What is gross total urinary incontinence?

Donna Hill Howes, RN
Family Practitioner

Mixed incontinence combines stress incontinence and urge incontinence. That means your bladder responds to physical pressures and makes you have to go more often. You may also feel strong urge to go at a moment's notice. Too often, you may not make it to the bathroom in time.

This form of incontinence occurs when a person's bladder has no ability to hold urine. This type of incontinence is rare, however. It is usually the result of a birth defect or severe injury to the spine or excretory system.

If you have symptoms of both overactive bladder and stress incontinence, you likely have mixed incontinence, a combination of both types. Most women with incontinence have both stress and urge symptoms—a challenging situation. Mixed incontinence also occurs in men who have had prostate removal or surgery for an enlarged prostate, and in frail older people of either sex.

Dr. Jill Rabin
OBGYN (Obstetrician & Gynecologist)

Total incontinence refers to a complete loss of bladder control. An individual with this type of incontinence constantly loses a small amount of urine and must wear a protective pad at all times. When and where urination will occur is totally out of that person’s control.

Mixed urinary incontinence occurs when there is a combination of both stress and urge incontinence present. Also, it occurs when there is more than one type of any urinary incontinence present.

For example, you may experience incontinence of the stress variety (SUI), which is usually due to a weak muscle and torn connective tissue, which supports the bladder and other pelvic organs. In women, this is generally due to childbirth, menopause, and the fact that women have a shorter urethra than men (less tissue to hold the urine back from the outside world). Symptoms of SUI include leakage of urine with cough or sneeze, usually a small amount of urine.

Urge incontinence (UUI), which is also a very common form of incontinence, happens when the nerves that govern the bladder and urethra allow the bladder to contract without warning the urethra, so that the end result is leakage, generally of a fairly large amount of urine. 

When urge and stress incontinence happen together, that is a form of mixed incontinence.

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There are several types of urinary incontinence. The most common are:

  • Stress incontinence: Urine leaks when you laugh, cough, sneeze, exercise, or exert yourself in any way that puts pressure on your bladder. This is the most common type of incontinence and can almost always be successfully treated.
  • Urge incontinence: You experience sudden and powerful urges to urinate that often result in an accident. An overactive bladder—one that contracts when you don't want it to—is usually the cause and may be due to anything from an infection to damaged nerves. In men, this type of urgency may be a sign of an enlarged prostate. It can also be an early sign of bladder cancer.
  • Mixed incontinence: You experience both stress and urge incontinence.
  • Overflow incontinence: You frequently leak small amounts of urine but are unable to completely empty your bladder when you try. This is usually caused by a blockage of some sort, such as an enlarged prostate in men, but may also be caused by weak bladder muscles.
  • Functional incontinence: You have relatively normal urine control but can't get to the bathroom in time because of a physical limitation or the inability to recognize the need to go. It usually affects older people who have a hard time getting around, people with dementia, and people with disabilities.

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Different types of urinary incontinence have different symptoms. Some people have more than one reason for this problem. The main types of urinary incontinence are:

  • Stress incontinence: People with stress incontinence may experience problems while they are laughing, coughing, sneezing, lifting, exercising, or standing up. The valve and the pelvic floor muscles for controlling urine cannot close tightly enough to prevent leakage.
  • Urge incontinence: Those with urge incontinence experience the need to urinate frequently. They must get to a restroom quickly to prevent leaking. The urge sensation can be uncomfortable or even painful. When the bladder is overactive, it responds by signaling the need to urinate even though there may be only a small amount of urine in the bladder.
  • Mixed incontinence: Individuals with mixed incontinence commonly experience a combination of stress and urge symptoms.
  • Overflow incontinence: Overflow incontinence occurs when some obstruction to the urine flow causes the bladder to overfill and leak small amounts. This can occur if the prostate is enlarged and squeezes the urethra or if the bladder valve does not open properly. There may be the feeling of having to urinate every few minutes because the bladder usually does not empty completely.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.