Table of ContentsView AllTable of ContentsStress IncontinenceUrge IncontinenceMixed IncontinenceOverflow IncontinenceFunctional IncontinenceTreatments
Table of ContentsView All
View All
Table of Contents
Stress Incontinence
Urge Incontinence
Mixed Incontinence
Overflow Incontinence
Functional Incontinence
Treatments
Urinary incontinence (UI), or the loss of bladder control, is a condition that affects roughly 25 million people living in the United States.Though females are twice as likely to experience UI than males—particularly females over 50—certain types are known to affect males more than females.
Managing UIcan be frustrating because there is no “one-size-fits-all” solution for every type of incontinence. This includes the five major types: stress incontinence, urge incontinence, mixed incontinence, overflow incontinence, and functional continence.
The first step in finding the right treatment is to obtain a correct diagnosis, either from aurologisttrained in disorders of the urinary tract or a specially trainedobstetrician-gynecologistknown as a urogynecologist.
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A Note on Gender and Sex TerminologyVerywell Health acknowledges thatsex and genderare related concepts, but they are not the same. To accurately reflect our sources, this article uses terms like “male,” “female,” “men,” and “women” as the sources use them.
A Note on Gender and Sex Terminology
Verywell Health acknowledges thatsex and genderare related concepts, but they are not the same. To accurately reflect our sources, this article uses terms like “male,” “female,” “men,” and “women” as the sources use them.
These include physical actions like:
SUI happens when the muscles at the bladder neck (called theurethral sphincters) and the muscles of thepelvic floorare weak. This allows urine to seep into theurethra(the tube through which urine exits the body), typically in smaller amounts.
The diagnosis of SUI involves a review of your medical history and a physical exam. As part of the evaluation, you may undergo a urinary stress test in which you are asked to cough or “bear down” to see if there is any bladder leakage.
Other specialized tests, likepost-residual urine volume (PRUV), may be ordered, but these are less commonly used for uncomplicated cases.
SUI is usually treated conservatively with pelvic floor exercises, fluid management, weight loss, vaginal pessaries, and other devices. Severe cases may benefit from injectable urethra bulking agents or surgery.These treatments are described in detail later in this article.
Who Can Diagnose Urinary Incontinence?
Urge incontinence, also known as urge urinary incontinence (UUI), is the sudden, uncontrollable urge to pee that causes bladder leakage before you can get to the bathroom. UUI is more common in older females and the most common form of urinary incontinence in males.
Common risk factors for UUI include:
UUI may require extensive testing, including:
In addition to pelvic floor exercises and fluid management, the treatment may involve medications to ease bladder spasms and bladder training to teach you how to “hold it in.” Surgery is a less common option reserved for severe cases.
Mixed incontinence, also known as mixed urinary incontinence (MUI), is when you have both stress incontinence and urge incontinence. MUI affects roughly 30% of females and 50% of males with urinary incontinence.
MUI is harder to diagnose and treat because the underlying cause is multifactorial. It is also more disruptive, with 1 in 3 affected women reporting signs ofchronic depression.
MUI is usually suspected when a person answers “yes” to the following two questions:
A urodynamic study is central to the diagnosis of MUI. This is a battery of tests that includes a urinary stress test, uroflowmetry (which measures how fast you urinate), cytometry (which measures the pressure inside the bladder), and post-void residual volume (which measures how much urine is left in the bladder after peeing).
While useful in differentiating MUI from SUI or UUI, a urodynamic study cannot diagnose MUI on its own. Additional tests and clinical expertise are required to render an accurate diagnosis.
The treatment plan varies based on the severity of symptoms. With that said, the antidepressantCymbalta (duloxetine)has proven effective in people with MUI, easing both the frequency of bladder leakage and the severity of depression symptoms.
Overflow incontinence, also known as overflow urinary incontinence (OUI), is leakage that occurs because the bladder is overfull. People with OUI experience leakage without the urge to urinate and tend to be unable to fully empty their bladder.
