Types of Urinary Incontinence

There are many causes leading to incontinence, and to manage them properly it’s important to determine the type of incontinence experienced.

Main Types of Urinary Incontinence:

  1. Urge Incontinence/OAB:

Also referred to as overactive bladder or OAB, it creates an urgent need to visit the bathroom throughout the day. The urge to pass urine is usually sudden and the patient may at times not make it to the bathroom. It may be accompanied by leakage.  Common causes include:

  • Sudden bladder spasms.
  • Stimulants like coffee and alcoholic drinks.
  • Urinary tract infections.
  • Spinal injuries.

Treatment may involve behavioral therapy, medications, pelvic muscle exercises and surgery.

  1. Stress Incontinence:

A weak bladder neck causes urine leakage when pressure is exerted on the bladder. Any action creating intra-abdominal stimulation such as bending, coughing, sneezing, jogging and even walking can trigger leakages. Common causes include:

  • Natural childbirth (as opposed to C-Section).
  • Excessive weight.
  • Aging.

Treatment include exercises, medications, behavioral therapy and at times surgery.

  1. Mixed type Urinary Incontinence:

The patient displays simultaneous symptoms of overactive bladder and stress incontinence. Both conditions must be treated, but the dominant of the two must be addressed first. Treatment options include medications, behavioral therapy, nerve stimulation, pelvic floor muscle strengthening exercises such as Kegel’s and when absolutely necessary, surgery.

Overflow incontinence:

There is an inability to sense a full bladder and the need to empty. Eventually, the bladder outlet gives way and urine flows spontaneously. Common causes include radical pelvic floor surgeries, spinal injuries, bladder trauma and the use of some medicines. Treatment includes behavioral therapy, neuro-modulation and urethral or suprapubic catheterization.

Anatomical Incontinence:

It is mainly due to a congenital abnormality and normally detected early in life. It can be the result of ectopic ureters, urinary fistulae and urethral diverticulum. Palliative treatment may involve catheterization or condom catheters (for men). Definitive treatment is almost always surgical.

Functional Incontinence:

Could be the consequence of other health conditions. The patient’s mental status and physical health conditions can play a role. A patient may be physically challenged to get to the bathroom fast enough and so the bladder gives way before getting there.  Treatment of this type of incontinence requires managing the underlying health condition. Good nursing care, bedside bathroom aids, and catheterization can help the patient while awaiting definitive treatment.

The first three types of urinary incontinence constitute about 90% of all cases. The last two represent the remaining 10% and although uncommon, it’s good to be aware of them to rule them out if the need arises.

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