Types of urinary incontinence

Stress incontinence

"Stress" here means physical effort, not emotional stress. Urine leaks when pressure in the abdomen suddenly rises: coughing, sneezing, laughing, running, jumping, lifting a child or shopping bags. There's usually no urge beforehand — the leak happens "out of nowhere", in small amounts.

Why it happens. The pelvic floor muscles and ligaments that support the urethra, or the urethral sphincter itself, are weakened. The main causes are pregnancy and childbirth, excess weight, chronic cough, constipation, heavy physical work and lower oestrogen after menopause.

How it's treated. The mainstay is regular pelvic floor muscle training for at least 3 months, weight loss and treating any cough. If that's not enough, surgical options are discussed. In the study of women in Kazakhstan, this was the most common type — more than half of all cases.

Urgency incontinence

You get a sudden, very strong need to pass urine that's hard or impossible to delay. Urine may leak on the way to the toilet, while you open the door or undress. The urges are often set off by "triggers": the sound of running water, cold weather, arriving home.

Urgency incontinence usually comes with frequent urination during the day and night — this is called overactive bladder syndrome. Some women have an overactive bladder without leakage: just frequent, urgent needs to go.

Why it happens. The bladder muscle contracts involuntarily before the bladder is full. The cause is often unknown; symptoms are made worse by caffeine, fizzy drinks, alcohol, constipation, excess weight, infections, menopause and some nervous system conditions.

How it's treated. Bladder training (gradually lengthening the time between toilet visits) for at least 6 weeks, less caffeine and a balanced fluid intake. If that's not enough, a doctor may prescribe medicines, and for difficult cases there are other options. In the study in Kazakhstan, this type had the biggest impact on quality of life.

Mixed incontinence

You have both leakage on effort and episodes after a strong urge. This is very common, especially in older women. Treatment usually starts with the symptoms that bother you most and combines pelvic floor training with bladder training.

Other, less common types

• Overflow incontinence — the bladder doesn't empty properly, becomes over-full and urine dribbles constantly. It can occur with diabetes, neurological conditions, after surgery or with severe prolapse. It always needs assessment.
• Continuous leakage — urine leaks all the time, day and night. It can be a sign of a fistula (an abnormal connection between the urinary tract and the vagina), for example after surgery or a difficult birth. See a specialist.
• Night-time incontinence (enuresis) in adults — leaking during sleep; the cause needs to be found.
• Functional incontinence — the bladder itself is fine, but limited mobility, dementia or difficult access to a toilet mean the person can't get there in time.

How to tell which type you have

Ask yourself a few questions — it will help both you and your doctor:

The ICIQ-SF test (the last question is about when leaks happen) and a bladder diary help pin down the type.

What to note before your appointment

• when symptoms first appeared and how they've changed;
• in which situations you leak and how much;
• how many times you pass urine during the day and night;
• how much and what you drink (especially coffee, tea, fizzy drinks, alcohol);
• pregnancies and births (how many, how they went, babies' weights);
• operations, long-term conditions and all medicines you take;
• what protection you use and how often you change it.

Sources

1. Haylen BT, et al. An IUGA/ICS joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29(1):4–20.
2. NICE guideline NG123. 2019. nice.org.uk
3. AUA/SUFU Guideline on the Diagnosis and Treatment of Idiopathic Overactive Bladder. 2024. auanet.org
4. Ryspayeva Zh, et al. IJERPH. 2026;23(7):893. mdpi.com