Unlike other forms of incontinence, OUI is more common in males than in females.
OUI occurs when the bladder is overfilled due to an obstruction, a weak detrusor muscle, or a neurologic condition that blocks signals to the brain telling it that the bladder is full.
Common causes of OUI include:
The diagnosis of OUI is similar to other types of incontinence. However, a type of X-ray called avoiding cystourethrogram(VCUG)is especially important as it can visualize the bladder as it fills and empties. This can help confirm the diagnosis of OUI.
Functional incontinence is the loss of bladder control arising from the inability to get to the toilet in time due to a physical or cognitive problem. It may be because a person has a physical disability or does not realize that they need to pee.
Functional incontinence is largely associated with older people who may be frail and experiencing cognitive decline, but it can also affect younger people for different reasons.
Causes of functional incontinence include:
Functional incontinence can be diagnosed based on physical or mental impediments that prevent you from getting to the toilet on time.
Even so, additional tests may be ordered to check for other forms of incontinence, such as SUI, UUI, or OUI. This is especially important for people who are bed-bound, are non-communicative, or have dementia or intellectual disability.
Urinary vs. Fecal IncontinenceFunctional incontinence can refer to both urinary incontinence (the loss of bladder control) and fecal incontinence (the loss of bowel control). The same causes can lead to both.
Urinary vs. Fecal Incontinence
Functional incontinence can refer to both urinary incontinence (the loss of bladder control) and fecal incontinence (the loss of bowel control). The same causes can lead to both.
Treatment for Different Types
Lifestyle and Behavioral Therapies
Studies suggest that up to 70% of incontinence cases can be relieved with changes in certain behaviors and lifestyle habits. Even if complete relief is not achieved, these changes can improve your overall response to treatment compared to doing nothing at all.
These include:
A number of products are available over-the-counter (OTC) and through medical retailers to help control bladder leakage. These don’t actively treat incontinence but can help you avoid the embarrassment of an accident while at work, at school, or in social situations.
Where to Find Incontinence AidsThe National Association for Continence offers a toll-free hotline that provides medical referrals to people with incontinence and listings of local and online retailers that carry incontinence aids. Call 1-800-BLADDER or visitwww.nafc.org.
Where to Find Incontinence Aids
The National Association for Continence offers a toll-free hotline that provides medical referrals to people with incontinence and listings of local and online retailers that carry incontinence aids. Call 1-800-BLADDER or visitwww.nafc.org.
Electrical Stimulation
Transcutaneous electrical stimulation (TENS)is a non-surgical treatment commonly used to treat incontinence. It involves placing electrodes on the muscles that control urination. The gentle electrical pulses are thought to strengthen the muscles.
The electrodes can be placed on the vagina, penis, rectum, orsacrum(the triangular bone at the base of the spine). Studies have shown that stimulating thetibial nerveat the outer ankle and foot may also help.
Despite showing promise in studies, TENS’s effectiveness varies significantly, and its benefits remain unclear. Even so, TENS is considered safe and noninvasive and can be self-administered in the comfort of your home.
Medications and Injections
Many differentmedicationscan be used to treat urinary incontinence. These are generally prescribed when bladder leakage cannot be controlled with lifestyle changes or your quality of life and well-being are being compromised.
Currently, no medications are approved for the treatment of SUI in the United States. However, people with MUI or pure UUI often respond well to drugs like:
There is no specific drug treatment for OUI, but people with an enlarged prostate may benefit fromalpha-blockersthat relax the bladder neck and improve urinary flow. These include oral medications likeFlomax (tamsulosin), Uroxatral (alfuzosin), Rapaflo (silodosin), and Cardura (doxazosin).
Another treatment sometimes is a product called a urethral bulking agent. Used mainly for SUI, this involves the injection of a substance around the opening of the urethra to narrow it. The narrowing helps prevent urine from escaping.
