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.
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.
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
- 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
Last updated: 30 April 2015
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