Incontinence - Urinary

How common is urinary incontinence?

It is thought that more than three million people in the UK may suffer from urinary incontinence. People of all ages can have difficulty controlling their bladders, whether they are school children or grandparents, men or women, otherwise healthy individuals or those with some disability. The condition tends to be more common in women than in men. Some people find that they need to go to the toilet at frequent intervals during the day and night while others may experience regular accidents.

How can people tell if they have urinary incontinence?

Most people need to empty their bladders no more than seven times a day and only once a night. They can consciously control when and where this process takes place. People with urinary incontinence are sometimes unable to control their bladders and release urine at the wrong time.

Is there more than one type of urinary incontinence?

There are several different types of urinary incontinence:

  • Stress incontinence - this is when the bladder leaks small amounts of urine as a result of stress. Confusingly the use of the word "stress" does not mean mental stress - it refers to the physical stress or pressure that sudden movements place on the muscles supporting the bladder. Such sudden movements include coughing, sneezing, laughing, lifting or any sudden physical exercise.
  • Unstable bladder - there are several symptoms of an unstable or overactive bladder. Some people with an unstable bladder need to go to the toilet frequently - more than seven times during the day and more than once at night (this is referred to as urinary frequency). Others experience a very strong urge to go to the toilet with no advance warning (this is referred to as urgency). Sometimes this urge is so strong that they are unable to delay passing water long enough to reach the toilet (this is referred to as urge incontinence).
  • Mixed incontinence - individuals who suffer from both stress incontinence and urge incontinence are described as having mixed incontinence.
  • Overflow incontinence - this occurs when the bladder does not empty properly. As a result, the quantity of urine in the bladder builds up over time eventually causing it to overflow. This type of incontinence is more common in men and is often the result of something blocking the bladder opening (such as an enlarged prostate).

Will I need any tests?

Your doctor or practice nurse will ask some questions about your bladder problems and your medical history. You may need an examination and a the doctor may test a sample of your urine. Your doctor may prescribe a course of treatment or refer you to a hospital specialist for further tests to find the cause of your bladder problems.

What can be done about urinary incontinence?

There are a number of ways in which urinary incontinence can be managed, from simple measures such as pelvic floor exercises to surgical procedures or drug therapy.

  • Exercise - sometimes something as simple as doing special exercises to strengthen the pelvic floor muscles, or retraining the bladder to hold on for longer, is all that is needed. There are special devices available which may help with this (eg, Aquaflex®, Kegel8® and PelvicTonerTM).
  • Medicine - some drugs can relieve and control the troublesome symptoms of an unstable bladder. Your doctor may prescribe one of the following drugs: darifenacin (Emselex®), fesoterodine (Toviaz®), mirabegron (Betmiga®), oxybutynin (eg, Cystrin®, Ditropan®, Kentera®, Lyrinel® XL), propiverine (Detrunorm®), solifenacin (Vesicare®), tolterodine (eg, Detrusitol®, Efflosomyl XL®, Mariosea XL®, Neditol XL®, Preblacon XL®, Santizor XL®), trospium (eg, Regurin®, Flotros®) or flavoxate (Urispas®). If you are suffering from stress incontinence your doctor may prescribe a medicine called duloxetine (eg, Yentreve®). If your doctor thinks you have a urinary tract infection he or she may prescribe an antibiotic to treat it.
  • Botulinum toxin - if medications are ineffective, injections of botulinum toxin into the bladder muscle may be tried.
  • Surgery - there are straightforward surgical procedures that can help to control bladder problems. These include operations to repair weakened muscles or remove any blockage from the bladder
  • Special products - if the underlying problem cannot be controlled, special products such as pants, pads, collection devices, chair and bed protection allow people to go on living normal lives

Help yourself

  • Watch your weight - being overweight makes urinary incontinence more likely
  • Women, practice your pelvic floor exercises - particularly before and after having a baby
  • Eat plenty of fresh fruit, vegetables and fibre to prevent constipation
  • Stop smoking - a chronic cough can cause incontinence
  • Don't drink too much liquid, although it is important to drink at least eight cups of water or soft drinks a day
  • Don't drink too much tea, coffee or alcohol - they can make you pass more urine

Further information available from:

The Continence Foundation

Factsheet provided by MIMS

Date last reviewed: March 2016

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