Urinary incontinence is a major symptom of overactive bladder (OAB), a clinical syndrome characterized by urinary urgency (and sometimes frequent urination and nocturia.) According to the American Urological Association, up to 5% of men and 30% of women experience urinary incontinence in the U.S.
However, loss of bladder control can be caused by other medical conditions or life changes, and there are several different types of urinary incontinence. Keep reading to learn more about the different types of urinary incontinence and for guidance on getting an accurate diagnosis and the right treatment.
What is urinary incontinence?
Urinary incontinence is a clinical term for the loss of bladder control. Other terms sometimes used to describe urinary incontinence are bladder leakage and OAB, which, as described above, is actually a syndrome of which urinary incontinence can present as one symptom.
Urinary incontinence can occur in men and women, though it is estimated to occur in twice as many women as men. This is thought to be linked to unique health events associated with women, such as pregnancy, childbirth, and menopause, though certain men’s health conditions – such as enlarged prostate – are also linked to incontinence. Like urinary incontinence specifically, OAB can occur in both men and women.
Some people assume that incontinence is a natural part of aging, especially since aging does have an effect on the muscles around the bladder and urethra that help control the release and retention of urine. However, chronic urinary incontinence can actually indicate underlying health conditions such as OAB, or other serious medical conditions such as infections, neurological diseases, and growths.
One factor in finding the underlying cause of one’s urinary incontinence is understanding the different types of urinary incontinence, the symptoms of each, and the most common causes. Keep reading to learn more.
Types Of URINARY INCONTINENCE
Urge incontinence
Urge incontinence presents as sudden, intense urges to urinate, followed by the involuntary loss or leakage of urine. Urge incontinence is one of several potential symptoms of OAB, and the terms are sometimes used interchangeably. Other OAB symptoms include frequent urination (urinating more than 8 times in a period of 24 hours) and nocturia (excessive nighttime urination).
Urge incontinence, especially if accompanied by frequent urination and/or nocturia, may be a sign of OAB; anyone experiencing these symptoms should discuss them carefully with a doctor.
Stress incontinence
Stress incontinence is a type of urinary incontinence in which bladder leaks are caused by pressure on the bladder. Stress incontinence can be triggered by basic tasks that push on the bladder, such as coughing, laughing, sneezing, exercising, or standing up.
Stress incontinence is the most common type of urinary incontinence in women because of their unique health issues, namely pregnancy (e.g., increased fetal weight) and childbirth.
For men, stress incontinence is often linked to procedures such as prostate removal, which can damage the nerves around the sphincter and weaken the muscles that keep urine in the bladder. Growths or tumors can also put pressure on the bladder in both men and women.
Mixed incontinence
Mixed incontinence is defined as the presence of both urge incontinence and stress incontinence. Mixed incontinence is a very common presentation of OAB. Still, like other types of urinary incontinence, it can indicate other underlying conditions such as infections (e.g., urinary tract infections), diabetes, or neurological diseases such as Parkinson’s or Multiple Sclerosis.
Overflow Incontinence
Overflow incontinence occurs when the bladder doesn’t completely empty. People with overflow incontinence feel the urge to urinate but can only release a small amount, leading to “overflows” (leakage) at a later time. Men who have an enlarged prostate, narrow urethra, or weakened pelvic muscles are at higher risk of experiencing overflow incontinence.
Functional Incontinence
Functional incontinence is a type of urinary incontinence caused by the inability to reach the restroom or toilet in time. This can be due to physical impairment, such as a disability or age-related issue that impedes a person’s ability to physically reach a toilet or even remove their clothes in time to urinate. It can also be linked to mental factors that impede a person’s ability to locate a toilet or to recognize that they have to urinate. For these reasons, functional incontinence is sometimes referred to as disability-associated urinary incontinence.
Your doctor can evaluate which particular category you may fall into, as different types of leakage may require different treatments.
Risk factors for urinary incontinence
Regardless of the specific type of incontinence you may be suffering from, there are some established risk factors that contribute to urinary incontinence. Some of the most common risk factors include:
- Gender – Incontinence affects twice as many women as men, and stress incontinence is the most common type of urinary incontinence in women.
- Age – The risk of urinary incontinence increases as you age. Hormonal changes linked to menopause as well as the weakening of the muscles around the bladder and urethra over time can all affect bladder functioning in older adults.
