Differentiate stress urinary incontinence from urge incontinence.

• A. Urge incontinence is leakage triggered by overactive bladder and sudden urge. Stress incontinence results from pelvic floor weakness causing leakage with exertion.
• B. Stress incontinence occurs from overactive bladder. Urge incontinence is leakage with exertion.
• C. Both types have identical mechanisms.
• D. Stress incontinence occurs only in men.

Answer: (D)

The difference rests on what triggers the leakage and what is happening in the bladder and pelvic floor. Stress incontinence occurs when leakage happens with activities that raise intra-abdominal pressure, such as coughing, sneezing, lifting, or exercising, due to weakness or poor support of the pelvic floor and urethral sphincter. Urge incontinence, on the other hand, is leakage that accompanies a sudden, strong urge to void and is typically related to detrusor overactivity, meaning the bladder muscle contracts involuntarily and you can’t delay urination.

Understanding these mechanisms helps explain typical patient patterns: with stress incontinence, the leakage is tied to physical effort rather than the urge to urinate, and with urge incontinence, leakage comes with a compelling urge even if the bladder isn’t full by usual measures. It’s also important to note that stress incontinence is more common in women due to pelvic floor changes from childbirth and menopause, though men can experience it after prostate surgery; urge incontinence can affect both sexes.