Urinary incontinence is not just embarrassing or a nuisance.  It is a real medical problem that should not be ignored. It requires a medical workup.

The urinary system is complex, and the process of urination involves a series of interactions between the brain and a number of organs and muscles.  A problem anywhere within this system can lead to incontinence.  That is why there are several types of incontinence, with a variety of causes - and why it is important to take incontinence seriously.

The types of incontinence include:

• Stress incontinence: small amounts of urine leak during any movement that puts pressure ("stress") on the bladder, such as exercise (including dancing), bending over, laughing, coughing, sneezing, lifting, etc.
• Occurs more often in women
• May be caused by weakened pelvic floor muscles 
• Urge incontinence (also called "overactive bladder" or "spastic bladder"): urine is released after a sudden, uncontrollable urge to urinate is felt
• Caused by sudden, uncontrollable, inappropriate bladder contraction
• Overactive bladder can cause urgency and frequency without leakage (dry overactive bladder)
• In this category, interstitial cystitis is sometimes included.  This is a disorder of the bladder wall muscle where it is intolerant of even small amounts of urine.  In this Second Opinion episode, Golf Pro Terri-Jo Myers shares her battle with Interstitial Cystitis.
• Mixed incontinence: a combination of stress and urge incontinence
• Overflow incontinence: small amounts of urine leak or dribble out often and unexpectedly because the bladder does not empty completely during normal urination, and then gets too full. This is often caused by:
• Blockages in the urine flow 
• Bladder muscles that do not contract completely

Those are the most common types of incontinence.  Other types appear less frequently, such as: 

• Functional incontinence: the inability of someone to get to the bathroom before urinating because of physical disabilities, external obstacles, or problems in thinking or communicating.  It is not caused by a specific bladder or urinary tract pathology.
• Reflex incontinence (also called unconscious incontinence): being unaware of the need to urinate
• Transient incontinence: urine leakage or inability to control urination because of a temporary condition, such as infection (such as a bladder infection or cystitis), medications or irritants (such as blood in the urine)

From this you might infer correctly that incontinence is not a disease or disorder in itself, but a symptom of some other problem.  That is why an accurate diagnosis is so important.

The process of diagnosing the problem usually begins with a physical exam and a frank discussion of the person's complaints or symptoms and urinating habits. At least, the discussion should be frank.  Unfortunately, as this episode of Second Opinion makes clear, too often people don't talk to their doctor about difficulties controlling urination. They don't take the issue seriously or, more commonly, they are embarrassed about it.

But the fact is, when it is a question of health, you cannot afford to be embarrassed.  The doctor's office is the one place where, for your own good, it is best to "tell all."

If you do have an incontinence problem, you may be asked to keep a "voiding diary," a record of how often you urinate, what times of day, how much each time, how soon after drinking, etc.  You may think you already know the answers and do not need to write them down, but you - and your doctor -may discover some surprises, or make some connections you were not aware of.  At any rate, the doctor needs the details to understand the problem.