Functional Incontinence

What is functional incontinence?

Functional incontinence is a type of urinary incontinence in which you lose control of your bladder, usually because another condition makes it difficult to get to a bathroom in time or prevents you from recognizing that you need to pee.

Another name for functional incontinence is functional urinary incontinence.

How common is functional incontinence?

In general, urinary incontinence is common. About 30 million people in the United States have some type of urinary incontinence, which may include functional incontinence.

What are the signs of functional incontinence?

Signs of functional incontinence may include:

• Regularly leaking or dribbling pee (urine).
• Involuntarily fully emptying your bladder.
• Inability to hold your pee long enough to get to a bathroom.
• The smell of pee on your clothes or around your house.

What is the cause of functional incontinence?

There are many possible causes of functional incontinence. Some causes include:

• Conditions that affect how your brain processes thoughts (cognitive disorders), including dementia, delirium and intellectual disabilities.
• Conditions that affect your brain, spinal cord or the nerves throughout your body (neurological disorders), including multiple sclerosis (MS), Parkinson’s disease and stroke.
• Conditions that affect your muscles and make it hard or impossible to get to the bathroom or remove clothing, including arthritis.
• Weak bladder or pelvic floor muscles.
• Physical barriers, including stairs, poor lighting that makes it difficult to see or large crowds.
• Thinning or irritation in vaginal tissues.
• Medicines that affect your ability to process thoughts, such as sleeping pills.
• Medicines that make you pee more often (diuretics).
• Urinary tract infections (UTIs).
• Constipation.

Who gets functional incontinence?

You’re at a greater risk of functional incontinence if you:

• Have a cognitive disorder.
• Have a neurological disorder.
• Have a condition that affects your muscles or joints.
• Take diuretics or medications that make you drowsy or sleepy.
• Are 65 or older; functional incontinence is the most common type of urinary incontinence in residents of nursing homes.
• Aren’t physically active.

How is functional incontinence diagnosed?

A healthcare provider can diagnose functional incontinence. They’ll perform a physical examination and ask questions, which may include:

• Are you currently receiving treatment for other conditions?
• What’s your diet like?
• How often do you eat?
• How much do you drink each day?
• What do you drink each day?
• Do you drink alcohol or caffeine?
• How often do you exercise?
• What sort of exercises do you do?
• Are you able to move around comfortably?

They may also order tests to help determine the cause of your functional incontinence.

What tests will be done to diagnose functional incontinence?

Your healthcare provider may order or perform the following tests to help confirm their diagnosis or determine the cause of your functional incontinence:

• Urinalysis. You’ll pee into a special container. Your provider will then examine the sample for signs of infection.
• Pelvic floor dysfunction tests. These tests measure how well your pelvic floor muscles work.
• Urodynamic testing. Urodynamic testing measures how well your nerves and muscles work. It also measures how strong your pee stream is and if there’s any pressure in or around your bladder.

Your provider may also refer you to a doctor who specializes in conditions that affect your urinary tract and reproductive system (urologist) or a doctor who treats women or people assigned female at birth (AFAB) with pelvic floor dysfunction (urogynecologist).

How do you reduce functional incontinence?

Reducing or treating functional incontinence depends on its cause.

For example, if arthritis makes it difficult or painful to unbutton or unzip clothing, it’s a good idea to wear clothes that are easy to take off. If you have a UTI, a healthcare provider can prescribe antibiotics to kill the bacteria. If medications cause functional incontinence, ask your provider if there are alternative medicines you can take.

Other treatments that may help reduce functional incontinence include:

• Incontinence pads or underwear (Depends®). You can wear incontinence underwear or line your regular underwear with incontinence pads to absorb leaks.
• Bladder training. You go to the bathroom at set times (usually every two hours) throughout the day to stop your bladder from getting too full, even if you don’t have to pee. Another name for bladder training is timed voiding.
• Urinary catheter. A urinary catheter is a flexible tube that a provider inserts into your urethra up to your bladder. It allows your bladder to drain pee into a bag outside your body.
• Condom catheter. A condom catheter fits over your penis to collect pee in a bag outside your body.
• Pelvic floor physical therapy. Pelvic floor physical therapy is a type of treatment that helps strengthen your pelvic floor muscles. Strengthening your pelvic floor muscles can help prevent leaks while you’re getting to the bathroom. Kegel exercises are a common type of pelvic floor exercise.

When you’re at home, it’s a good idea to ensure you have a clear path to the bathroom. Make sure the doors are open and clean up any clutter that could slow you down or make you trip. If you have trouble seeing, install extra lights around your house or carry a small flashlight in your pocket. If you’re in public, note where the bathrooms are before you need to pee.

Can functional incontinence be prevented?

You can’t prevent the muscular, neurological or cognitive conditions that may cause functional incontinence.

What can I expect if I have functional incontinence?

If you have a chronic (long-lasting) condition that causes functional incontinence, you may have functional incontinence for the rest of your life. In these cases, talk to a healthcare provider about the best ways to manage your symptoms.

How do I take care of myself?

The following tips can help you take care of yourself if you have functional incontinence:

• Keep a bladder diary. A bladder diary helps track how much you drink, what you eat and drink, how much you pee, how long it takes you to pee and how often you pee. This information can help you during bladder training.
• Avoid foods and drinks that can irritate your bladder. Caffeine, alcohol, soda pop, spicy foods, chocolate, tomatoes and citrus juices can irritate your bladder and make you pee more often.
• Maintain a healthy weight for you. Losing weight in your abdominal area can help reduce pressure on your bladder.
• Walk regularly. Walking can help you recognize when your bladder is getting full and when you should start looking for a bathroom. Aim to walk for at least 30 minutes each day.
• Quit smoking. Quitting smoking may help reduce functional incontinence.

When should I see my healthcare provider?

Schedule an appointment with a healthcare provider as soon as you develop symptoms of functional incontinence. They can help you determine its cause and help avoid accidental leaks.

What questions should I ask my doctor?

• What’s causing my functional incontinence?
• What tests will you order to confirm functional incontinence?
• When will I get the test results?
• Are there any activities I should avoid?
• What foods and drinks should I avoid?
• How should I take care of myself at home?
• How should I take care of myself when I’m away from home?
• Are there any other symptoms I should look out for?

What are the types of urinary incontinence?

There are many different types of urinary incontinence, including functional incontinence. Some other types of urinary incontinence include:

• Overflow incontinence. Overflow incontinence is when your bladder is full, but you can’t empty it completely. You may leak or dribble pee because your bladder is full, but you don’t realize you need to use the bathroom.
• Stress incontinence. Sudden pressure (stress) on your bladder causes you to unintentionally pee. Some common causes include sneezing, coughing, laughing, lifting heavy objects and certain physical activities.
• Urge incontinence. Urge incontinence is a sudden, uncontrollable need (urge) to pee, but you can’t make it to the bathroom in time.

A note from Cleveland Clinic

Functional incontinence can interrupt your life. Even though it’s common, it can make you feel self-conscious or embarrassed. You may even refrain from participating in your everyday activities because you’re afraid you can’t get to a bathroom quickly. Talk to a healthcare provider if you or a loved one have signs of functional incontinence. They can help identify the cause and recommend ways to control or prevent leaks.