Urinary incontinence is not one condition — it is an umbrella term for several distinct patterns of involuntary urine loss, each with different underlying mechanisms and different effective treatments. Applying the wrong treatment to the wrong type produces poor results and is one of the primary reasons women experience inadequate management. The starting point for effective treatment is accurate characterization of the incontinence type.
The most common types in women are stress urinary incontinence, urge urinary incontinence, and mixed urinary incontinence. Overflow incontinence and functional incontinence are less common but clinically important in specific patient populations. Each is identified through a combination of symptom history, physical examination, and when needed, urodynamic testing.
The specific circumstances under which leakage occurs are the most diagnostically useful information in distinguishing incontinence types. The following describes the characteristic patterns of each major type.
Stress Urinary Incontinence — Leakage With Physical Effort
Stress urinary incontinence (SUI) produces leakage specifically in response to physical effort that increases intra-abdominal pressure: coughing, sneezing, laughing, lifting, jumping, running, or changing position. The leakage is immediate and proportional to the effort — a severe cough produces more leakage than a light cough. There is no preceding urge — the leakage simply occurs with the physical trigger. SUI is caused by failure of the urethral support mechanism and responds to pelvic floor therapy, continence pessary, and midurethral sling surgery. Learn more about stress incontinence →
Urge Urinary Incontinence — Leakage With Sudden Urgency
Urge urinary incontinence produces leakage associated with a sudden, compelling urge to urinate that cannot be deferred. Women often describe leakage on the way to the bathroom, or when they hear running water, put a key in the door, or arrive home. The urgency itself — not the physical effort — is the trigger. Urge incontinence reflects bladder overactivity and responds to behavioral techniques, pelvic floor training with urge suppression, and pharmacologic management. Learn more about overactive bladder →
Mixed Urinary Incontinence — Both Patterns Present
Mixed incontinence describes the coexistence of stress and urge components — leakage with both physical effort and urgency. This is a common pattern. The clinical task is to characterize which component predominates, because treatment is targeted to the dominant type. Women with significant mixed incontinence often benefit from addressing both components in a structured management plan.
Overflow Incontinence — Leakage From a Full Bladder
Overflow incontinence occurs when the bladder fails to empty completely, accumulates residual urine, and eventually leaks. It may present as continuous dribbling, frequent small-volume voids, or the inability to sense bladder fullness. In women, overflow incontinence may result from bladder prolapse obstructing the urethra, neurologic conditions affecting bladder contractility, or urethral obstruction from prior surgical procedures. A post-void residual measurement is the key diagnostic step.
Most urinary leakage is addressed through scheduled evaluation. Contact our office promptly if leakage is accompanied by:
- Blood in the urine — hematuria in the context of new incontinence always warrants prompt evaluation
- Inability to urinate at all alongside pelvic pressure and a large vaginal bulge
- New onset of urinary incontinence after recent pelvic surgery
Incontinence treatment at Lapeer Women’s Health is led by Dr. Ramona D. Andrei, MD, PhD, FACOG — with treatment matched specifically to the incontinence type identified at evaluation.
For Stress Incontinence
Supervised pelvic floor physical therapy is first-line. A continence pessary provides mechanical urethral support as a non-surgical option. Midurethral sling surgery achieves cure in over 85 percent of candidates with a minimally invasive outpatient procedure. Local vaginal estrogen improves urethral tissue health in postmenopausal women as an adjunct. Learn more →
For Urge Incontinence
Behavioral bladder training and urge suppression techniques are first-line. Pelvic floor physical therapy adds muscular urge suppression capacity. Anticholinergic and beta-3 agonist medications reduce bladder overactivity. Local vaginal estrogen addresses the GSM contribution to urgency in postmenopausal women. Learn more →
For Mixed Incontinence
Both components are addressed in sequence or simultaneously depending on their relative severity. The predominant type is treated first. When the stress component is dominant and surgical correction is planned, the urge component is reassessed postoperatively, as urgency often improves after prolapse repair and continence procedures in women with mixed incontinence.
Many women with urinary incontinence have been wearing pads for years — not because effective treatment is unavailable, but because the evaluation that identifies the specific type and offers specific treatment was never performed. Stress incontinence and urge incontinence have different causes and respond to different treatments, and the success of any management approach depends on correctly identifying which is present.
The evaluation that starts the path to effective management begins at Lapeer Women’s Health — at both our Lapeer and Rochester Hills offices, without a referral required.
Urinary Leakage in Women
Our team at Lapeer Women’s Health identifies the type of incontinence and provides targeted treatment at both our Lapeer and Rochester Hills offices. No referral required.
Schedule a Gynecologic VisitThe information on this page is intended for educational purposes only and does not constitute medical advice. Content reviewed by Dr. Ramona D. Andrei, MD PhD FACOG.
Gynecologic care for women of every age
Lapeer Women’s Health — Rochester Hills
2710 S Rochester Rd, Suite 2
Rochester Hills, MI 48307
Serving patients in Lapeer, Rochester Hills, and surrounding communities throughout Southeast Michigan.