incontinence. Updated August 21, 2019.

  7. Harvard Men's Health Watch. Try these techniques to relieve common urinary symptoms without medication. Updated September 19, 2019.

  8. Urology Care Foundation, American Urological Society. What is urinary incontinence? Updated April 2020.

  9. Wakamatsu M. 4 behavioral changes to tame urinary incontinence. Harvard Health Publishing. July 10, 2019.