Different bulking agents a urologist can use include:
Of the four, polydimethylsiloxane is often preferred because it is permanent, while the others require additional injections after the first year.
Drugs Commonly Used in Urology
Surgery
Surgery is generally the last resort for treating urinary incontinence. There are different types of surgery for different conditions. Some procedures may be combined.
Many procedures can be performedlaparoscopically, using small “keyhole” incisions, narrow surgical tools, and a lighted, fiber-optic scope. Other procedures are transurethral, meaning the surgeon accesses the bladder through the urethra. Others still areopen surgeriesinvolving a large incision.
Surgeries used to treat SUI include:
Surgeries used to treat UUI include:
No specific surgeries are used to treat OUI, but different types can be used to clear blockages or reduce external pressure on the bladder. Examples include:
Summary
The five major types of urinary incontinence are stress incontinence, urge incontinence, mixed incontinence, overflow incontinence, and functional incontinence. Each has different causes, diagnosis methods, and treatments.
While some treatments (like pelvic floor exercises and fluid management) are useful for all types of incontinence, others, like medications and surgery, are specific to each type. It is important to seek a diagnosis from a urologist or urogynecologist. A treatment for one type of incontinence may not work for another.
20 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.John Hopkins Medicine.Urinary incontinence in women.Irwin GM.Urinary incontinence.Prim Care Clin Office Prac.2019;46(2):233-242. doi:10.1016/j.pop.2019.02.004Office of Research on Women’s Health.Urinary incontinence.National Association for Continence.Stress urinary incontinence in women.O’Connor E, Nic an Riogh A, Karvitakis M, Monagas S, Nambiar R.Diagnosis and non-surgical management of urinary incontinence – a literature review with recommendations for practice.Int J Gen Med.2021;14:4555–4565. doi:10.2147/IJGM.S289314McDonald J, Homewood D, West C, Fong E, Elmer S.Managing female stress urinary incontinence in a post mesh era: what to do, when to refer.Aust J Gen Prac.2024;53(5):283-288. doi:10.31128/AJGP-11-23-7019Chung E, Katz DJ, Love C.Adult male stress and urge urinary incontinence - a review of pathophysiology and treatment strategies for voiding dysfunction in men.Aust Fam Physician.2017;46(9):661-666.Sharma N, Chakrabarti S.Clinical evaluation of urinary incontinence.J Midlife Health.2018;9(2):55–64. doi:10.4103/jmh.JMH_122_17Nightingale G.Management of urinary incontinence.Post Reprod Health. 2020;26(2):63-70. doi:10.1177/2053369120927112Chungtai B, Laor L, Dunphy C, et al.Diagnosis, evaluation, and treatment of mixed urinary incontinence in women.Rev Urol. 2015;17(2):78–83. doi:10.3909/riu0653Cheng MC, Liu SP, Chuang YC, Hsu KCP, Chow PM.Prevalence and impacts of male urinary incontinence on quality of life, mental health, work limitation, and health care seeking in China, Taiwan, and South Korea (LUTS Asia): results from a cross-sectional, population-based study.Investig Clin Urol.2022;63(1):71–82. doi:10.4111/icu.20210259MedlinePlus.Urinary incontinence.Badejoko OO, Salako AA, Egharevba P.Overflow urinary incontinence due to bladder stones.Int Urogynecol J.2014;25(3):425-7. doi:10.1007/s00192-013-2153-4Jerez-Roig J, Santos MM, Souza DL, Amaral FL, Lima KC.Prevalence of urinary incontinence and associated factors in nursing home residents.Neurourol Urodyn. 2016;35(1):102-107. doi:10.1002/nau.22675Balk EM, Rofeberg VN, Adam GP, Kimmel HJ, Trikalinos TA, Jeppson PC.Pharmacologic and nonpharmacologic treatments for urinary incontinence in women: a systematic review and network meta-analysis of clinical outcomes.Ann Intern Med.2019;170(7):465-479. doi:10.7326/M18-3227MedlinePlus.Urinary incontinence products.Carneiro Sarmento AL, Silva Sá B, Gomes Vasconcelos A, et al.Perspectives on the therapeutic effects of pelvic floor electrical stimulation: a systematic review.Int J Environ Res Public Health.2022;19(21):14035. doi:10.3390/ijerph192114035Gandi C, Sacco E.Pharmacological management of urinary incontinence: current and emerging treatment.Clin Pharmacol.2021;13:209–223. doi:10.2147/CPAA.S289323Giammo A, Geretto P, Ammirati E, et al.Urethral bulking in the treatment of stress and mixed female urinary incontinence: results from a multicenter cohort and predictors of clinical outcomes.J ClinMed.2022;11(6):1569. doi:10.3390/jcm11061569American College of Obstetricians and Gynecologists.Surgery for stress urinary incontinence.
