Urinary incontinence – signs, symptoms and treatments

Urinary incontinence

Urinary incontinence

Urinary incontinence is the unintentional passing of urine. It’s a common problem thought to affect millions of people.There are several types of urinary incontinence, including:

stress incontinence – when urine leaks out at times when your bladder is under pressure; for example, when you cough or laugh

urge incontinence – when urine leaks as you feel a sudden, intense urge to pass urine, or soon afterwards

overflow incontinence (chronic urinary retention) – when you’re unable to fully empty your bladder, which causes frequent leaking

total incontinence – when your bladder can’t store any urine at all, which causes you to pass urine constantly or have frequent leaking

It’s also possible to have a mixture of both stress and urge urinary incontinence.

Read about the symptoms of urinary incontinence.

When to seek medical advice

See your GP if you have any type of urinary incontinence. Urinary incontinence is a common problem and you shouldn’t feel embarrassed talking to them about your symptoms.

This can also be the first step towards finding a way to effectively manage the problem.

Urinary incontinence can usually be diagnosed after a consultation with your GP, who will ask about your symptoms and may carry out a pelvic examination (in women) or rectal examination (in men).

Your GP may also suggest you keep a diary in which you note how much fluid you drink and how often you have to urinate.

Read about diagnosing urinary incontinence.

Causes of urinary incontinence

Stress incontinence is usually the result of the weakening of or damage to the muscles used to prevent urination, such as the pelvic floor muscles and the urethral sphincter.

Urge incontinence is usually the result of overactivity of the detrusor muscles, which control the bladder.

Overflow incontinence is often caused by an obstruction or blockage to your bladder, which prevents it emptying fully.

Total incontinence may be caused by a problem with the bladder from birth, a spinal injury, or a bladder fistula.

Certain things can increase the chances of urinary incontinence developing, including:

pregnancy and vaginal birth

obesity

a family history of incontinence

increasing age – although incontinence is not an inevitable part of ageing

Read about the causes of urinary incontinence.

Treating urinary incontinence

Initially, your GP may suggest some simple measures to see if they help improve your symptoms.

These may include:

lifestyle changes – such as losing weight and cutting down on caffeine and alcohol

pelvic floor exercises – exercising your pelvic floor muscles by squeezing them, taught by a specialist

bladder training – where you learn ways to wait longer between needing to urinate and passing urine, guided by a specialist

You may also benefit from the use of incontinence products, such as absorbent pads and handheld urinals.

Medication may be recommended if you’re still unable to manage your symptoms.

Read about non-surgical treatments for urinary incontinence.

Surgery may also be considered. The specific procedures suitable for you will depend on the type of incontinence you have.

Surgical treatments for stress incontinence, such as sling procedures, are used to reduce pressure on the bladder or strengthen the muscles that control urination.

Operations to treat urge incontinence include enlarging the bladder or implanting a device that stimulates the nerve that controls the detrusor muscles.

Read about surgery and procedures for urinary incontinence.

Preventing urinary incontinence

It’s not always possible to prevent urinary incontinence, but there are some steps you can take that may help reduce the chance of it developing.

These include:

controlling your weight

avoiding or cutting down on alcohol

keeping fit – in particular, ensuring that your pelvic floor muscles are strong

Healthy weight

Being obese can increase your risk of developing urinary incontinence. You may therefore be able to lower your risk by maintaining a healthy weight through regular exercise and healthy eating.

Use the healthy weight calculator to see if you are a healthy weight for your height.

Get more information and advice about losing weight.

Drinking habits

Depending on your particular bladder problem, your GP can advise you about the amount of fluids you should drink.

If you have urinary incontinence, cut down on alcohol and drinks containing caffeine, such as tea, coffee and cola. These can cause your kidneys to produce more urine and irritate your bladder.

The recommended weekly limits for alcohol consumption are 14 units for men and women.

A unit of alcohol is roughly half a pint of normal-strength lager or a single measure (25ml) of spirits.

Read more about drinking and alcohol.

If you have to urinate frequently during the night (nocturia), try drinking less in the hours before you go to bed. However, make sure you still drink enough fluids during the day.

Pelvic floor exercises

Being pregnant and giving birth can weaken the muscles that control the flow of urine from your bladder. If you’re pregnant, strengthening your pelvic floor muscles may help prevent urinary incontinence.

Read more about staying active during pregnancy.

Men may also benefit from strengthening their pelvic floor muscles with pelvic floor exercises.

Find out more about pelvic floor exercises.