Continence involves a balance of the urethral closure and detrusor muscle activity. Urethral pressure will usually exceed bladder pressure which will result in urine remaining in the bladder. The urethra and bladder are both located within the pelvis. In the event that intra-abdominal pressure should increases (due to coughing or sneezing) transmitting the pressure to both the urethra and the bladder equally, leaving the pressure differential unchanged, resulting in continence. Stress incontinence is caused by pelvic floor muscle weakness and is the loss of small amounts of urine when coughing, laughing, sneezing, exercising, or other physical activity that increase the intra abdominal pressure, which increases bladder on the bladder. In some cases physical changes that are the result of pregnancy, childbirth, and menopause which are all often causes of stress incontinence. In men it is common among those who have recently had a prostatectomy. It is more common in women and is treatable. A urethra is supported by fascia of the pelvic floor. If this support becomes weakened the urethra can move downward at times of increased abdominal pressure which causes stress incontinence. This is common for women who are pregnant or giving birth. It is also possible for stress incontinence to get worse during the week prior to a woman's menstrual cycle. During this period of the month lowered estrogen levels may lead to lower muscular pressure in the area around the urethra, which then increases the chances of urine leakage. It is common for women to develop stress incontinence after going through menopause because of lowered levels of estrogen in their bodies. Urge incontinence may also be called reflux incontinence if it results from overactive nerves that control the bladder. Many medical professionals describe bladder such as these as unstable, spastic, or overactive. Some patients suffer from incontinence while they are sleeping, even after drinking only small amount of water, or when they touch it or hear it running such as then taking a shower. Some patients may experience involuntary actions of bladder muscles because of prior damage to the nerves of the bladder, to the nervous system which includes the spinal cord and brain, or to the muscles themselves. Other serious conditions that can cause damage to the bladder nerves or muscles include multiple sclerosis, Parkinson's disease, Alzheimer's disease, stroke, and injury. Some of those suffering from functional incontinence may have problems thinking, moving, or communicating then prevent them from making it to the restroom it time. Some of those with Alzheimer's disease may not think well enough to be able to plan enough time to go to the restroom. It is also more difficult for someone in a wheelchair who may be blocked from getting to the restroom in time. This is more common for elderly women and men who don't have the necessary care.

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