Urinary incontinence 

Introduction 

Urinary incontinence

Stress, childbirth and age can all cause incontinence. Get expert advice on treatments, including pelvic floor exercises, medication and surgery.

Media last reviewed: 18/03/2013

Next review due: 18/03/2015

How we pass urine

Urine passes from the kidneys through tubes called ureters to the bladder, where it is stored.

The bladder is supported by pelvic floor muscles. Some of this muscle wraps around the urethra – the tube that runs from the bladder to outside the body – to help keep it closed until you need to pass urine.

Once the bladder is full, a signal is sent to the brain that you need to pass urine. When you are ready, the brain tells the pelvic floor muscles to relax and open the urethra. The muscles around the bladder contract and push the urine out.

A problem in any part of this process can result in urinary incontinence.

Urinary incontinence is the unintentional passing of urine. It is a common problem and is thought to affect millions of people worldwide.

It's not clear exactly how many people are affected, but it's estimated that between 3 and 6 million people in the UK may have some degree of urinary incontinence.

Urinary incontinence affects both men and women, but it tends to be more common in women overall.

Signs and symptoms

The symptoms of urinary incontinence depend on the type you have.

There are several types of urinary incontinence, but the most common are:

  • 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

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

Read more about the symptoms of urinary incontinence.

What causes urinary incontinence?

The causes of urinary incontinence depend on the type.

Stress incontinence is usually the result of the weakening or damaging of 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.

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 more about the causes of urinary incontinence.

Seeking medical advice

Although you may feel embarrassed talking to someone about your symptoms, it's a good idea to see your GP if you have any type of urinary incontinence as this can 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 more about diagnosing urinary incontinence.

How urinary incontinence is treated

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 help you can 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 hand-held urinals (urine collection bottles).

If you are still unable to manage your symptoms, medication may be recommended. 

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 tape or 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 more about non-surgical treatments for urinary incontinence and surgery and procedures for urinary incontinence.

Preventing urinary incontinence

It is not always possible to prevent urinary incontinence, but there are some steps you can take that may help reduce the chance of it developing, such as:

  • controlling your weight
  • avoiding or cutting down on alcohol
  • keeping fit – in particular, ensuring that your pelvic floor muscles are strong

Read more about preventing urinary incontinence.




Page last reviewed: 06/10/2014

Next review due: 06/10/2016

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The 1 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Pearshaped3573 said on 12 November 2014

I suffer from very bad stress incontinence, and have done for years. I finally plucked up the courage to go see a female GP, and I now have a referral to the hospital. I know it feels like such a shameful / debilitating condition that no one wants to talk about. But I would love to find other women with this condition. From women who have been successfully treated, ones half way through treatment, and most importantly from women who are suffering from this condition who feel to embarrassed/ashamed to go see their GP. A tip I found was it was so much easier speaking about it to a Dr I had never seen. There wasn't the built up relationship, and I didn't feel like I would be judge. Even though the Dr's will know just how many women are suffering without saying a word. And obviously they can't tell by just looking at you. I hope we can get a group of strong women together, who can support each other through the rough days, and more importantly the good days. I look forward to listening to you soon. I'm here to offer support to anyone who may take some comfort in speaking to someone unknown.

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