Stress and urge incontinence are not the same
Stress incontinence
Leakage with coughing, sneezing, laughing, lifting, running or jumping because pressure exceeds the urethral support and closure response.
Urge incontinence
Leakage associated with a sudden compelling need to pass urine that is difficult to defer; frequency and night-time urination may occur.
Mixed incontinence
Both stress and urgency features are present. Treatment usually starts with the symptom that is most troublesome.
Other causes
Infection, retention with overflow, medicines, diabetes, neurological disease, mobility barriers and fistula require different assessment.
A short bladder diary makes the pattern clearer
Record drinks, times of urination, urgency, leakage, pads and triggers for at least three days. A clinician may review duration, childbirth or surgery, bowel symptoms, medicines, diabetes, neurological symptoms and the effect on daily life. Urinalysis and selected examination or testing may be indicated.
Conservative treatment depends on the type
- Stress or mixed incontinence: supervised pelvic-floor muscle training is a first-line treatment, commonly for at least three months.
- Urgency or mixed incontinence: bladder training for at least six weeks is a first-line treatment.
- Lifestyle factors: fluid pattern, caffeine, constipation, body weight and smoking are reviewed where relevant, without unsafe fluid restriction.
- Medicines or procedures: selected after diagnosis, contraindication review and discussion of benefits and side effects.
Containment pads can support dignity and participation, but they should not be the only plan when treatable symptoms are present.
Persistent symptoms still have options
If supervised conservative care is not enough, further assessment may include post-void residual measurement, specialist urology or gynaecology review, medication for overactive bladder, or discussion of procedures. Decisions depend on the incontinence type, health, goals and future pregnancy plans.
Frequently asked questions
What is the difference between stress and urge incontinence?
Stress incontinence occurs with a rise in pressure such as coughing or lifting. Urge incontinence is leakage associated with a sudden difficult-to-defer urge to urinate.
What is overactive bladder?
It describes urinary urgency, usually with frequency and night-time urination, with or without urge incontinence, after other causes are considered.
Can urinary incontinence be treated without surgery?
Often, yes. Supervised pelvic-floor training, bladder training and targeted lifestyle changes are first-line options, depending on the type. Persistent symptoms may need specialist options.
Related guidance
Clinical references
Authoritative sources used for the educational review: