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Incontinence, urinary

Introduction

[Original article on NHS Choices website]

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

It is not clear exactly how many people are affected, but it is estimated that between three and six million people in the UK have some degree of urinary incontinence.

Urinary incontinence affects about twice as many women as men and becomes more common with age.

What are the symptoms of urinary incontinence?

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

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

stress incontinence – when the pelvic floor muscles are too weak to prevent urination, causing urine to leak when your bladder is under pressure, for example when you cough or laugh
urge incontinence – when urine leaks as you feel an intense urge to pass urine, or soon afterwards

These two types of urinary incontinence are thought to be responsible for over 9 out of 10 cases. 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 of condition.

Stress incontinence is usually the result of the weakening or damaging of the muscles that are 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
family history of incontinence
increasing age

Read more about the causes of urinary incontinence.

How is it diagnosed?

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.

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

If your GP thinks a urinary infection might be the underlying cause, they will test a sample of your urine.

Read more about diagnosing urinary incontinence.

How is urinary incontinence treated?

Urinary incontinence can be an uncomfortable and upsetting problem. Though it is more common as you get older, many people wrongly believe that it is an inevitable part of ageing.

There are several forms of effective treatment, including:

lifestyle changes, such as losing weight
pelvic floor muscle training (exercising your pelvic floor muscles by squeezing them)
bladder training, so you can wait longer between needing to urinate and passing urine

If these measures are not effective, medication may be used to treat stress and urge incontinence.

You may also benefit from the use of incontinence products, such as absorbent pads and hand-held urinals (urine collection bottles).

If these treatments are not successful, a number of different surgical techniques can be considered.

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 can include the enlargement of the bladder or the implanting of a device that stimulates the nerve that controls the detrusor muscles.

Preventing urinary incontinence

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

controlling your weight
reducing or stopping your alcohol consumption
keeping fit

Read more about preventing urinary incontinence.