Definition & Facts for Bladder Control Problems (Urinary Incontinence)

In this section:

• What are bladder control problems?
• Do bladder control problems have another name?
• What are the types of bladder control problems?
• How common are bladder control problems?
• Who is more likely to develop bladder control problems?
• What are the complications of bladder control problems?

What are bladder control problems?

Bladder control problems are conditions that affect the way a person holds or releases urine. Accidental loss or leaking of urine, called urinary incontinence (UI), is one of the most common bladder control problems. UI is not a disease but a condition that may be related to another health problem or life event, such as prostate problems or pregnancy.

Talk with a health care professional about how to manage your bladder control problem and lifestyle changes you can make.

Bladder control problems can be a small annoyance or can greatly affect your quality of life. You may be too embarrassed or afraid to participate in activities because of these problems, or you may be unable to complete your normal routine. For example, you may lose urine while running or coughing, or you may leak urine before you can get to a toilet.

Bladder control problems are common. Proper treatment may improve your quality of life. Talk with a health care professional about urine leaks. Health care professionals—especially gynecologists, urologists, and geriatricians—often talk with people about bladder control problems. Health care professionals can help treat the problem or manage the symptoms by suggesting simple lifestyle changes. Caregivers may find help from a health care professional or a support group. The sooner you get help, the sooner UI may improve.

Do bladder control problems have another name?

Bladder control problems that cause urine to leak are also called urinary incontinence (UI), urine leakage, and urine loss.

What are the types of bladder control problems?

Types of bladder control problems are identified by their symptoms. The most common bladder control problems include

• stress incontinence
• urgency incontinence
• reflex incontinence
• overflow incontinence
• functional incontinence
• temporary incontinence
• bedwetting

Stress incontinence

Stress incontinence occurs when movement—coughing, sneezing, laughing, or physical activity—puts pressure on the bladder and causes urine to leak.

Urgency incontinence

Urgency incontinence occurs when you have a strong urge or need to urinate, and urine leaks before you can get to a toilet. Urgency incontinence is often referred to as overactive bladder. This type of incontinence happens when certain nerves and bladder muscles don’t work together to hold urine in the bladder, and the urine is released at the wrong time.

You can have urgency and stress incontinence at the same time, which is called mixed incontinence.

Reflex incontinence

With reflex incontinence, urine leaks without a warning or urge to urinate. This type of incontinence often happens when your bladder nerves are damaged and don’t “talk” to your brain correctly. During reflex incontinence, the bladder contracts, or reflexes, at the wrong time, causing urine to leak. Nerve damage from health conditions, such as
multiple sclerosis, or from trauma, such as a spinal cord injury, are among the causes of reflex incontinence. Reflex incontinence is sometimes called “unaware” or “unconscious” incontinence.

Overflow incontinence

Overflow incontinence occurs when the bladder doesn’t empty all the way, causing too much urine to stay in the bladder. With overflow incontinence, urine leaks because the bladder becomes too full.

Functional incontinence

Functional incontinence occurs when a physical disability or barrier, or a problem speaking or thinking, prevents you from reaching the toilet in time. For example, a person in a wheelchair may not be able to get to a toilet in time, someone with arthritis may have trouble unbuttoning his or her pants, or a person with Alzheimer’s disease may not realize he or she needs time to get to the toilet.

Temporary incontinence

Temporary, or transient, incontinence lasts a short time due to a temporary situation, such as using a certain medicine or having an illness that causes leaking. For example, a urinary tract infection (UTI) or a bad cough may cause temporary incontinence.

Bedwetting

Bedwetting, also called nocturnal enuresis, doesn’t only occur in children. Some adults leak urine while sleeping for a variety of reasons. Certain medicines or drinking caffeine or alcohol at night can make it hard to sleep through the night without leaking urine. In some cases, the bladder can’t hold enough urine overnight. Lifestyle changes often can improve these symptoms.