20 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.John Hopkins Medicine.Urinary incontinence in women.Irwin GM.Urinary incontinence.Prim Care Clin Office Prac.2019;46(2):233-242. doi:10.1016/j.pop.2019.02.004Office of Research on Women’s Health.Urinary incontinence.National Association for Continence.Stress urinary incontinence in women.O’Connor E, Nic an Riogh A, Karvitakis M, Monagas S, Nambiar R.Diagnosis and non-surgical management of urinary incontinence – a literature review with recommendations for practice.Int J Gen Med.2021;14:4555–4565. doi:10.2147/IJGM.S289314McDonald J, Homewood D, West C, Fong E, Elmer S.Managing female stress urinary incontinence in a post mesh era: what to do, when to refer.Aust J Gen Prac.2024;53(5):283-288. doi:10.31128/AJGP-11-23-7019Chung E, Katz DJ, Love C.Adult male stress and urge urinary incontinence - a review of pathophysiology and treatment strategies for voiding dysfunction in men.Aust Fam Physician.2017;46(9):661-666.Sharma N, Chakrabarti S.Clinical evaluation of urinary incontinence.J Midlife Health.2018;9(2):55–64. doi:10.4103/jmh.JMH_122_17Nightingale G.Management of urinary incontinence.Post Reprod Health. 2020;26(2):63-70. doi:10.1177/2053369120927112Chungtai B, Laor L, Dunphy C, et al.Diagnosis, evaluation, and treatment of mixed urinary incontinence in women.Rev Urol. 2015;17(2):78–83. doi:10.3909/riu0653Cheng MC, Liu SP, Chuang YC, Hsu KCP, Chow PM.Prevalence and impacts of male urinary incontinence on quality of life, mental health, work limitation, and health care seeking in China, Taiwan, and South Korea (LUTS Asia): results from a cross-sectional, population-based study.Investig Clin Urol.2022;63(1):71–82. doi:10.4111/icu.20210259MedlinePlus.Urinary incontinence.Badejoko OO, Salako AA, Egharevba P.Overflow urinary incontinence due to bladder stones.Int Urogynecol J.2014;25(3):425-7. doi:10.1007/s00192-013-2153-4Jerez-Roig J, Santos MM, Souza DL, Amaral FL, Lima KC.Prevalence of urinary incontinence and associated factors in nursing home residents.Neurourol Urodyn. 2016;35(1):102-107. doi:10.1002/nau.22675Balk EM, Rofeberg VN, Adam GP, Kimmel HJ, Trikalinos TA, Jeppson PC.Pharmacologic and nonpharmacologic treatments for urinary incontinence in women: a systematic review and network meta-analysis of clinical outcomes.Ann Intern Med.2019;170(7):465-479. doi:10.7326/M18-3227MedlinePlus.Urinary incontinence products.Carneiro Sarmento AL, Silva Sá B, Gomes Vasconcelos A, et al.Perspectives on the therapeutic effects of pelvic floor electrical stimulation: a systematic review.Int J Environ Res Public Health.2022;19(21):14035. doi:10.3390/ijerph192114035Gandi C, Sacco E.Pharmacological management of urinary incontinence: current and emerging treatment.Clin Pharmacol.2021;13:209–223. doi:10.2147/CPAA.S289323Giammo A, Geretto P, Ammirati E, et al.Urethral bulking in the treatment of stress and mixed female urinary incontinence: results from a multicenter cohort and predictors of clinical outcomes.J ClinMed.2022;11(6):1569. doi:10.3390/jcm11061569American College of Obstetricians and Gynecologists.Surgery for stress urinary incontinence.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
