Urinary Incontinence For Health Professionals: Differential Diagnosis

Text Size: Normal / Medium / Large
Printer-friendly versionPrinter-friendly version

Differential Diagnosis

Establish the type of urinary incontinence, after having eliminated reversible causes.

Stress incontinence

Definition: involuntary loss of urine that occurs during physical activity, coughing, sneezing, rising from a sitting position

  • without pelvic floor muscle weakness
    • attributable to a deficiency of the internal sphincter or to an anatomic deviation of the bladder neck
      • particularly in women who have had a difficult childbirth or who suffer from hereditary collagen problems
    • attributable to urethral instability
  • with pelvic floor muscle weakness (deficiency of the external sphincter)
    • attributable to sarcopenia, obesity, or recurrent straining

Urgency incontinence

Definition: a strong, sudden need to urinate accompanied by involuntary urine loss

  • attributable to factors such as age or idiopathic
  • attributable to damage to central inhibition pathways:
    • frontal stroke, Parkinson's disease, tumour, normal pressure hydrocephalus
  • attributable to localized bladder irritation:
    • stones, polyps, cancer, cystitis
  • attributable to pelvic floor muscle weakness associated with excess consumption of caffeinated drinks (often along with difficulty walking)

Overflow incontinence due to chronic urniary retention

Definition: involuntary loss of urine associated with bladder retention in the absence of detrusor contraction.

  • Bladder obstruction:
    • in women: large cystocele or prolapse, stenosis following surgery or radiotherapy.
  • Detrusor dysfunction:
    • injury to the spinal cord, metastasis of the spinal cord, spinal stenosis
    • anticholinergic or narcotic medication

Mixed incontinence

Definition: usually a combination of both stress and urgency urinary incontinence 

Next: Treatment Options


We are pleased to house this series of FAQs for health professionals, supervised by Cara Tannenbaum, from the Centre de recherche de l’Institut universitaire de gériatrie de Montréal.

Browse Content of Urinary Incontinence for Health Professionals:

Not a health professional? Click here for more information on urinary incontinence