Stress Incontinence vs. an Overactive Bladder: How Are They Different?

Stress Incontinence vs. an Overactive Bladder: How Are They Different?

Millions of Americans suffer from urinary incontinence, yet if you’re one of those millions, it’s easy to feel like you’re alone. That's because a lot of people don’t discuss their incontinence symptoms with their doctors, perhaps because they’re embarrassed or because they wrongly believe it’s “just a part of aging.”

The good news is urinary incontinence (UI) is treatable, and like a lot of chronic problems, the sooner you start treatment, the sooner — and easier — your symptoms will resolve. The first step is determining which type of UI you have — and in most cases, it comes down to either stress incontinence or urge incontinence, also known as overactive bladder (OAB).

At Adult and Pediatric Urology in Manhattan, Brooklyn, and Queens, New York, Alfred Shtainer, MD, FACS, and his team offer a broad range of treatment options for urinary incontinence, enabling him to tailor every treatment for the individual patient. 

To mark Bladder Health Awareness Month, this post is devoted to helping you understand the differences between stress incontinence and overactive bladder, along with the treatment options for each.

Stress incontinence

Stress incontinence happens when you leak urine as a result of physical stress on the bladder. People with this type of incontinence may leak urine during physically strenuous activities, like exercise or heavy lifting. But even simple things, like coughing, sneezing, or laughing can also cause leakage. 

Stress incontinence is typically caused by weakened pelvic floor muscles that are no longer effective in supporting and controlling the bladder and urethra. Pelvic surgery, obesity, and even childbirth and pregnancy can increase your risk of this type of incontinence, and so can age-related changes in your muscles.

Many people with stress incontinence benefit from special exercises designed to strengthen the pelvic floor muscles. For more severe symptoms, surgery can help by restoring support to your bladder and other pelvic organs or by supporting the urethra and the neck of the bladder.

Overactive bladder

An overactive bladder involves an uncontrollable urge to urinate, even during the night while you’re trying to sleep. These urges can occur at any time, including when your bladder isn’t full.


While the underlying cause of OAB isn’t always easy to determine, common causes include aging, nerve-related problems, infections, and chronic bladder irritation. Unlike stress incontinence, OAB causes leakage even without the presence of a physical stressor, like exercise.

OAB treatment can include lifestyle modifications to eliminate potential bladder irritants, pelvic floor exercises, or medications to calm bladder spasms. Many people benefit from a combination of therapies.

Relief for your urinary incontinence

Urinary incontinence can have various causes, and tailoring your treatment based on that cause is the key to relieving your symptoms. Before recommending a treatment, Dr. Shtainer relies on an array of tests to evaluate your bladder’s structure and function, along with a thorough medical history to understand your risk factors. 

Incontinence doesn’t just cause physical symptoms — it takes an emotional toll, too. To learn more about treatments that can help, book an appointment online or over the phone with Dr. Shtainer and the team at Adult and Pediatric Urology today.

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