Types of incontinence

There are three main types of incontinence: urge (including overactive bladder), stress and mixed. It should be noted that the word ‘incontinence’ is often associated with stigma for many people, so some patients may respond better to use of phrases such as “urine leakage” or “bladder weakness”.  

Stress urinary incontinence (SUI) is the commonest type (roughly 50 per cent) and is characterised by dribbling or leakage of urine on sneezing, coughing, laughing, exercise, rising from sitting, or lifting. The urethral sphincter muscle and/or pelvic floor muscles are insufficiently strong to contain the flow of urine when intra-abdominal pressure increases. 

SUI is commonly associated with pregnancy and childbirth where damage causes pelvic organ prolapse, which stops the sphincter muscles or pelvic floor working properly. Lack of oestrogen at the menopause can affect the health of vaginal and urethral tissue, and the resulting atrophy can aggravate or cause SUI.

Urge incontinence (around 15 per cent of cases) is defined as urgency and failure to reach a toilet in time. Patients describe feeling a sudden, intense and uncontrollable urge to pass urine and may say that they know if they don’t go to the toilet immediately, they will have urine leakage.