Urinary incontinence is when the normal process of storing and passing urine is disrupted. This can happen for several reasons. Certain factors may also increase your chance of developing urinary incontinence. Some of the possible causes lead to short-term urinary incontinence, while others may cause a long-term problem. If the cause can be treated, this may cure your incontinence. Stress incontinence is when the pressure inside your bladder as it fills with urine becomes greater than the strength of your urethra to stay closed. Your urethra is the tube that urine passes through to leave the body. Any sudden extra pressure on your bladder, such as laughing or sneezing, can cause urine to leak out of your urethra if you have stress incontinence. Your urethra may not be able to stay closed if the muscles in your pelvis (pelvic floor muscles) are weak or damaged, or if your urethral sphincter – the ring of muscle that keeps the urethra closed – is damaged. Problems with these muscles may be caused by: The urgent and frequent need to pass urine can be caused by a problem with the detrusor muscles in the walls of your bladder. The detrusor muscles relax to allow the bladder to fill with urine, then contract when you go to the toilet to let the urine out. Sometimes the detrusor muscles contract too often, creating an urgent need to go to the toilet. This is known as having an overactive bladder. The reason your detrusor muscles contract too often may not be clear, but possible causes include: Overflow incontinence, also called chronic urinary retention, is often caused by a blockage or obstruction affecting your bladder. Your bladder may fill up as usual, but because of an obstruction, you will not be able to empty it completely, even when you try. At the same time, pressure from the urine that's left in your bladder builds up behind the obstruction, causing frequent leaks. Your bladder can be obstructed by: Overflow incontinence may also be caused by your detrusor muscles not fully contracting, which means your bladder does not completely empty when you urinate. As a result, the bladder becomes stretched. Your detrusor muscles may not fully contract if: Total incontinence is when your bladder cannot store any urine at all. It can mean you either pass large amounts of urine constantly, or you pass urine occasionally with frequent leaking in between. Total incontinence can be caused by: Some medicines can disrupt the normal process of storing and passing urine or increase the amount of urine you produce. These include: Stopping these medicines, if advised to do so by a doctor, may help resolve your incontinence. In addition to common causes, some things can increase your risk of developing urinary incontinence without directly being the cause of the problem. These are known as risk factors. Some of the main risk factors for urinary incontinence include:
Page last reviewed: 07 November 2019 Urinary incontinence is the unintentional passing of urine. It's a common problem thought to affect millions of people. There are several types of urinary incontinence, including: It's also possible to have a mixture of both stress and urge urinary incontinence. Find out more about the symptoms of urinary incontinence. See a GP if you have any type of urinary incontinence. Urinary incontinence is a common problem and you should not feel embarrassed talking to them about your symptoms. This can also be the first step towards finding a way to effectively manage the problem. Urinary incontinence can usually be diagnosed after a consultation with a GP, who will ask about your symptoms and may do a pelvic or rectal examination, depending on whether you have a vagina or a penis. The GP may also suggest you keep a diary in which you note how much fluid you drink and how often you have to urinate. Find out about diagnosing urinary incontinence. Stress incontinence is usually the result of the weakening of or damage to 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. Overflow incontinence is often caused by an obstruction or blockage in your bladder, which prevents it from emptying fully. Total incontinence may be caused by a problem with the bladder from birth, a spinal injury, or a small, tunnel like hole that can form between the bladder and a nearby area (fistula). Certain things can increase the chances of urinary incontinence, including:
Find out more about the causes of urinary incontinence. Initially, a GP may suggest some simple measures to see if they help improve your symptoms. These may include:
You may also benefit from the use of incontinence products, such as absorbent pads and handheld urinals. Medicine may be recommended if you're still unable to manage your symptoms. Find out more about non-surgical treatments for urinary incontinence. Surgical treatmentsSurgery may also be considered. The procedures that are suitable for you will depend on the type of incontinence you have. Surgical treatment for stress incontinence, such as a sling procedure, is used to reduce pressure on the bladder or strengthen the muscles that control urination. Surgery to treat urge incontinence includes enlarging the bladder or implanting a device that stimulates the nerve that controls the detrusor muscles. Find out more about surgery and procedures for urinary incontinence. It's not always possible to prevent urinary incontinence, but there are some steps you can take that may help reduce the chance of it happening. These include:
