Urinary Incontinence is a common but embarrassing issue that affects a person’s bladder control. As a result, the sufferer experiences an unintentional passing of urine. The extremities of the condition can vary but there are many simple measures that can improve symptoms.

Here, we’ll explore the symptoms, types and causes of Urinary Incontinence, how it’s treated and why it happens. For more information and support in navigating Urinary Incontinence, sign up to Carecircle and connect with fellow patients, carers and experts.

What is Urinary Incontinence?

When a person has Urinary Incontinence, they experience a loss of bladder control and thus, the unintentional passing of urine. It’s a common but embarrassing issue and thought to affect millions of people.

The severity of Urinary Incontinence can vary from occasional leaks of urine while coughing or sneezing to sudden urges to pee that prevents the sufferer from reaching the toilet on time. In extreme cases, the sufferer may experience a constant leaking of urine. For this reason, the condition can often prevent some people from enjoying everyday life.

What are the symptoms of Urinary Incontinence?

The symptoms of Urinary Incontinence vary and depend on the type and severity of the condition itself. In the next section, we’ll detail the types of Urinary Incontinence and the symptoms of each.

But for now, the following are common signs of Urinary Incontinence, ranging from mild to extreme:

• Urine leaking while coughing, sneezing or laughing
• Urine leaking following a sudden urge to pee
• Frequent leaking as a result of the inability to fully empty your bladder
• Frequent leaking or the constant passing of urine

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Types of Urinary Incontinence

There are several main types of Urinary Incontinence, which include:

• Stress incontinence – This is one of the most common types of the condition and is when urine leaks when the bladder is under pressure. For example, stress incontinence can happen as a result of exercise, coughing, sneezing, laughing, bending or lifting
• Urge incontinence (or overactive bladder) – This is when the sufferer experiences a sudden and intense urge to urinate, followed by an involuntary loss of urine. Sometimes this type of incontinence can be caused by a disease (for example, diabetes) or an infection
• Reflex incontinence – Similar to urge incontinence, reflex incontinence is when the bladder spasms and causes a sudden urge to urinate. With this type of incontinence, larger amounts of urine leak with little or no warning
• Overflow incontinence – This type of incontinence sees the bladder being unable to completely empty itself. As a result, the sufferer experiences frequent or constant dribbling
• Total incontinence – This is when the sufferer is unable to store any urine at all. As a consequence, the bladder is either leaking frequently or passing urine constantly
• Mixed incontinence – Sometimes the sufferer may experience more than one type of incontinence. Usually, this is a combination of stress incontinence and urge incontinence

What causes urinary incontinence?

Urinary Incontinence can be caused by a number of things and sometimes the condition is a temporary symptom of something else. If the cause is treated, the sufferer may see their symptoms improve.

Here are some of the causes of the main types of Urinary Incontinence.

Stress incontinence

Sometimes when the bladder is under intense strain or your pelvic floor muscles are weak or damaged, the urethra is unable to stay closed and leaks urine as a result. This can be caused by:

• Damage or strain caused by vaginal childbirth
• Increased pressure on the stomach as a result of pregnancy or extra weight
• Damage to the area in and around the bladder as a result of surgery (for example, a hysterectomy)
• Connective tissue disorders (for example, Ehlers-Danlos syndrome)
• Brain and spinal cord conditions (for example, Parkinson’s)
• Certain medications

Urge incontinence

If there’s a problem with the detrusor muscles in your bladder walls (which ultimately relax and contract to store and release urine), it can cause a sudden urge to urinate. Possible causes include:

• Excessive alcohol or caffeine drinking
• Dehydration
• Constipation
• Neurological conditions
• Lower urinary tract conditions (for example, Urinary Tract Infections (UTIs))
• Certain medications

Overflow incontinence

If your bladder experiences an obstruction or blockage, it may become unable to empty completely. This can cause pressure leading to frequent leaks. Common causes include:

• Enlarged prostate glands in the penis
• Bladder stones
• Constipation
• Nerve damage as a result of surgery or spinal cord injury
• Certain medications

Total incontinence

If the bladder is unable to store any urine at all, frequent leaks and urination can occur. This can be caused by:

• Spinal cord injuries that disrupt the nerve signals between your brain and bladder
• Bladder problems from birth
• Bladder fistulas (small tunnel-like holes in the bladder region)

Medications that can cause Urinary Incontinence include diuretics, certain antidepressants, angiotensin-converting enzyme (ACE) inhibitors, hormone replacement therapy (HRT) and sedatives.

