Aging & Health A to Z

Urinary Incontinence

Causes & Symptoms

Types of Urinary Incontinence and Their Symptoms

There are several types of UI, and each type has different symptoms. 

Urge UI
You may have urge UI if you have sudden and very strong urge to urinate and are sometimes unable to make it to the toilet on time.  This is the most common type of UI in older persons.

Stress UI
You may have stress UI if you leak or dribble urine when the pressure in your abdomen (stomach area) increases.  This may happen when you cough, sneeze, laugh or are physically active.  

Mixed UI
If you leak urine with both sudden and strong urges and with physical activity, you may have mixed UI. 

Overflow UI
If you can’t completely empty your bladder when you use the toilet, this is called overflow UI.  This is the least common form of UI.  You may have dribbling or other urinary tract symptoms.  This is caused by incomplete emptying of the bladder. 

Overactive Bladder
You may have an overactive bladder if you have a very strong urge to urinate, but do not necessarily lose control of your bladder.  You may also have to urinate frequently during the day and night.

Each of these types of UI may be accompanied by additional symptoms, including:

• The need to urinate frequently
• Frequent urination at night
• Slow urination
• Delayed urination (it takes you a while to start urinating)
• A sense that you are unable to completely empty your bladder
• Urination that starts and stops (you begin urinating, are temporarily unable to continue even though you still have urine in your bladder, and then start urinating again). 

Causes of and Risk Factors for UI

Many things can either cause or increase your risk of developing urinary incontinence. These include:

• Increased age.  Between 15 and 30 percent of adults 65 and older have UI.
• Racial and ethnic background.  White women are more likely to develop UI than black, Hispanic or Asian women.  It is not certain how racial and ethnic differences affect men.
• Health problems that affect walking. Conditions more common in older adults, such as arthritis or Parkinson’s disease, may affect your ability to get to or on a toilet in time. 
• Certain medical problems. These include diabetes, sleep apnea, depression, and swelling in the legs (edema).
• Certain medications. This includes non-steroidal anti-inflammatory drugs (NSAIDs), some other pain relievers, certain antidepressants, some diuretics or “water pills,” estrogen, drugs known as “cholinesterase inhibitors” that are prescribed for dementia, certain heart medications, and drugs used to treat serious mental health problems.
• Infections or other problems with your urinary tract.  The urinary tract includes your kidneys; the ureters or “tubes” connecting your kidneys and bladder; your bladder; and your urethra, the tube through which urine passes out of your bladder.
• Lifestyle factors.  For example, drinking a lot of soda and other carbonated drinks, alcohol, and caffeinated beverages, or drinking too little or too much water and other fluids.
• Constipation.
• Overweight or obesity.
• Prostate or gynecological problems.
• Dementia or other cognitive (thinking) difficulties.  However, the most common reason why persons with dementia develop UI is problems walking, and not the thinking difficulty.

Complications

Untreated UI can contribute to or increase your risk of other health problems including:

• Urinary tract infections (more info)
• Lack of sleep (if you often get up at night to use the toilet)
• Social withdrawal (if your fear of leaking urine, or  failing to get to  the toilet on time,  leads you to cut back on the time you spend with other people)
• Depression
• Low self-esteem
• Falls and fractures (if you leak urine on the floor and slip while walking, or rush to get to the bathroom)
• Sexual problems

Updated: March 2012
Posted: March 2012