Which statement best describes the difference between urge and stress incontinence?

• A. Stress leakage occurs with increased intra-abdominal pressure (e.g., coughing); urge leakage occurs with a sudden urge to void, often with leakage.
• B. They are the same condition.
• C. Urge occurs only at night.
• D. Stress occurs only in the elderly.

Answer: (A)

Two forms of urinary leakage are driven by different triggers. Stress incontinence leaks when there’s a rise in intra-abdominal pressure—coughing, sneezing, laughing, or lifting—because the pelvic floor and urethral closure aren’t able to stay closed under that added pressure. Urge incontinence leaks with a sudden, strong urge to void, often with leakage as the bladder contracts or can’t hold urine, even if the person hasn’t been bearing down or lifting. This distinction matters because it points to different underlying mechanisms and treatments, and mixed incontinence can occur when both processes contribute. The other statements aren’t correct because they either imply the conditions are the same, or they incorrectly restrict when urge or stress leakage can occur (for example, urge leakage is not limited to nighttime, and stress leakage is not limited to the elderly).