Symptoms

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Urinary incontinence is the inability to control the release of urine from your bladder. The problem has varying degrees of severity. Some people experience only occasional, minor leaks — or dribbles — of urine. Others wet their clothes frequently. For a few, incontinence means both urinary and fecal incontinence — the uncontrollable loss of stools.

Types of urinary incontinence include:

Stress incontinence. This is loss of urine when you exert pressure — stress — on your bladder by coughing, sneezing, laughing, exercising or lifting something heavy. It has nothing to do with psychological stress. Stress incontinence occurs when the sphincter muscle at the bladder is weakened. The problem is especially noticeable when you let your bladder get too full. Stress incontinence is one of the most common types of incontinence, often affecting women. Physical changes resulting from pregnancy, childbirth and menopause can cause stress incontinence. In men, removal of the prostate gland can lead to this type of incontinence.

Urge incontinence. This is a sudden, intense urge to urinate, followed by an involuntary loss of urine. Your bladder muscle contracts and may give you a warning of only a few seconds to a minute to reach a toilet. With urge incontinence, you may also need to urinate often. The need to urinate may even wake you up several times a night. Some people with urge incontinence have a strong desire to urinate when they hear water running or after they drink only a small amount of liquid. Simply going from sitting to standing may even cause you to leak urine. Urge incontinence may be caused by a urinary tract infection or by anything that irritates the bladder. It can also be caused by bowel problems or damage to the nervous system associated with multiple sclerosis, Parkinson's disease, Alzheimer's disease, stroke or injury. In urge incontinence, the bladder is said to be "overactive" — it's contracting even when your bladder isn't full. In fact, urge incontinence is often called an overactive bladder.

Overflow incontinence. If you frequently or constantly dribble urine, you may have overflow incontinence. This is an inability to empty your bladder, leading to overflow. With overflow incontinence, sometimes you may feel as if you never completely empty your bladder. When you try to urinate, you may produce only a weak stream of urine. This type of incontinence is common in people with a damaged bladder or blocked urethra and in men with prostate gland problems. Nerve damage from diabetes also can lead to overflow incontinence. Some medications can cause or increase the risk of developing overflow incontinence.

Mixed incontinence. If you experience symptoms of more than one type of urinary incontinence, such as stress incontinence and urge incontinence, you have mixed incontinence. Usually one type is more bothersome than the other is.

Functional incontinence. Many older adults, especially people in nursing homes, experience incontinence simply because a physical or mental impairment keeps them from making it to the toilet in time. For example, a person with severe arthritis may not be able to unbutton his or her pants quickly enough. Someone with Alzheimer's disease may not plan well enough to make a timely trip to the toilet. This type of incontinence is called functional incontinence.

Gross total incontinence. This term is sometimes used to describe continuous leaking of urine, day and night, or periodic large volumes of urine and uncontrollable leaking. The bladder has no storage capacity. Some people have this type of incontinence because they were born with an anatomical defect. It can be caused by a spinal cord injury or by injury to the urinary system from surgery. An abnormal opening (fistula) between the bladder and an adjacent structure, such as the vagina, also may cause this type of high-grade urinary incontinence.