Some people wet the bed because they don’t produce enough of a certain hormone at night, which could be a sign of diabetes insipidus. Other health problems, such as a UTI, kidney stones, congestive heart failure, chronic kidney disease, prostate enlargement, or obstructive sleep apnea, can cause you to wet the bed or urinate frequently at night.

How common are bladder control problems?

Bladder control problems are common, especially in women. Researchers estimate that approximately half of all women experience UI.1 Women are more likely to develop UI during and after pregnancy, childbirth, and menopause. These events and how the female urinary tract is built make UI more common in women than men. Although UI is common, it is not a routine part of being a woman or getting older.

As many as 1 in 3 men over the age of 65 may lose urine by accident, and approximately half of men who seek treatment for lower urinary tract symptoms experience UI.2,3 A man is more likely to develop UI with age because prostate problems occur more often with age.

Who is more likely to develop bladder control problems?

Factors that make you more likely to develop UI include

• being female
• being older—as you age, your urinary tract muscles weaken, making it harder to hold in urine
• life events, such as pregnancy, childbirth, and menopause in women and prostate problems in men
• health problems, such as diabetes, obesity, Parkinson’s disease, multiple sclerosis, or long-lasting constipation
• smoking
• birth defects that involve a problem with the structure of the urinary tract

Your health care professional can help find the cause of your bladder control problems and talk with you about your options for treatment.

You are more likely to have a particular type of UI if a family member has that same type of UI. For example, bedwetting often runs in families, and children may outgrow the problem at about the same age their parents did.

What are the complications of bladder control problems?

Reduced physical activity

Physical activity is important for overall health and may prevent further bladder control problems. However, some activities such as running, jumping, or brisk walking may cause some people with UI to leak. If you haven’t found a medicine or other treatment that’s right for you, or you want extra peace of mind, new incontinence briefs and pads are discreet and effective at absorbing leaks and controlling odor. New technology and designs can make these products more comfortable to wear and may give you the confidence to get moving again.

Talk with your health care professional if your bladder control problems are making it difficult for you to be active.

Bladder problems don’t have to limit your activities. Getting help from a health care professional may keep you moving.

Emotional distress

Untreated bladder problems can upset your lifestyle. You may avoid activities you once enjoyed. You might stop going to movies, meetings, or events because you don’t want to use the restroom in the middle of an activity or have an accident. These lifestyle changes can lead to depression or social anxiety.

If you often feel depressed or anxious about living with bladder control problems, talk with a health care professional.

Intimacy problems

Some people may avoid intimacy because they worry they may leak urine during sex. Talk with a health care professional if your bladder control problems are getting in the way of your sex life. Gynecologists and urologists regularly talk with people about health problems and can offer solutions.

Related bladder symptoms and problems

If you have UI, you are more likely to have other bladder symptoms or problems, such as

• urinary frequency
• getting up from sleep to urinate, called nocturia
• difficulty urinating
• trouble emptying your bladder fully, called urinary retention
• dribbling urine after you think you’ve finished

When speaking about other symptoms you may have with UI, health care professionals may use the term LUTS, which stands for lower urinary tract symptoms.

Working with a health care professional to prevent and treat these related symptoms and problems is important for the health of your bladder and your overall health.

References

[1] Lee UJ, Feinstein L, Ward JB, et al. Prevalence of urinary incontinence among a nationally representative sample of women, 2005–2016: findings from the Urologic Diseases in America Project. Journal of Urology. 2021;205(6):1718–1724. doi:10.1097/JU.0000000000001634

[2] Clemens JQ. Urinary incontinence in men. UpToDate. Updated December 2, 2019. Accessed May 6, 2021.

www.uptodate.com/contents/urinary-incontinence-in-men

[3] Helfand BT, Smith AR, Lai HH, et al. Prevalence and characteristics of urinary incontinence in a treatment-seeking male prospective cohort—results from the LURN Study. Journal of Urology. 2018;200(2)397–404. doi:10.1016/j.juro.2018.02.075

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