As always in healthcare, we have a name and acronym for everything and we love, love, LOVE to put symptoms into groups. Bladder leakage is no exception. The broad category for bladder leakage is “urinary incontinence” or “UI”. There are four main types of UI and the treatment options will differ depending on which category your symptoms fall into. Because of this, it is important to know which type of UI is your UI. Let’s go over each one below!
Stress Incontinence, or SUI, is UI that happens with any movement or activity that puts pressure on the bladder. Common triggers for SUI include coughing, sneezing, laughing, jumping, lifting, exercise, and sex. Having a full bladder during these times makes it even more likely to have leakage. SUI is the most common type of UI and can range in severity from a small leak here and there with only “worst case scenarios” (think full bladder at a trampoline park!) to full bladder loss with getting up off a couch. SUI is typically caused by the pelvic floor not being able to give a strong enough lift to support the bladder and/or a bladder that has fallen to the wrong spot (see our post about prolapses!).
Quick side note here: while fairly rare, sometimes we have UI with only laughing or only sex. If this is the case, we call these types of UI “giggle incontinence” or “coital incontinence”. Let your provider know if this is the case. How we treat true giggle or coital incontinence will be slightly different from standard SUI.
The next main type of UI is called “Urge Incontinence” or “UUI”. Urge Incontinence occurs when the bladder spasms and pushes urine out. In a healthy bladder, we should get progressively stronger warning signals letting us know about how much time we have before we have to go to the bathroom to pee. These signals will start very gentle and will take a good bit of time before hitting the “GET TO THE BATHROOM NOW” phase. With UUI, those warning signals will often go completely out the window. We’ll be doing perfectly fine and then, out of nowhere, BAM! The bladder presses the panic button and we either barely make it after rushing to the bathroom or we leak.
Often (but not always!), you will end up going to the bathroom to urinate too frequently if you are having UUI. Especially if you haven’t yet had your first visit with a pelvic health provider, keep a journal of when you go to the bathroom, when you leak, what was going on at the time of any leaks (urgency, any specific trigger, etc…), and when/how much fluid you drink. Tracking these things for at least a few days will give your provider insight into what may be going on and help them guide treatment. Trust me when I say I get SUPER excited when a patient brings a bladder journal to their first visit!
Some terminology you will often see associated with Urge Incontinence is “Overactive Bladder” or “OAB” and “Lock & Key” Incontinence. OAB is when the bladder routinely spasms and causes a high frequency of needing to pee. Having OAB makes it much more likely to have UUI (don’t worry, we’ll be doing a whole post on OAB later!). Lock & Key Incontinence is a term we use to describe one of the more common patterns of UUI. Some people find that their UUI is almost exclusively triggered by the same events or situations. For those with Lock & Key UUI, the trigger is often something like opening their front door or pulling up into the driveway of their home. Let your provider know if you see patterns to your own triggers.
Sometimes it seems like our bladder is really determined to give us a hard time and we have both Stress and Urge Incontinence. When this happens we call it “Mixed Incontinence” or MUI. Treatment for MUI will likely take a combination of treatments typically used for both SUI and UUI.
The last main type of incontinence occurs when we simply cannot get to the bathroom in enough time due to mobility issues. We call this “Functional Incontinence” or “FUI”. Sometimes difficulty getting up out of a chair, or navigating to the bathroom, or even simply having the dexterity to get undressed can cause us to not have enough time to make it to the bathroom. Let your pelvic health provider know if you think this may be the case for you. Your healthcare team can help find strategies to make getting to the bathroom safer and easier!
Keeping the admittedly confusing incontinence family tree straight can be confusing, but it is important to know what kind of incontinence your symptoms fall into. Your pelvic health provider will be able to give you the best direction in classifying your UI and deciding what treatment options will be best for your own unique body and situation.
