Which urinary incontinence type is caused by detrusor overactivity?

• A. Stress incontinence
• B. Overflow incontinence
• C. Functional incontinence
• D. Urge incontinence

Answer: (D)

Detrusor overactivity causes urge incontinence by making the bladder muscle contract involuntarily during filling. When the bladder canal fills, these abrupt, uncontrolled contractions trigger a sudden, often strong urge to void, and leakage can occur before a toilet is reached. That rapid, urgent leakage is the hallmark of urge incontinence.

This differs from other types in how the leakage happens. Stress incontinence leaks with activities that raise abdominal pressure, like coughing or sneezing, due to weakness or poor support of the urethra. Overflow incontinence involves leakage from a bladder that isn’t emptying properly, often with a consistently full or distended bladder due to underactive detrusor or obstruction. Functional incontinence is leakage caused by nonbladder factors, such as mobility or cognitive problems, that prevent timely toileting.

Understanding the mechanism helps explain the signs you’d look for: a sudden urge with leakage points to detrusor overactivity and urge incontinence, while the other patterns reflect different underlying issues with the bladder, urethral support, or access to the restroom. Treatments aim to calm the detrusor (for example, antimuscarinics or beta-3 agonists) and improve bladder training and pelvic floor function.