Healthy weightBeing obese can increase your risk of urinary incontinence. You may be able to lower your risk by maintaining a healthy weight through regular exercise and healthy eating. Use the healthy weight calculator to see if you are a healthy weight for your height. Get more information and advice about losing weight. Drinking habitsDepending on your particular bladder problem, a GP can advise you about the amount of fluids you should drink. If you have urinary incontinence, cut down on alcohol and drinks containing caffeine, such as tea, coffee and cola. These can cause your kidneys to produce more urine and irritate your bladder. The recommended weekly limit for alcohol consumption is 14 units. A unit of alcohol is roughly half a pint of normal strength lager or a single measure (25ml) of spirits. Find out more about alcohol units. If you have to urinate frequently during the night (nocturia), try drinking less in the hours before you go to bed. However, make sure you still drink enough fluids during the day. Pelvic floor exercisesBeing pregnant and giving birth can weaken the muscles that control the flow of urine from your bladder. If you're pregnant, strengthening your pelvic floor muscles may help prevent urinary incontinence. Find out more about exercise during pregnancy. Everyone may benefit from strengthening their pelvic floor muscles with pelvic floor exercises. Find out more about pelvic floor exercises.
If you:
Our guide to social care and support explains your options and where you can get support.
Page last reviewed: 07 November 2019 Page 2 For many people with urinary incontinence, the following self-help tips and lifestyle changes are enough to relieve symptoms. Pelvic floor exercises can be effective at reducing leaks, but it's important to do them properly. Find out how to do pelvic floor exercises. You may have to do pelvic floor exercises for 3 months before you see any benefits. If you smoke, you put yourself at risk of incontinence, because coughing puts strain on your pelvic floor muscles. Find out about NHS Smokefree support services, or call the Smokefree National Helpline to speak to a trained adviser on 0300 123 1044 from Monday to Friday 9am to 8pm and Saturday and Sunday 11am to 4pm. Find out more about how to stop smoking. High-impact exercise and sit-ups put pressure on your pelvic floor muscles and can increase leaks. To strengthen your pelvic floor to relieve symptoms, replace high-impact exercise, such as jogging and aerobics, with strengthening exercise, such as pilates. Pilates strengthens your core muscles, which is beneficial for stress incontinence. Lifting puts strain on your pelvic floor muscles, so avoid it whenever you can. When you do need to lift something, such as picking up children or shopping bags, tighten your pelvic floor muscles before and during the lift. Being overweight can weaken your pelvic floor muscles and cause incontinence because of the pressure of fatty tissue on your bladder. Your symptoms may improve, and could go away completely, if you lose any excess weight. Use the healthy weight calculator to check you're a healthy weight for your height. Find out more about how to lose weight. Straining to poo weakens your pelvic floor muscles and makes urinary incontinence worse. Never ignore the urge to poo. If you have constipation, it may help to change your diet and lifestyle. Eating more fibre and exercising more can help. It may also help if you change the way you sit and use your muscles to empty your bowels. A specialist physiotherapist can advise you on this. Find out more about how to have a healthy diet. Caffeine irritates the bladder and can make incontinence worse. Coffee has the biggest effect, so stop drinking it or switch to decaffeinated coffee. Fizzy drinks, tea, green tea, energy drinks and hot chocolate also contain caffeine, so cut down on these too and replace them with water and herbal or fruit teas. Alcohol is a diuretic, which makes you urinate more often. Cutting down may help incontinence symptoms. Find out more about how to cut down on alcohol. Drink 6 to 8 glasses of fluid a day (but no more) unless your doctor advises you otherwise. Many people with urinary incontinence avoid drinking fluids, as they feel it causes more problems. However, limiting your fluid intake makes incontinence worse, because it reduces your bladder's capacity. Not drinking enough fluid can also cause constipation or make it worse. Find out which are the healthiest drinks. Avoid spicy and acidic foods, such as curries and citrus fruits, as they can irritate the bladder and make leaks and other incontinence symptoms worse.
Page last reviewed: 07 November 2019 |