How do you diagnose urinary incontinence?

If you’re experiencing symptoms of Urinary Incontinence, your doctor will speak to you about your toilet habits, when the condition appears, any medications you’re currently taking, your fluid, alcohol and caffeine intake and any other symptoms you’re experiencing. Before your appointment, they may suggest keeping a bladder diary for three weeks so that you can give them as much information as possible.

Your doctor may also carry out tests and examinations to rule out potential causes of your Urinary Incontinence. If you’re female, this may involve a pelvic examination, asking you to cough to see if any urine leaks and placing a finger inside of your vagina while you squeeze your pelvic floor muscles. If you have a penis, the doctor may check the health of your prostate by carrying out a digital rectal examination. Enlarged prostate glands can sometimes cause Urinary Incontinence and frequent urination.

Other tests include a dipstick test, where your urine sample is tested for bacteria; a residual urine test, which checks your bladder’s urine levels after peeing using an ultrasound; a cystoscopy, which uses a camera to look inside your bladder and urinary tract; and urodynamic tests, which can check your bladder pressure, tummy pressure and urine flow.

While the condition can be embarrassing, it is important to speak to your GP openly about your condition and symptoms so they can provide an accurate diagnosis and prescribe appropriate treatments.

Join Carecircle for free and find help, hope, and control with your Urinary Incontinence diagnosis. Our global network for health makes you part of a worldwide community where your voice matters. Together, we can work toward a better future.

What’s the treatment for urinary incontinence?

Treatment for Urinary Incontinence depends on the type and severity of your condition. As Urinary Incontinence can be caused by underlying conditions, your GP may treat this first to see if your symptoms improve.

Other treatments for Urinary Incontinence include:

• Lifestyle changes – This may include reducing your alcohol or caffeine intake, adjusting your daily fluid intake and losing weight if you are obese
• Pelvic floor muscle training (kegel exercises) – As weak or damaged pelvic floor muscles can cause incontinence, you may be encouraged to do kegel exercises by contracting your pelvic floor muscles a minimum of eight times, at least three days a week for at least three months. If you’re unable to squeeze your pelvic floor muscles at all, your doctor may insert a small probe with an electric current into your vagina or anus to help strengthen your muscles. Biofeedback (which monitors your pelvic floor muscles while you do them) and vaginal cones (which put small weights into the vagina to assist with your pelvic floor muscle training) may also be used
• Bladder training – This involves learning techniques to help you hold your urine in for longer and may be used alongside pelvic floor muscle training to help ease symptoms. Usually, this is for at least six weeks
• Incontinence products – This can include handheld urinals, absorbent pants or pads, a catheter and devices that are placed into the vagina or urethra while you exercise
• Medication– Your GP may prescribe an antidepressant which can increase the muscle tone of your urethra to help keep it closed. Other medications may include antimuscarinic medicines to help overactive bladders and others which help your bladder muscles to relax so that they can better store urine. If you’re suffering from nocturia, a condition that causes the need to pee frequently at night, you may be prescribed desmopressin or a loop diuretic.

If the above treatments are unsuccessful or unsuitable, you may be recommended surgery and other procedures. Should you wish to have children, you may be recommended to wait until afterwards since some surgeries can fail from the physical strain of pregnancy and childbirth.

Surgeries and procedures for Urinary Incontinence include:

• Colposuspension – This is where a small cut is made in your lower tummy to help prevent involuntary urine leakage
• Sling surgery – This procedure makes a small cut in your lower tummy and vagina to place a sling around the bladder neck to offer support and prevent urine leakage
• Vaginal mesh surgery – Also called tape surgery, this permanent procedure places a strip of synthetic mesh behind the urethra to provide support
• Urethral bulking agents – Suitable if you have a vagina, this substance is injected into the urethra walls to allow it to stay closed with more force. Since this procedure doesn’t require any cuts, it is considered a less invasive procedure for people with a vagina
• Artificial urinary sphincter – More suitable for people with a penis, this procedure fits an artificial urinary sphincter (a ring of muscle that prevents urine from flowing) to prevent your bladder from leaking urine
• Botulinum toxin A injections – This treatment injects Botulinum toxin A into the sides of your bladder to treat urge incontinence and overactive bladder syndrome. Since these injections last only for several months, they may need to be repeated
• Sacral nerve stimulation – This inserts a device near one of your sacral nerves to send an electric current. This helps the sacral nerves, located at the base of your back, to improve the signals between your brain and bladder muscles
• Posterior tibial nerve stimulation – This treatment inserts a very thin needle through the skin of your ankle to send a mild electric current through to it. The treatment may include 12 sessions and is believed to offer relief from urge incontinence and overactive bladder syndrome
• Augmentation cystoplasty – This operation enlarges your bladder by adding a piece of tissue from your intestine into the bladder wall. Following this procedure, you may need to use a catheter
• Urinary diversion – This treatment involves redirecting the tubes that lead from your kidneys to your bladder (ureters) so that urine doesn’t flow through to the bladder. Instead, it is sent outside of the body and collected into a bag
• Clean intermittent catheterisation (CIC) – This treatment teaches you how to pass a catheter through your urethra and into your bladder so that urine can flow through the catheter and into the toilet. Depending on your circumstances, you may be required to do this once or several times a day
• Indwelling catheterization – If occasional catheter use is not enough to treat your condition, this treatment inserts an indwelling catheter that collects your urine in a bag and stays in place.