- Family history – People with a family history of urinary incontinence are at higher risk of developing symptoms.
- Weight – There may be a link between excess body weight and urinary incontinence, particularly stress incontinence.
- Smoking – Smoking can both exacerbate OAB symptoms and lead to chronic coughing, which can in turn cause increased stress leaks.
- Medical conditions – Growths in the pelvic area, diabetes, and neurological diseases like Parkinson’s have all been linked to various types of urinary incontinence.
Diagnosis and treatment
All types of urinary incontinence can significantly damage patients’ quality of life, restricting certain exercises, recreational activities, ability to travel, and more. Luckily, urinary incontinence is usually treatable.
The first step to treatment is receiving an accurate diagnosis. Beyond clinical tests such as urinalysis, keeping a bladder diary tracking your incontinence symptoms can help your doctor get a fuller picture of your condition to determine the underlying cause.
If your urinary incontinence is caused by OAB, your doctor will likely approach treatment behaviorally first, before considering medication, then advanced therapies. Learn more about each treatment path below.
Behavioral methods for treating urinary incontinence
Behavioral methods are the least invasive treatment method for OAB-related incontinence, which is why they are the first-line option. Your doctor may recommend dietary changes, fluid control, bladder training, pelvic floor exercises, or Kegel exercises to manage and reduce your symptoms behaviorally.
Medication
If behavioral methods do not resolve your OAB-related incontinence symptoms, your doctor may recommend medication.
There is a wide range of pharmaceutical options with different mechanisms depending on the type of urinary incontinence in question. Anticholinergics work by blocking signals from the brain that trigger abnormal bladder contractions. Other medications are designed to relax the bladder muscles and increase bladder capacity (the amount of urine the bladder can hold). Some incontinence can be treated with estrogen, chemodenervation, and even certain antidepressants.
Medications come with side effects, and it may take some trial and error to find the right medication for your symptoms and body chemistry.
Advanced therapies
When urinary incontinence is not resolved with behavioral methods or medication, advanced therapies such as electrical stimulation or surgery may be recommended, depending on the underlying cause.
When urinary incontinence is not resolved with behavioral methods or medication, advanced therapies such as electrical stimulation or surgery may be recommended, depending on the underlying cause.
The AxonicsTM Sacral Neuromodulation system provides gentle stimulation to the nerves that communicate between the brain and bladder. This advanced therapy may restore normal communication which can result in symptom improvement. To learn more about this treatment option, read about Axonics Therapy today.
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Results and experiences may vary and are unique to each individual.
IMPORTANT SAFETY INFORMATION:
Indications: Axonics SNM Therapy for urinary control is indicated for the treatment of urinary retention and the symptoms of overactive bladder, including urinary urge incontinence and significant symptoms of urgency-frequency alone or in combination, in patients who have failed or could not tolerate more conservative treatments. Axonics SNM Therapy for bowel control is indicated for the treatment of chronic fecal incontinence in patients who have failed or are not candidates for more conservative treatments.
Contraindications: Axonics SNM Therapy is contraindicated for patients who have not demonstrated an appropriate response to test stimulation or patients who are unable to operate the Axonics SNM Systems.
Warnings: Implantation and use of the Axonics Systems incur risks beyond those normally associated with surgery, some of which may necessitate surgical intervention. These risks include, but are not limited to adverse change in voiding function (bowel and/or bladder), infection, pain or irritation at the implant site, lead or device migration, electrical shock, change in sensation or magnitude of stimulation which has been described as uncomfortable (jolting or shocking) by some patients, and heating or burns at the device site.
Results and experiences may vary and are unique to each patient. No promise or guarantee is made about specific results or experiences. Talk to your doctor to see if Axonics Therapy is right for you and to discuss the potential risks and benefits.
For a complete listing of indications, contraindications, warnings and precautions, go to www.axonics.com/isi.
Precautions: The safety and effectiveness of Axonics Therapy has not been established for use in women who are pregnant or in delivery; for pediatric patients (under the age of 18 years for fecal incontinence and under the age of 16 years for overactive bladder and urinary retention); for patients with neurological diseases, such as multiple sclerosis or diabetes, or for bilateral stimulation.
Caution: U.S. federal law restricts this device to sale and use by, or on the order of, a physician.
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