Types of Urinary Incontinence

Are there different types of urinary incontinence? YES

• Urge incontinence — sometimes called "overactive bladder." Leakage usually happens after a strong, sudden urge to urinate. The sudden urge may occur when you don't expect it, such as during sleep, after drinking water, or when you hear running water or touch it.
  
  
• Functional incontinence — leaking because you can't get to a toilet in time. People with this type of incontinence condition may have problems thinking, moving, or speaking that keep them from reaching a toilet. For example, a person with Alzheimer's disease may not plan a trip to the bathroom in time to urinate. A person in a wheelchair is unable to get to a toilet in time.
  
  
• Stress incontinence — leakage happens with coughing, sneezing, exercising, laughing, lifting heavy things, and other movements that put pressure on the bladder. It is the most common type of incontinence. It can be treated and sometimes cured.
  
  
• Mixed incontinence — two or more types of incontinence together, most often stress and urge incontinence.
  
  
• Transient incontinence — leaking urine for a short time due to an illness such as a bladder infection. Leaking stops when the illness is treated.
  
  
• Overflow incontinence — leaking urine because the bladder doesn't empty completely. Overflow incontinence is less common in women.

How do I talk to my doctor about urinary incontinence?

Most people don't want to talk to their doctor about this personal topic. However, keep in mind that urinary incontinence is a common medical problem. Millions of people have the same problem, so your doctor has probably heard many stories like yours.

Some doctors don't treat bladder control problems, so ask for a referral of a doctor who does.

Here are some questions to ask your doctor:

• Could what I eat or drink cause bladder problems?
• Could my medicines (prescription or over-the-counter) cause bladder problems?
• Could other medical conditions cause loss of bladder control?
• What are the treatments to regain bladder control? Which one is best for me?
• What can I do about the odor and rash caused by urine?

It may help to write down when you leak urine. Be sure to note what you were doing at the time, for example, sneezing, coughing, laughing, or sleeping. Take this log with you when you visit your doctor.

How do I find out if I have urinary incontinence?

The first step is to see your doctor. If your doctor doesn't treat bladder problems, ask for help finding someone who does.

Your doctor will ask you about your symptoms and take a medical history. Your doctor may ask:

• how often you empty your bladder
• how and when you leak urine
• how much urine you leak

Your doctor will do a physical exam to look for signs of health problems that can cause incontinence. Your doctor also will do a test to figure out how well your bladder works and how much it can hold. For this test, you will drink water and urinate into a measuring pan, after which your doctor will measure any urine still in the bladder. Your doctor also may order one or more of the following other tests:

• Stress test — while you cough or bear down, the doctor watches for loss of urine.
  
  
• Urinalysis — you give a urine sample, which is tested for signs of infection and other causes of incontinence.
  
  
• Blood test — you give a blood sample, which is sent to a lab where it is tested for signs of other causes of incontinence.
  
  
• Ultrasound — sound waves are used to take a picture of the kidneys, bladder, and urethra. Your doctor will look to see if there are any problems in these areas that could cause incontinence.
  
  
• Cystoscopy — a thin tube with a tiny camera is placed in the urethra to view the inside of the urethra and bladder.
  
  
• Urodynamics — a thin tube is placed into your bladder and your bladder is filled with water. Your doctor measures the pressure in the bladder.

Your doctor may ask you to write down when you empty your bladder and how much urine you produce for a day or a week.