Health A-Z

Medical Content Created by the Faculty of the
Harvard Medical School

Urinary Incontinence

What Is It?

Urinary incontinence is a loss of control over urination so that urine leaks before you are able to get to a toilet. There are various types of urinary incontinence.

One type of urinary incontinence is stress incontinence. Stress incontinence happens when your pelvic muscles beneath the bladder aren't strong enough to withstand a "stress" or pressure pushing on the bladder from above. Whenever your pelvic muscles give way, they release their squeeze around the bottom of your bladder, so urine can drain out. Stress incontinence is common during pregnancy; during coughing, sneezing, lifting or laughing; or during awkward body movements that stress the body's bladder control.

Another common type of urinary incontinence is urge incontinence, also called overactive bladder. With urge incontinence, the bladder is overly sensitive to stretching and to nerve signals, so you may feel the urge to urinate when your bladder is only partly filled. Also with urge incontinence, your bladder can squeeze after such a minimal trigger that even the thought of urinating can trigger you to leak urine. In this case, you may wet yourself when you hear running water or turn on running water to wash dishes or to wash your hands. You may also wet yourself just at the time you arrive at a bathroom or just as you arrive home and place your key in your door if you are planning to go straight to the bathroom.

It is common for women to have urinary incontinence following childbirth. Pregnancy and childbirth can affect the conditioning of the pelvic muscles, but it can also cause stretching and injury of nerves in the pelvis. Nerve injury can cause urge incontinence. Incontinence may last for a surprisingly long time after childbirth, particularly when nerve healing must occur. One survey found that three months after giving birth, 15% of women still had urinary leakage.

Temporary urinary incontinence is frequently caused by a urinary tract infection. Urinary incontinence can also result from sagging of the uterus (uterine prolapse) or irritation of the vagina (vaginitis). Neurologic problems such as multiple sclerosis or a spinal cord injury can cause the bladder to overfill and overflow or to empty unpredictably. Incontinence can be a complication of radiation treatment or prostate surgery.

Some people have normal bladder function and control, but they are not able to move easily to get to the bathroom. Problems such as severe arthritis can lead to urinary incontinence because the person moves too slowly to get to the bathroom in time.

Urinary incontinence affects approximately 13 million people in the United States and is more common in women than in men. It occurs in 10% to 25% of women younger than age 65 and in 15% to 30% of women older than age 60 who do not live in nursing homes. Among nursing home residents, incontinence is even more common, affecting more than 50% of female patients.