Overview of Stress Incontinence

People with stress incontinence lose urine involuntarily during physical activities that put pressure on the abdomen. This type of incontinence is often seen in women after they reach middle age. A weak pelvic floor and a poorly supported uretheral sphincter cause stress incontinence.

Activities commonly associated with stress incontinence include the following:

  • Coughing
  • Exercising
  • Laughing
  • Lifting
  • Rising from a chair or bed
  • Sneezing

Types of Stress Incontinence

Stress incontinence occurs when the bladder neck and urethra do not close properly. When these structures move down and bulge (herniate) through weakened pelvic floor muscles, they are said to be hypermobile. Herniation, or cystocele, changes the angle of the urethra, which causes it to remain open and allow urine to leak out. There are three classifications of stress incontinence.

Type I – The bladder neck and urethra are open and slightly hypermobile, and the urethra moves down less than 2 cm when stressed. Type I patients have little or no sign of cystocele.

Type II – The bladder neck and urethra are closed and hypermobile, and the urethra moves down more than 2 cm when stressed. Patients who have cystocele inside the vagina have Type IIA stress incontinence. When cystocele is outside the vagina, it is classified as Type IIB.

Type III (severe) – The urethral sphincter is very weak (called intrinsic sphincter deficiency).

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 09 Jun 1998

Last Modified: 06 Oct 2015