尿失禁：4种类型及其区别的重要性

最后更新： 2026年8月30日

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Urinary incontinence — the involuntary leaking of urine — is not a 威胁生命 problem, and that is precisely why so many people put up with it in silence for years. For those living with it the effect on daily life is severe, and it becomes more common with age. It is common enough that most people reading this know someone affected, whether or not that person has ever said so.

This article is the overview. The single most useful thing to understand is that incontinence is not one condition but four, and they are treated in completely different ways — so working out which type you have is not a formality before treatment, it 是 the first half of the treatment.

How common is it, and why every source gives a different number

If you search this question you will find figures ranging from about 10% to nearly 50%, which is not because anyone is being careless. It is because the answer depends entirely on what is being counted — any leakage at all in the past year, leakage at least weekly, or leakage bothersome enough that the person wants something done about it. Those three questions give answers several times apart in the same population. Treat any single headline percentage with that in mind, including the ones below.

With that caveat, the figures worth knowing:

• Incontinence overall is about two to three times more common in women — one large population study reported roughly 49% of women against 22.6% of men when any leakage was counted.
• That whole gap comes from the stress type. Stress incontinence ran at about 26% of women against 3% of men in the same study. Urge incontinence was close to equal, around 5.3% of women and 5.0% of men.
• 膀胱过度活动症, which overlaps closely with the urge type, affects roughly 12% of adults — the landmark EPIC study reported 11.8% overall, 12.8% of women and 10.8% of men. Guideline summaries give wider population ranges of about 7–27% in men and 9–43% in women, again because of differing definitions.
• Age changes everything. By 65 and over, overactive bladder reaches roughly 40% of men and 46% of women. Among men over 60, the urge type is the commonest form of incontinence there is.

Note, August 2026: an earlier version of this article quoted a worldwide total of 400 million people affected and described incontinence as roughly twice as common in women. The global total could not be traced to a reliable source and has been removed; the sex difference has been replaced with the figures above, which are more useful because they show where the difference actually sits.

Why the causes differ between men and women

Risk factors in women

• A history of pregnancy, and the number of childbirths
• 糖尿病
• Severe obesity

Risk factors in men

In men the picture is dominated by one thing: a history of prostate surgery, particularly radical prostatectomy for prostate cancer, which can weaken the sphincter that holds urine back. It is worth knowing about in advance rather than discovering it afterwards, because it is a recognised and manageable consequence rather than a sign something went wrong. Where it does not settle with time and pelvic floor training, an artificial urinary sphincter is the established surgical answer, and Dr. Soarawee performs that operation at Bangkok Hospital Headquarters.

The second male pattern is age-related urge incontinence from an overactive bladder, which is easy to overlook because men expect incontinence to be a women’s problem and so do not raise it. As the figures above show, that expectation is wrong for this type.

The 4 types of urinary incontinence

1. 压力性尿失禁

Leakage brought on by a rise in intra-abdominal pressure — coughing, sneezing, laughing, lifting or exercise — with no warning urge at all. Overwhelmingly a female condition, at roughly 26% of women against 3% of men, and the reason incontinence as a whole looks like a women’s problem in the statistics. In men it is largely confined to those who have had prostate surgery.

2. 敦促尿失禁

Leakage preceded by a sudden, intense need to pass urine that cannot be held long enough to reach the toilet. It becomes steadily more common with age and, unlike the stress type, affects men and women in roughly equal numbers — in men over 60 it is the commonest form. It overlaps closely with 膀胱过度活动症.

3. Mixed incontinence

Features of both stress and urge at once, and more common in women than in men. This is the type that most often gets treated badly, because a plan aimed at one half can leave the other half untouched or even aggravate it — which is exactly the situation where a urodynamic study earns its place.

4. Overflow incontinence

Leakage from a bladder that is chronically over-full and never empties properly. The causes divide into nerve-related — spinal cord injury, long-standing diabetes, or an 膀胱活动不足 — and obstructive, such as an 前列腺肥大 or a pelvic mass.

This one deserves particular attention, because it is the type where leaking is the least of the problem. A bladder that never empties can lead to repeated infections and, if it goes on long enough, to pressure on the kidneys — so overflow incontinence is worth identifying promptly rather than managing with pads. It is also the reason the overactive-bladder medications are not a safe default: given to someone whose bladder is already failing to empty, they make it worse.

When leaking needs same-day attention

Incontinence itself is a quality-of-life problem, not an emergency. A few things travelling with it are different, and belong in an emergency department the same day rather than in a clinic appointment — in Thailand the emergency number is 1669:

• Sudden inability to pass urine at all, with a painful, swollen lower abdomen — acute retention.
• Fever or shivering with pain in the flank or lower back alongside urinary symptoms.
• 生殖器或大腿内侧周围出现新的麻木感、腿部无力或大小便失禁 together with new urinary symptoms.
• 血尿, with or without pain, needs investigation in its own right and should not be put down to incontinence.

