Incontinence is the inability to control the passage of urine (urinary incontinence) or feces (fecal incontinence). Both are symptoms of an underlying medical condition, not a disease in themselves. The term “incontinence” alone is most commonly used in reference to urinary incontinence.

Urinary incontinence affects many Americans. More than 20 million women and 6 million men have or have had episodes of incontinence according to the National Institutes of Health. Although it is more common in older adults, incontinence is not considered a normal part of the aging process. It occurs during a malfunction of the urinary system, which is composed of two kidneys, two ureters, a bladder and a urethra. The kidneys are two bean-shaped organs that produce urine, which is moved to the bladder by the tube-like ureters. Urine is stored in the bladder until it is passed from the body through the urethra.

There are several types of urinary incontinence that are classified according to the symptoms and circumstances of urine leakage. For instance, stress incontinence occurs when an increase in pressure in the abdomen forces the urinary sphincter (ring of muscles that surrounds the urethra) to open inappropriately causing urine to leak. Stress incontinence may occur from activities such as coughing or exercising.

Urge incontinence is another type of urinary incontinence. This form occurs when the bladder unnecessarily contracts and can cause an abrupt, overwhelming urge to urinate followed by urine leakage. Urge incontinence is often associated with a condition called overactive bladder (OAB).

A third type of urinary incontinence, known as mixed incontinence, occurs when the patient has more than one type of incontinence, usually stress and urge incontinence

There are many possible causes for urinary incontinence. Some are temporary and easily addressed, such as drinking too much alcohol or caffeine, taking certain types of medications or having a urinary tract infection. More often, however, incontinence is a persistent condition caused by a physical problem. Among conditions that can lead to chronic incontinence are pregnancy and childbirth, hormonal changes following menopause, changes in a man's prostate gland and neurological disorders.

In addition to a physical examination, several medical tests may be performed to diagnose the cause of urinary incontinence. Examples include a post-void residual measurement (determines whether urine remains after a patient has attempted to empty the bladder) and a urinalysis (detects abnormalities in the urine).

The treatment of incontinence depends on the severity of the problem and its underlying cause. Treatment can be divided into four categories – behavioral techniques, medications, medical devices and surgery.

In some individuals, incontinence cannot be prevented because its cause is out of the patient’s control. However, other cases can be prevented with lifestyle changes including losing weight and avoiding beverages that increase the rate of urine production (e.g., caffeine, alcohol). Pelvic muscle exercises and bladder training programs also may help reduce or prevent urinary incontinence.