Urinary Incontinence

Please note: the information below does not constitute medical advice. If you have any concerns at all, speak to your GP or consultant.

Approved: April 2024

Review date: April 2026

About urinary incontinence

An estimated 6 million adults in the UK experience continence issues.

What is it?

Urinary incontinence is the involuntary loss of urine. It can range from occasional leakage such as a cough or sneeze through to leakage before accessing a toilet.

What causes it?

There are many reasons why people might experience urinary incontinence. These include weak pelvic floor muscles, nerve damage, hormonal changes, certain medications, urinary tract infections (UTIs), and underlying medical conditions such as diabetes or neurological disorders such as multiple sclerosis. Instances of incontinence also increase with age.

The most common forms are:

  • Stress incontinence – accidental loss of urine that occurs when coughing, sneezing, laughing, or exercising
  • Urge incontinence – strong and sudden urges to urinate accompanied with, or closely followed by, some leakage
  • Mixed incontinence – a combination of the symptoms of stress and urge incontinence
  • Overflow incontinence – an overfill of the bladder causing leakage

Why does it happen?

Urinary incontinence can happen for a number of reasons:

  • Stress incontinence happens when the muscles used to contain urine in the bladder are weakened to the point that the bladder cannot withstand any extra pressure put on it. This is why urine escapes when coughing or sneezing.
  • Urge incontinence occurs when bladder muscles contract in an uncontrolled manner. The contraction of these muscles causes unplanned urination.
  • Overflow incontinence occurs when the bladder muscles cannot push urine out of the bladder completely, or a blockage stops the bladder from emptying properly. The remaining urine eventually builds up and leaks out.

Diagnosing urinary incontinence

Many people are reluctant or embarrassed to discuss their toilet habits and often tolerate their symptoms. However, incontinence is a common condition and there are multiple ways to manage it. Therefore, it is important to consult the GP or healthcare professional to discuss treatment plans.

In a typical consultation, the GP will discuss your general health, medical history and urinary habits. Physical examinations, such as urine tests, are an integral part of the GP’s examination.

If the results of the consultation prove inconclusive, the GP may recommend a referral for further investigation. This might include ultrasound scans, cystoscopies (examinations of the bladder using a small camera),urinary flow studies, or urodynamic tests (examinations testing bladder storage and ability to urinate).

Treating urinary incontinence

Treatment for urinary incontinence will depend on the type of incontinence and the symptoms. Non-medical and moderate treatments to improve bladder control are usually explored first and might include lifestyle changes such as:

  • Avoiding certain foods and caffeinated drinks and alcohol,
  • Drinking fluids in moderation, especially before bed
  • Stopping smoking
  • Weight loss

Other recommendations might include:

  • Pelvic floor exercises
  • Retraining the bladder to pass urine less often

If these are ineffective, other options include:

  • Medication
  • Intravaginal devices to support the urethra for stress leakage
  • Self catherisation for overfilled bladders
  • Intravesicle botulinum toxin for overactive bladder leakage
  • Sacral Nerve stimulation ( SNS) to help reduce overactive symptoms
  • Surgery – a number of surgical operations can be performed that give extra support to the bladder and urethra, reducing accidental leakage.

Clinical trials

For general information about clinical trials, including what they are and advice on how to find a clinical trial, click here.

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