John Hopkins Medicine.Urinary incontinence in women.Irwin GM.Urinary incontinence.Prim Care Clin Office Prac.2019;46(2):233-242. doi:10.1016/j.pop.2019.02.004Office of Research on Women’s Health.Urinary incontinence.National Association for Continence.Stress urinary incontinence in women.O’Connor E, Nic an Riogh A, Karvitakis M, Monagas S, Nambiar R.Diagnosis and non-surgical management of urinary incontinence – a literature review with recommendations for practice.Int J Gen Med.2021;14:4555–4565. doi:10.2147/IJGM.S289314McDonald J, Homewood D, West C, Fong E, Elmer S.Managing female stress urinary incontinence in a post mesh era: what to do, when to refer.Aust J Gen Prac.2024;53(5):283-288. doi:10.31128/AJGP-11-23-7019Chung E, Katz DJ, Love C.Adult male stress and urge urinary incontinence - a review of pathophysiology and treatment strategies for voiding dysfunction in men.Aust Fam Physician.2017;46(9):661-666.Sharma N, Chakrabarti S.Clinical evaluation of urinary incontinence.J Midlife Health.2018;9(2):55–64. doi:10.4103/jmh.JMH_122_17Nightingale G.Management of urinary incontinence.Post Reprod Health. 2020;26(2):63-70. doi:10.1177/2053369120927112Chungtai B, Laor L, Dunphy C, et al.Diagnosis, evaluation, and treatment of mixed urinary incontinence in women.Rev Urol. 2015;17(2):78–83. doi:10.3909/riu0653Cheng MC, Liu SP, Chuang YC, Hsu KCP, Chow PM.Prevalence and impacts of male urinary incontinence on quality of life, mental health, work limitation, and health care seeking in China, Taiwan, and South Korea (LUTS Asia): results from a cross-sectional, population-based study.Investig Clin Urol.2022;63(1):71–82. doi:10.4111/icu.20210259MedlinePlus.Urinary incontinence.Badejoko OO, Salako AA, Egharevba P.Overflow urinary incontinence due to bladder stones.Int Urogynecol J.2014;25(3):425-7. doi:10.1007/s00192-013-2153-4Jerez-Roig J, Santos MM, Souza DL, Amaral FL, Lima KC.Prevalence of urinary incontinence and associated factors in nursing home residents.Neurourol Urodyn. 2016;35(1):102-107. doi:10.1002/nau.22675Balk EM, Rofeberg VN, Adam GP, Kimmel HJ, Trikalinos TA, Jeppson PC.Pharmacologic and nonpharmacologic treatments for urinary incontinence in women: a systematic review and network meta-analysis of clinical outcomes.Ann Intern Med.2019;170(7):465-479. doi:10.7326/M18-3227MedlinePlus.Urinary incontinence products.Carneiro Sarmento AL, Silva Sá B, Gomes Vasconcelos A, et al.Perspectives on the therapeutic effects of pelvic floor electrical stimulation: a systematic review.Int J Environ Res Public Health.2022;19(21):14035. doi:10.3390/ijerph192114035Gandi C, Sacco E.Pharmacological management of urinary incontinence: current and emerging treatment.Clin Pharmacol.2021;13:209–223. doi:10.2147/CPAA.S289323Giammo A, Geretto P, Ammirati E, et al.Urethral bulking in the treatment of stress and mixed female urinary incontinence: results from a multicenter cohort and predictors of clinical outcomes.J ClinMed.2022;11(6):1569. doi:10.3390/jcm11061569American College of Obstetricians and Gynecologists.Surgery for stress urinary incontinence.
