What Are the Most Common Causes of Urinary Incontinence?
Medically reviewed by Jamin Brahmbhatt, MDMedically reviewed by Jamin Brahmbhatt, MDUrinary incontinence occurs when you cannot control your bladder and you leak urine. The main types are stress incontinence, in which you leak when you cough or sneeze, and urge incontinence, in which you suddenly need to pee but can’t hold it. Other types include overflow, total, and functional incontinence.A healthcare provider can help you determine the cause and course of treatment.This article covers the causes of each type of incontinence and available treatment options.
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Causes of Urinary IncontinenceUrinary incontinence can result from daily habits, such as drinking too much caffeine, health conditions, or medication side effects. Some causes, like infections or constipation, can lead to temporary issues, while others, such as diabetes or spinal cord injuries, can cause long-term problems.
Stress IncontinenceStress incontinence occurs when pressure on your bladder causes urine leakage, especially when you cough or sneeze. Weak pelvic floor muscles, which normally keep the bladder and urethra (the tube that carries urine out of your body) closed, are the leading cause. When these muscles are weak, they can't hold back the urine under pressure. Urge IncontinenceUrge incontinence happens when you suddenly need to pee and can't hold it long enough to get to the bathroom. Underlying causes include:Bladder stones DiabetesLow estrogen Nerve damageObesityOveractive bladderUrinary tract infectionWeak pelvic floor musclesOverflow IncontinenceOverflow incontinence is when your bladder doesn’t empty completely and fills until it overflows. Weak bladder muscles, a blockage in the urethra, or nerve problems can cause this issue. Over time, if the bladder stretches, it may not send strong signals to the brain, so you might not feel the urge to pee even though your bladder is full.An enlarged prostate is a common cause of overflow incontinence in males. As the prostate gets bigger, it squeezes the urethra, causing urine to back up, similar to a clogged sink. At first, a little water might linger in the sink, but if you keep the faucet on, the sink will eventually overflow.Total IncontinenceTotal incontinence is when you cannot control your bladder at all. Serious issues like spinal cord injuries, conditions present at birth, or nerve damage can cause permanent incontinence. However, if an infection is the problem, it may be temporary, and treatment will likely improve it.Functional IncontinenceFunctional incontinence occurs when physical or mental issues prevent you from getting to the bathroom in time. Conditions like arthritis or memory problems can make it hard to move quickly or remember to go, leading to accidents even if your bladder is healthy.Medicines That May Cause IncontinenceIncontinence can be a medication side effect. For example, antihistamines like Benadryl (diphenhydramine) can block a chemical that helps the bladder empty completely. Diuretics like Lasix (furosemide), which (help remove excess fluids and salts from the body), increase urine production, which can overwhelm the bladder. Other examples include:Antidepressants AntipsychoticsBlood pressure medicationsHormone replacementMuscle relaxersOpioidsParkinson’s disease medicationsSedativesRisk Factors for IncontinenceThere are many risk factors for incontinence depending on the condition. Examples include:Weakened pelvic floor muscles can cause stress incontinence.An overactive bladder increases the risk of urge incontinence.A large prostate is a concern for overflow incontinence.Spinal cord injuries are a risk for total incontinence.Memory problems are a greater risk for functional incontinence. Risk factors that increase the likelihood of incontinence include:Aging Altered mental stateBladder irritants like caffeine and alcoholConstipationCoughingDiabetesEnlarged prostate Heart diseaseHigh impact sportsHysterectomy (removal of female reproductive organs)Infections (urinary, vaginal, prostate)Limited mobilityMenopause (when the menstrual cycle has stopped for 12 straight months)Neurological disorders, such as Parkinson’s diseaseNot being activeObesityPolyuria (peeing a lot, often due to diuretics or diabetes)Pregnancy and childbirthProstate surgeryProstatitis (irritation and swelling of the prostate)Smoking StressThin, dry vaginal and urethral tissuesUrinary tract infectionsHow Is Urinary Incontinence Treated?When treating urinary incontinence, healthcare providers look for obvious causes, like an infection or constipation, and treat those first. They may also recommend lifestyle changes, such as avoiding alcohol, caffeine, cigarettes, and spicy foods, or losing weight. Treatment can also be specific to each type of incontinence. Stress Incontinence TreatmentStress incontinence treatment options include:Artificial urinary sphincter (AUS) in malesBladder sling surgery (to support the bladder and urethra)Bulking agents (to help the urethra close more tightly)Pelvic floor exercises (including Kegels)Urethral inserts (tampon-like devices)Vaginal estrogen (strengthens urethral tissue)Vaginal pessaries (soft, removable devices inserted in the vagina)Urge Incontinence TreatmentUrge incontinence treatments include:Bladder retraining Botox (onabotulinumtoxinA) injectionsMedications like Ditropan (oxybutynin), Myrbetriq (mirabegron), or Enablex (darifenacin)Neuromodulation (helps nerves control the bladder)Pelvic floor exercisesAdditional Treatment OptionsTreatment for overflow, total, and functional incontinence involves fixing the underlying condition when possible. Overflow incontinence often requires surgery, like a prostate reduction. A urinary catheter or supportive care (absorbent products) may be necessary to treat overflow or total incontinence. In addition, the following may be beneficial for those with functional incontinence:Assistive devices (walker, bedside commode)Cognitive therapy Improved bathroom accessPhysical therapyWhen to Contact a Healthcare ProviderUrinary incontinence can be embarrassing and inconvenient, but there are ways to manage it. Contact a healthcare provider if it interferes with daily life, causes emotional distress, or if you experience the following:A weak urine streamBloody or cloudy urineDifficulty emptying your bladderFrequent urination (eight or more times a day)Incontinence that worsens despite treatmentInfections that recurPain or burning when you peePelvic painTrouble starting or stopping urination Seek emergency care if you experience:High feverLarge amounts of blood in the urineSevere painSudden loss of bladder control with confusion or weaknessThe inability to urinate even though you have a full bladderSummary Urinary incontinence occurs when you lose control over your bladder and this leads to urine leakage. The main types are stress and urge incontinence. However, you can also experience overflow incontinence, total incontinence, and functional incontinence. Underlying causes might involve bladder irritants, weak bladder muscles, medication side effects, diabetes, prostate problems, menopause, or surgery.While some types of incontinence may respond to lifestyle changes, others may require medications, medical devices, surgery, or urinary catheters. If you experience incontinence, contact a healthcare provider to understand your treatment options. Read the original article on Verywell Health.
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