Stress vs. Urge Incontinence: How to Tell the Difference
Many people come to see me because they’re experiencing urinary leakage but don’t understand why or how it’s happening. Every day, I provide education to help patients better understand their symptoms—and more importantly, the appropriate treatment options.
Here’s a quick guide to help you identify the difference between stress and urge incontinence so you can take the right steps toward relief.
What Is Stress Incontinence?
Stress incontinence occurs when physical pressure or “stress” on your bladder causes urine to leak. This can be triggered by actions such as:
Coughing
Laughing
Sneezing
Jumping
Lifting something heavy
It’s often related to weakness or poor coordination in the pelvic floor muscles, or an inability to properly manage pressure in the trunk. The pelvic floor plays a key role in supporting the bladder and urethra during movements that increase intra-abdominal pressure. When this system isn’t working effectively, leakage occurs.
Stress incontinence is commonly seen in people who have experienced:
Vaginal childbirth
Pelvic surgery
Menopause (due to hormonal changes)
Chronic coughing or high-impact exercise
What Is Urge Incontinence?
Urge incontinence feels different. It’s typically characterized by a strong, sudden need to urinate—often so intense that you may not make it to the bathroom in time.
Many people describe feeling like they need to know where all the bathrooms are located at all times. You might also find yourself going to the bathroom both when you leave and arrive at places, “just in case.” And when you finally do void, the stream may vary—sometimes it’s strong, other times it feels like barely anything came out.
Common triggers for urge incontinence include:
Hearing running water
Driving into the driveway
Unlocking the front door
Walking past a bathroom
Urge incontinence is associated with overactive bladder (OAB) and is often due to miscommunication between the brain and bladder. The bladder may contract before it’s full or send an urgent signal when there’s no real emergency.
This condition can be influenced by:
Neurological conditions (e.g., MS, Parkinson’s)
Bladder irritation (from infection, diet, or inflammation)
Chronic pelvic tension
Poor bladder habits, such as frequent “just in case” trips
So… Can You Have Both?
Absolutely. This is called mixed incontinence, and it’s more common than many people realize—especially among those who’ve had children or are postmenopausal.
What Are My Options?
The good news? These conditions are very treatable, and often without the need for surgery or medication. Pelvic Floor Physical Therapy can offer effective, conservative treatment for both stress and urge incontinence.
How a Pelvic Floor Physical Therapist Can Help
For Stress Incontinence:
Targeted pelvic floor muscle training (not just Kegels—timing and coordination matter!)
Breathing and pressure management strategies
Body mechanics training for lifting and movement
Techniques to support pelvic organs and soft tissue
For Urge Incontinence:
Bladder retraining strategies to increase time between voids
Urge suppression techniques (including breath work and posture)
Identification of dietary or behavioral bladder triggers
Manual therapy to reduce pelvic floor tension
Final Thoughts
Understanding whether you’re dealing with stress, urge, or mixed incontinence is key to getting the right support. If you’re not sure which type you have, a pelvic floor physical therapist can perform a thorough evaluation and create a personalized treatment plan for you.
Leaking urine may be common—but it’s not normal. And with the right tools and guidance, you can get better.
If you’re looking for help with bladder leaks—or just want to better understand your body—reach out to schedule an assessment. You don’t have to live with this alone.