Establishing which type you have

Assessment begins with a careful history and physical examination, which is enough in many cases. Where the symptoms are mixed, or do not respond to treatment as expected, a 尿动力学检查 measures how the bladder and urethra behave as the bladder fills and empties — it distinguishes an overactive bladder from a weak sphincter from a bladder that is failing to empty, and it is the test that turns a description of symptoms into a diagnosis. Soarawee 医生在曼谷医院总部进行尿动力学检查。.

It is worth knowing which treatments are provided here and which are not, so that a referral is not a surprise. Assessment, urodynamic study, behavioural therapy, medication and the artificial urinary sphincter are all available at Bangkok Hospital Headquarters. Bladder botulinum toxin injection, sacral neuromodulation, mid-urethral sling and urethral bulking agents are not performed here, and referral to a centre offering them is arranged where they are the right answer.

Because this problem affects quality of life so profoundly, it is well worth seeking advice rather than quietly enduring it. You do not have to organise your day around the nearest toilet.

如果您正在经历尿失禁，并希望获得量身定制的评估，Soarawee Weerasopone 医生将在曼谷医院总部提供专家咨询。. 预约咨询. 如需预约三美泰是拉差医院，请致电泌尿科： 088-022-1445.

曼谷医院远程医疗服务适用于无法亲自就诊的患者，包括国际患者——请通过电子邮件提前向泌尿科预约： bhquro@bdms.co.th. A video consultation is a good way to go through a completed bladder diary, previous surgery and current medications, and to decide what testing is needed; examination and urodynamic study are done in person. Samitivej Sriracha is in-person only. For the cost of any consultation, test or procedure, please contact the Urology department at bhquro@bdms.co.th 与其在这里问。.

尿失禁常见问题解答

尿失禁

Urinary incontinence is the involuntary leakage of urine. It is not a life-threatening condition, but it significantly affects quality of life, and it becomes more common with age in both sexes. Reported prevalence varies several-fold between studies depending on whether any leakage, weekly leakage, or bothersome leakage is being counted.

尿失禁有多普遍？它在女性中更常见吗？

Incontinence overall is about two to three times more common in women, with one large population study reporting roughly 49% of women against 22.6% of men when any leakage was counted. That difference comes almost entirely from stress incontinence, at about 26% of women against 3% of men. Urge incontinence is close to equal between the sexes, around 5.3% and 5.0%, and in men over 60 it is the commonest form. Overactive bladder affects roughly 12% of adults overall, rising to about 40% of men and 46% of women aged 65 and over. All of these figures shift considerably with the definition used and the population studied.

尿失禁的主要类型有哪些？

There are four main types: stress incontinence (leakage triggered by coughing, sneezing, or exertion), urge incontinence (sudden overwhelming urge with involuntary leakage), mixed incontinence (a combination of stress and urge types), and overflow incontinence (leakage from an overfull bladder, often due to obstruction or nerve problems). The type decides the treatment, so identifying it correctly comes first.

女性尿失禁的原因是什么？

In women, the main risk factors include a history of pregnancy, the number of childbirths, diabetes mellitus, and severe obesity. Excess weight in particular increases intra-abdominal pressure, which worsens stress-type leakage, and weight loss can significantly improve symptoms.

男性尿失禁的原因有哪些？

In men, the commonest cause of stress-type leakage is a history of prostate surgery, particularly radical prostatectomy for prostate cancer, which can weaken the urinary sphincter. Where it does not settle with time and pelvic floor training, an artificial urinary sphincter is the established surgical treatment and is performed at Bangkok Hospital Headquarters. Separately, urge incontinence from an overactive bladder is common in older men and is the commonest form of incontinence in men over 60.

How is the type of incontinence identified?

A careful history and physical examination identify the type in many cases. Where symptoms are mixed or have not responded to treatment as expected, a urodynamic study measures bladder and urethral behaviour during filling and emptying, distinguishing an overactive bladder from a weak sphincter and from a bladder that fails to empty. This matters because the four types are treated in completely different ways, and because medication for an overactive bladder makes matters worse in someone whose bladder is not emptying.

尿失禁可以治疗吗？

Yes. Treatment is tailored to the specific type of incontinence. Options include pelvic floor exercises, lifestyle modifications, medications, and surgical procedures. Early consultation with a urologist is important to identify the correct type and design the most effective individualised treatment plan. At Bangkok Hospital Headquarters, assessment, urodynamic study, behavioural therapy, medication and artificial urinary sphincter surgery are provided; bladder botulinum toxin, sacral neuromodulation, mid-urethral sling and urethral bulking agents are not performed there, and referral is arranged where those are appropriate.

免责声明 This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters. It is intended for educational purposes only and does not constitute medical advice. Prevalence figures are drawn from published population studies and vary considerably with the definition of incontinence used and the population studied. No medical advice, diagnosis or prescription is provided through personal messaging channels or social media. Always consult a qualified healthcare professional before starting any medical treatment.