man and woman having to hold the urge to pee

Continence is defined as the ability to hold in and let out urine under voluntary control. This requires a properly working central nervous system, lower urinary tract, and pelvic floor. To learn more about pelvic floor anatomy, click here. Incontinence is when one or more of these systems are not functioning properly, leading to involuntary leakage of urine or bowels. The 3 most common types of incontinence are stress, mixed, and urge urinary incontinence.

Prevalence of Incontinence

Approximately 3.5 million Canadians have some form of urinary incontinence, with women more affected than men. One in 3 or 4 women versus 1 in 9 men are affected.

The incidence of incontinence increases as you age:

  • Young women = 20-30%
  • Middle aged women = 30-40%
  • Elderly women = 30-50%

Overall, 50% of women will experience urinary incontinence at some point in their life, and 33% will develop regular problems.

Classifications of Incontinence

  • Stress Incontinence: urine leakage as a result of an increase in intra-abdominal pressure (e.g. coughing, sneezing, laughing, lifting, exercise, or transitional movements). This is usually the result of pelvic floor muscles not being strong enough
  • Urge Incontinence: urine loss linked to a strong, uncontrollable urge to void. This is usually the result of overactive (hypertonic) pelvic floor muscles
    • Someone with an overactive bladder gets frequent urges to go to the bathroom, but doesn’t experience urge incontinence
  • Mixed Urinary Incontinence: combination of stress and urge incontinence; urine leakage associated with both increased intra-abdominal pressure (stress) and an uncontrollable urge to void (urge)
  • Functional Incontinence: urine loss as a result of physical (e.g. broken hip) or cognitive (e.g. memory loss) impairment, unwillingness (e.g. dementia) or environmental barriers to getting to the bathroom
  • Overflow Incontinence: bladder doesn’t empty fully and becomes distended, leading to small dribbles of urine loss. Caused by Diabetes, Parkinson’s disease, stroke, radiation, or fistula (small hole)
collage of the three types of urinary incontinence: stress, urge and mixed incontinence

Stress, Mixed, and Urge Urinary Incontinence are the 3 most common types of incontinence. While all of the above can be treated and managed, the approach to treating each type differs. Click here to learn more about why you may need to see a pelvic floor physiotherapist.

Summary

Continence is under voluntary control and requires many different systems to work together. Incontinence is more common in women. The 3 most common types of incontinence are stress, mixed, and urge urinary incontinence. Incontinence (or urinary leakage) is not something you just have to deal with; like a lot of other conditions, it can be well treated and managed. Your pelvic floor physiotherapist is here to help!

References

Interested in learning more?

Read on in our series of articles on Pelvic Health!

About the Author - Sonia Gashgarian

sonia gashgarian physiotherapist

Sonia Gashgarian is a registered physiotherapist who graduated with a Master of Science in Physical Therapy from the University of Toronto. Prior to this she completed her Bachelor of Science in Kinesiology with Honours from the University of Waterloo. Sonia has completed courses in sports taping and basic kinesio-taping, as well as the McKenzie Method of Mechanical Diagnosis and Therapy and Mulligan Concept. She also has her APTEI Acupuncture and Dry Needling Certification.

Sonia uses a variety of treatment techniques to help clients feel better and return to their regular activities as soon as possible. Her individualized treatments may include the following: education, joint mobilizations, exercise prescription, soft tissue release, trigger point release, taping, acupuncture and dry needling, cupping, and Gua Sha.

Too book in please call us at (519) 442-2206 or click here.

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