Living with Urinary Incontinence

If you are suffering from Urinary Incontinence but feel you are able to live with the symptoms, there are many ways to make your life easier and reduce embarrassment. These include:

• Using bed and chair protectors and special hygiene and skincare products
• Wearing specially adapted clothing and swimwear, pull-up pants or absorbent pads in your underwear to soak up urine
• Using catheters and penile sheaths
• Doing pelvic floor exercises to strengthen your muscles and reduce leaks
• Cutting down on alcohol and caffeine
• Stopping smoking
• Losing excess weight
• Avoiding lifting
• Drinking plenty of water
• Avoiding spicy and acidic foods

Urinary Incontinence FAQs

It’s natural to have questions about Urinary Incontinence. Here are the answers to some FAQs.

Why do I need to pee so much?

If you’re experiencing frequent urination, this could be the result of a Urinary Tract Infection, which is the most common cause of the frequent need to pee. Other causes include urinary incontinence, diabetes, diabetes insipidus, diuretics, painful bladder syndrome, pregnancy, kidney stones, too much alcohol or coffee, menopause, constipation, and sleep apnea. Or put simply, you could be consuming too much fluid.

Why am I peeing so much all of a sudden?

If you find yourself peeing so much all of a sudden, you may have urge incontinence or another type of condition. It is recommended that you visit your GP if you are concerned or if it is affecting your day-to-day life.

How to stop needing a wee?

If you are suffering from urge incontinence, you may find that stopping or reducing your alcohol or caffeine intake may help. You may also find that avoiding lifting, stopping smoking to avoid coughing and sipping water slowly instead of gulping it makes a difference.

You can also train your bladder to hold more urine for longer periods of time by doing kegel exercises. Simply squeeze your pelvic muscles for 10 seconds, release and repeat on a regular basis. You’ll need to do this regularly for at least three months to notice a difference. Increasing your fibre intake to avoid constipation and losing weight to reduce pressure on your bladder may also help.

What causes frequent urination in females?

Age, medical conditions, infections and lifestyle habits all contribute to the need to urinate frequently. But in females, the condition can also be caused by pregnancy, decreased estrogen (during menopause, for example), vaginitis and weakened pelvic floor muscles (as a result of childbirth, for example).

Join Carecircle for free and find help, hope, and control with your Urinary Incontinence diagnosis. Our global network for health makes you part of a worldwide community where your voice matters. Together, we can work toward a better future.

Urinary Incontinence Resources

If you’re suffering from the effects of Urinary Incontinence, you may find the following resources and links useful:

• Urinary Incontinence – NHS
• Bladder & Bowel UK
• Urinary and bowel incontinence help and advice – Age UK
• Bladder & Bowel Community

Urinary Incontinence is a condition that weakens the strength of your bladder and causes involuntary urination. The condition varies in severity and can be caused by a number of factors including medical issues, infections, pregnancy and weak pelvic floor muscles. Depending on the cause and type of Urinary Incontinence, the condition can be temporary and relieved by various treatments including losing weight and stopping certain medications.

Guide Sources

• https://www.nhs.uk/conditions/urinary-incontinence/
• https://www.mayoclinic.org/diseases-conditions/urinary-incontinence/symptoms-causes/syc-20352808
• https://www.urologyhealth.org/urology-a-z/u/urinary-incontinence
• https://www.webmd.com/urinary-incontinence-oab/ss/slideshow-incontinence-frequent-pee
• https://www.webmd.com/urinary-incontinence-oab/oab-tips