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Incontinence vs OAB: Understanding the Difference


Overactive Bladder (OAB) and Incontinence often get confused for the same condition. Both involve a malfunction in the bladder and can result in constant trips to the restroom or embarrassing leakage. However, OAB and incontinence are two different conditions that require different treatments. The first step toward treatment for either problem is recognizing which condition it is, what might have caused it, and what to do next. 

What is OAB?  

Overactive bladder syndrome is classified as a condition of the urinary system that may cause sudden and uncontrollable urges to urinate. These urges can come during the day or night. People who suffer from OAB may often feel that they are having to put their lives on hold due to the constant interruption of bathroom visits. These urges usually start without any warning or other signs, and often come when the bladder is completely empty. However, if the bladder is full, it can lead to light leakage, or incontinence. Urinary incontinence is a common and embarrassing symptom of OAB, and 40-70 percent of urinary incontinence cases are linked to overactive bladder.

Common Symptoms and Causes of OAB

With an overactive bladder, you may experience some or all of the following symptoms:

  • The sudden and uncontrollable urge to urinate
  • Urge incontinence: The involuntary loss of urine immediately after the urge to urinate
  • Frequent urination: Urinating more than eight times in a 24 hour period
  • Nocturia: Waking up more than once a night because of the urge to urinate

OAB is often the result of spasms in the detrusor muscle, which is the main muscle of the urinary bladder wall. Broadly, an overactive bladder can be caused by any of the following conditions or factors:

  • Diabetes
  • Bladder abnormalities including bladder stones or tumors
  • Neurological disorders
  • Bladder obstruction
  • Excessive intake of alcohol and/or caffeine
  • Aging
  • A serious UTI

What is Incontinence?

Incontinence is any involuntary loss of urine or fecal matter. Incontinence can happen at any stage of life and is a treatable and often curable condition.

Unlike OAB, incontinence may not come with any urge to urinate. People with OAB may only experience occasional leakage due to a sudden urge, however, people with incontinence experience involuntary urination or defecation with little to no warning.  

Types of Incontinence: 

Not all cases of incontinence are the same. It can have a variety of causes and treatment options, and different people may experience different symptoms. For people suffering from incontinence, identifying the type and cause of the condition is the first step to treating the problem and potentially finding a cure.

1.    Urge Incontinence

Urge incontinence happens when the bladder contracts, causing sudden, uncontrollable urges to urinate, resulting in involuntary loss of urine. Very similar to OAB, although urge incontinence by definition will always result in leakage, whereas OAB does not necessarily. Women who have given birth via C-section are at an increased risk for urge incontinence later in life, as well as patients suffering from nerve damage, prostate cancer and bladder cancer.

2.    Stress Incontinence

Stress incontinence is a condition where the muscles in the bladder and urethra have become weak and cannot hold in the urine when any pressure is applied. These muscles usually become weak from childbirth, serious injuries or surgeries, advanced aging, or menopause. Any pressure, such as coughing, sneezing, laughing, or exercising, could be enough to cause involuntary loss of urine in some people. It is various forms of physical pressure, or stress, that causes this incontinence; there is no link to psychological stress like many people think.

3.    Fecal Incontinence

Fecal incontinence is described as the failure to prevent fecal matter from leaving the rectum. Similar to stress incontinence, the condition is caused by a weakening of the muscles and nerves in the area, leading to involuntary leakage. The muscles and/or nerves surrounding the anus can be weakened by childbirth, surgery, age, dementia, and certain physical disabilities.

4.    Overflow Incontinence

Overflow incontinence can occur when a person is unable to completely empty their bladder, even though it is full. This can lead to leakage, and if it happens often enough, urinary tract infections. Patients with overflow incontinence often can’t feel that their bladders are full, which leads to frequent, involuntary accidents.

Treatments for Incontinence  

For those who suspect they have incontinence, a doctor will review their medical history and order a serious of tests to diagnose and determine the severity of the condition. These tests, depending on the type of incontinence, typically include a urinalysis to rule out any infections, physical exams, bladder stress tests, and neurological testing. The treatment options vary greatly according to the type of incontinence, so it is important to seek an expert in urological conditions. Once diagnosed, the doctor may recommend one of the following options.

  • Behavioral Therapy: Including Kegel exercises, biofeedback, change of diet, and a bathroom schedule.
  • Prescriptions: Taking drugs like Darifenacin (Enablex) or Mirabegron (Myrbetriq).
  • Surgery and Procedures: Rare in most cases, but can include retropubic colposuspension, implanting a vaginal pessary device or a sling procedure to support the urethra.

Living with Incontinence or OAB

Incontinence and OAB can both have a major impact on a person’s mental health and overall quality of life. affect a person’s ability of be self-efficient  People who suffer from incontinence often feel that the condition hinders their ability to be self-sufficient and live a normal life because of their dependency on pads or diapers. A recent study shows that people struggling with incontinence are at a higher risk for developing depression and anxiety than those without the condition.

Overactive bladder syndrome can also have detrimental effects on one’s physical and psychological wellbeing. 33 million Americans suffer from OAB, and these people constantly worry about being near a restroom in case of a sudden urge, which can interfere with work, social interactions, exercise, or sleep. The embarrassment that comes with these conditions leads to a reluctance in discussing bladder health, which can leave patients feeling very isolated and lonely.


It is important to know the difference between OAB and incontinence so you can start getting the proper treatment right away. If you have questions about your bladder symptoms, don’t hesitate to contact Advanced Urology today.