If you lose urine for no apparent reason after suddenly feeling the need or urge to urinate, you may have urge incontinence. Although urge incontinence may occur in anyone at any age, it is more common in women and the elderly.

A common cause of urge incontinence is unexpected bladder contractions or bladder spasms. Often these contractions occur regardless of the amount of urine that is in the bladder. It also may result from neurological injuries (such as spinal cord injury or stroke), neurological diseases (such as multiple sclerosis), infection, bladder cancer, bladder stones, bladder inflammation, or bladder outlet obstruction. The majority of cases of urge incontinence however are idiopathic, which means a specific cause cannot be identified.

Patients with urge incontinence can have urine leakage during sleep, or if you try to hold your urine too long is the daytime. Other stimuli can lead to bladder spasms, including the sound or feel of running water (washing dishes, taking a shower). Some patients will experience urgency with incontinence when they drive into their garage, or try to get the key into their door (their bladder knows they are home, and will not wait any longer!). Certain fluids and medications such as diuretics, or emotional states such as stress and anxiety, can worsen this condition. Some medical conditions, such as hyperthyroidism and uncontrolled diabetes, can also lead to or worsen urge incontinence.

Involuntary spasms of the bladder muscle can occur because of damage to the nerves of the bladder, to the nervous system (spinal cord and brain), or to the muscles themselves. Multiple sclerosis, Parkinson’s disease, Alzheimer’s disease, stroke, and injury—including injury that occurs during surgery—all can harm bladder nerves or muscles.