John Hopkins Medicine.Urinary incontinence in women.
Irwin GM.Urinary incontinence.Prim Care Clin Office Prac.2019;46(2):233-242. doi:10.1016/j.pop.2019.02.004
Office of Research on Women’s Health.Urinary incontinence.
National Association for Continence.Stress urinary incontinence in women.
O’Connor E, Nic an Riogh A, Karvitakis M, Monagas S, Nambiar R.Diagnosis and non-surgical management of urinary incontinence – a literature review with recommendations for practice.Int J Gen Med.2021;14:4555–4565. doi:10.2147/IJGM.S289314
McDonald J, Homewood D, West C, Fong E, Elmer S.Managing female stress urinary incontinence in a post mesh era: what to do, when to refer.Aust J Gen Prac.2024;53(5):283-288. doi:10.31128/AJGP-11-23-7019
Chung E, Katz DJ, Love C.Adult male stress and urge urinary incontinence - a review of pathophysiology and treatment strategies for voiding dysfunction in men.Aust Fam Physician.2017;46(9):661-666.
Sharma N, Chakrabarti S.Clinical evaluation of urinary incontinence.J Midlife Health.2018;9(2):55–64. doi:10.4103/jmh.JMH_122_17
Nightingale G.Management of urinary incontinence.Post Reprod Health. 2020;26(2):63-70. doi:10.1177/2053369120927112
Chungtai B, Laor L, Dunphy C, et al.Diagnosis, evaluation, and treatment of mixed urinary incontinence in women.Rev Urol. 2015;17(2):78–83. doi:10.3909/riu0653
Cheng MC, Liu SP, Chuang YC, Hsu KCP, Chow PM.Prevalence and impacts of male urinary incontinence on quality of life, mental health, work limitation, and health care seeking in China, Taiwan, and South Korea (LUTS Asia): results from a cross-sectional, population-based study.Investig Clin Urol.2022;63(1):71–82. doi:10.4111/icu.20210259
MedlinePlus.Urinary incontinence.
Badejoko OO, Salako AA, Egharevba P.Overflow urinary incontinence due to bladder stones.Int Urogynecol J.2014;25(3):425-7. doi:10.1007/s00192-013-2153-4
Jerez-Roig J, Santos MM, Souza DL, Amaral FL, Lima KC.Prevalence of urinary incontinence and associated factors in nursing home residents.Neurourol Urodyn. 2016;35(1):102-107. doi:10.1002/nau.22675
Balk EM, Rofeberg VN, Adam GP, Kimmel HJ, Trikalinos TA, Jeppson PC.Pharmacologic and nonpharmacologic treatments for urinary incontinence in women: a systematic review and network meta-analysis of clinical outcomes.Ann Intern Med.2019;170(7):465-479. doi:10.7326/M18-3227
MedlinePlus.Urinary incontinence products.
Carneiro Sarmento AL, Silva Sá B, Gomes Vasconcelos A, et al.Perspectives on the therapeutic effects of pelvic floor electrical stimulation: a systematic review.Int J Environ Res Public Health.2022;19(21):14035. doi:10.3390/ijerph192114035
Gandi C, Sacco E.Pharmacological management of urinary incontinence: current and emerging treatment.Clin Pharmacol.2021;13:209–223. doi:10.2147/CPAA.S289323
Giammo A, Geretto P, Ammirati E, et al.Urethral bulking in the treatment of stress and mixed female urinary incontinence: results from a multicenter cohort and predictors of clinical outcomes.J ClinMed.2022;11(6):1569. doi:10.3390/jcm11061569
American College of Obstetricians and Gynecologists.Surgery for stress urinary incontinence.
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