What is urinary incontinence

Urinary Incontinence: Types & Symptoms

The most common types of urinary incontinence are:

  • Stress incontinence, formerly called stress incontinence.
  • Urge incontinence, also Urgeinontinenz or syndrome of the overactive bladder ("overactive bladder", OAB), irritable bladder.
  • Mixed incontinence from stress and urge incontinence.
  • Overflow incontinence, also: urinary incontinence in chronic urinary retention (urinary flow disorder).

Depending on gender and age, different forms prevail:

  • Men: The most common is urge incontinence.
  • Women: Overall, stress incontinence predominates (approx. 50 percent), followed by mixed incontinence (approx. 30 percent) and urge incontinence (approx. 15 percent). With increasing age, the proportion of urge and mixed incontinence increases.

Stress incontinence

The urethral closure mechanism no longer works properly. If the pressure in the abdomen increases, urine may leak out unintentionally, usually in droplets. Depending on the severity (I-III) of the stress urinary incontinence, this can happen in the following situations:

  • when coughing, sneezing, laughing and carrying, but also when walking, when getting up (I),
  • for sporting activities (II),
  • when lying down or when changing positions in bed, or with less strenuous movements (III).

In women, this form of incontinence may arise as a late consequence of severe or multiple births. It can also show up in the last trimester of pregnancy, but usually disappears again after the birth.

Urge incontinence

The urge to urinate is frequent and sometimes very intense, with unwanted urine leakage. Those affected have to pass small amounts of urine very often (pollakiuria). This can be a major burden, especially at night (nocturia). The urge to urinate can build up so quickly and intensely that a toilet is no longer available in time (imperative to urinate). This can be due to excessive bladder sensitivity and uninhibited contractions of the urinary bladder muscle (detrusors). Possible causes include:

In older and very old people, urge incontinence often leads to falls.

You can find more information under Seniors & Accidents: The dangers lurk at home.

Mixed incontinence

Stress and urge incontinence are present at the same time. This leads to an involuntary loss of urine and usually a strong urge to urinate. The reasons are an overactive urinary bladder and weak urethral occlusion. Older women often develop urge incontinence in addition to existing stress incontinence.

Overflow incontinence

A mostly continuous, dropwise loss of urine is typical, whereby the urinary bladder is never completely emptied. The outflow of urine is obstructed so that the urinary bladder is overfilled and over-stretched in the long term. As a long-term consequence, the kidneys can be damaged by a backlog of urine. Overflow incontinence mainly affects men.

Possible causes of flow obstruction:e.g. enlarged prostate, urinary stones or urethral constriction, tumors, age-related weak bladder muscles.