Causes of Incontinence

A deep dive into the common causes of incontinence and the types of leakage that result.

Incontinence = Bladder Leaks

If you're experiencing bladder or bowel leaks, you're not alone. This is called incontinence and it's surprisingly common. In fact, millions of people experience light to heavy leaks every year. Incontinence is not a disease, but it can be a sign or symptom of something else: an underlying condition, a side effect of a medication, or a result of a diet or lifestyle change.

What Causes Bladder Leaks?

Even though it's common, there are still a lot of misconceptions about why incontinence occurs. And there are many types of bladder leaks to understand, all with their own triggers. Take a look at some of the common causes here:

  • Repetitive work-related activities (e.g. heavy lifting)
  • Smoking and lung disease
  • Poor nutrition
  • Certain foods and beverages
  • Constipation
  • Obesity
  • Previous urinary tract or renal problems
  • Loss of pelvic muscle tone
  • Menopause and hormonal changes
  • Pregnancy
  • Pelvic surgery or trauma (e.g. hysterectomy, childbirth)
  • Neuromuscular impairments
  • Neurological disorders and stroke
  • Cognitive impairments (e.g. Alzheimer's)
  • Medication side effects
  • Urinary tract infection
  • Enlarged prostate
  • Tumors
  • Other systemic disorders that restrict mobility and bodily functions

Types of Bladder Leaks

Which of these experiences feels familiar to you? Once you figure that out, you'll be closer to narrowing down the causes of your bladder leaks.

Stress Incontinence: Light Bladder Leakage

Light bladder leakage means you're experiencing just a few droplets or occasional dribbles. This happens when pressure is placed on the bladder through routine actions like sneezing, coughing, laughing, and exercising. It can also be due to more stressful physical activity like childbirth and surgery.

Common Causes:

Strenuous physical activities
Loss of muscle tone
Enlarged prostate
Hormonal changes in women
Pregnancy and childbirth
Pelvic surgery and trauma

Urge Incontinence: Moderate and Frequent Bladder Leakage

Urge incontinence is associated with an Overactive Bladder (OAB). OAB is a common condition that causes spontaneous bladder spasms and contractions, making you feel the frequent, sudden need to urinate. Often, these urges are so strong that you can't get to the bathroom in time.

Common Causes:

Caffeine and carbonated drinks
Bladder stimulants & irritants such as alcohol
Sedatives, cold medicines, and high blood pressure medicines
Hormonal changes in women
Urinary tract infection and cancer
Nerve dysfunction associated with trauma, diabetes, multiple sclerosis, spinal cord injury
Diseases of the nervous system including Alzheimer's and Parkinson's

Mixed Incontinence: Moderate and Frequent Bladder Leakage

If you're experiencing bladder leaks when completing certain routine actions like sneezing or laughing in combination with frequent, strong urges that don't allow you enough time to get to the bathroom, you likely have mixed incontinence. Mixed incontinence occurs when symptoms of both stress and urge incontinence are present.

Reflex Incontinence: Heavy Bladder Leakage

If it's hard to tell when you need to use the bathroom, resulting in a frequent loss of bladder control with little to no warning, you may have reflex incontinence. This is important to recognize as it can be a symptom of other conditions or greater illness.

Common Causes:

Spinal cord injury
Brain tumor

Overflow Incontinence: Heavy Bladder Leakage

Does your bladder always feel full? If you experience a constant dribble and increasingly frequent urges to go to the bathroom, you might have overflow incontinence. This occurs when the urine passageway is blocked or affected by another condition.

Common Causes:

Bladder injury
Benign Prostatic Hypertrophy (BPH)
A narrowing of the urethra
Radical pelvic surgery
Nerve damage from diabetes
Medications with side effects

Functional Incontinence: Heavy Bladder Leakage

Functional Incontinence occurs when your urinary system functions properly, but immobility or cognitive impairment prevents you from getting to the bathroom in time.

Common Causes:

Functional disability and psychological impairment
Environmental barriers like stairs, clothing, or wheelchair accessibility
Physical and mental disabilities, like immobility or cognitive impairments

Bowel Incontinence: Heavy Bowel Leakage

If you're unable to control your bowel movements, you have bowel – or fecal – incontinence. This leakage can be present at any age, though it's more common in the senior population. And no matter how light or heavy it seems to be, bowel incontinence is considered heavy leakage because it involves more than urine. People with bowel incontinence often feel embarrassed and uncomfortable discussing it with their healthcare provider, however this conversation is essential to evaluate possible underlying medical conditions and determine the right treatment options.

Common Causes:

Muscle damage caused by childbirth
Nerve damage from childbirth, bowel movement strain, spinal cord injury or stroke
Chronic constipation
Scarred or stiffened rectum due to surgery, radiation treatment or bowel disease
Rectal prolapse