Urinary incontinence risk factors: who is more likely to leak urine

What urinary incontinence is

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 (NIDDK). It can range from a minor problem to something that greatly affects your daily life, and in any case it can get better with proper treatment (MedlinePlus).

Researchers estimate that approximately half of all women experience UI. As many as 1 in 3 men over the age of 65 may lose urine by accident (NIDDK). Although UI is common, it is not a routine part of being a woman or getting older (NIDDK).

Who is more likely to develop urinary incontinence

The NIDDK and MedlinePlus list these factors (NIDDK) (MedlinePlus):

• Being female, especially after pregnancy, childbirth, and menopause. These events and how the female urinary tract is built make UI more common in women than men (NIDDK).
• Being older: as you age, your urinary tract muscles weaken, making it harder to hold in urine (NIDDK).
• Prostate problems in men: a man is more likely to develop UI with age because prostate problems occur more often with age (NIDDK).
• Health problems, such as diabetes, obesity, Parkinson's disease, multiple sclerosis, or long-lasting constipation (NIDDK).
• Smoking (NIDDK).
• Birth defects that involve a problem with the structure of the urinary tract (NIDDK).

You are more likely to have a particular type of UI if a family member has that same type. For example, bedwetting often runs in families (NIDDK). In children, bedwetting is more common in younger children, boys, and those whose parents wet the bed when they were children (MedlinePlus).

Types of urinary incontinence

• Stress incontinence: movement such as coughing, sneezing, laughing, or physical activity puts pressure on the bladder and causes urine to leak (NIDDK). Causes include weak pelvic floor muscles and the bladder being out of its normal position (MedlinePlus).
• Urge (urgency) incontinence: a strong urge to urinate, and urine leaks before you can get to a toilet. It is often referred to as overactive bladder (NIDDK). It is most common in older people, can sometimes be a sign of a urinary tract infection (UTI), and can happen in some neurological conditions, such as multiple sclerosis and spinal cord injuries (MedlinePlus).
• Mixed incontinence: urgency and stress incontinence at the same time (NIDDK).
• Overflow incontinence: the bladder doesn't empty all the way, becomes too full, and leaks (NIDDK). This form is most common in men, and some of the causes include tumors, kidney stones, diabetes, and certain medicines (MedlinePlus).
• Reflex incontinence: urine leaks without a warning or urge, often because bladder nerves are damaged, for example by multiple sclerosis or a spinal cord injury (NIDDK).
• Functional incontinence: a physical disability or barrier, or a problem speaking or thinking, prevents you from reaching the toilet in time (NIDDK).
• Temporary incontinence: lasts a short time due to a temporary situation, such as using a certain medicine or having an illness. A UTI or a bad cough may cause it (NIDDK).
• Bedwetting: not only in children. In adults, causes include some medicines, caffeine, and alcohol, and health problems such as diabetes insipidus, a UTI, kidney stones, enlarged prostate (BPH), and sleep apnea (MedlinePlus).

What causes urinary incontinence

Health changes and problems, including those with your nervous system, and lifestyle factors can cause or contribute to UI in women and men (NIDDK).

• Health changes and problems: aging, bladder infection, constipation, birth defects, a blocked urinary tract from a tumor or kidney stone, a chronic cough, diabetes, overweight or obesity, and genitourinary fistulas (NIDDK).
• Nerve damage: bladder nerves and muscles can be damaged or affected by diabetes, vaginal childbirth, surgery for prostate cancer, stroke, Parkinson's disease, multiple sclerosis, Alzheimer's disease, brain or spinal cord injury, anxiety, and heavy metal poisoning (NIDDK).
• Lifestyle factors: eating foods that cause constipation; drinking alcohol or caffeinated or carbonated beverages; certain medicines; physical inactivity; and smoking (NIDDK).

In women, pregnancy and childbirth, trauma or injury such as sexual assault, pelvic organ prolapse such as a cystocele, and menopause can lead to stress incontinence by weakening the pelvic floor muscles (NIDDK).

In men, UI sometimes develops along with prostate problems. Treatment for enlarged prostate (BPH) can lead to stress incontinence, but it is usually temporary. Men who have a history of radiation or surgery for prostate cancer may have short-term or long-term UI, and bladder control problems after prostate cancer treatment can get better over time (NIDDK).

Symptoms and when to see a health care professional

Signs and symptoms of UI can include leaking urine during everyday activities such as lifting, bending, coughing, or exercising; being unable to hold in urine after a sudden, strong urge; leaking without any warning or urge; being unable to reach a toilet in time; wetting the bed during sleep; and leaking during sexual activity (NIDDK).

See a health care professional if you have symptoms of a bladder problem, such as trouble urinating, a loss of bladder control, waking to use the bathroom, pelvic pain, or leaking urine (NIDDK). The sooner you get help, the sooner UI may improve (NIDDK).

Lowering your risk of leaks

MedlinePlus lists lifestyle changes a provider may first suggest to reduce leaks: drinking the right amount of liquid at the right time, being physically active, staying at a healthy weight, avoiding constipation, and not smoking. Bladder training and exercises to strengthen the pelvic floor muscles, called Kegel exercises, can also help (MedlinePlus).

Common questions

Is urinary incontinence a normal part of aging?

No. Although UI is common, it is not a routine part of being a woman or getting older (NIDDK). Urinary tract muscles do weaken with age, which is why being older raises the chance (NIDDK).

What are the risk factors for stress incontinence?

In women, pregnancy and childbirth, trauma or injury, pelvic organ prolapse, and menopause can weaken the pelvic floor muscles and lead to stress incontinence (NIDDK). In men, treatment for BPH can lead to stress incontinence, usually temporary, and prostate cancer treatments can too (NIDDK).

What are the risk factors for urge incontinence?

Urge incontinence is most common in older people, can sometimes be a sign of a UTI, and can happen in some neurological conditions, such as multiple sclerosis and spinal cord injuries (MedlinePlus).

Does obesity cause urinary incontinence?

Obesity is one of the health problems that make you more likely to develop UI, and the NIDDK lists overweight or obesity among the health problems that can lead to it (NIDDK) (NIDDK).