Urinary incontinence

Urinary incontinence is a loss of bladder control, which means
you sometimes pee unintentionally. It’s estimated that more than 3 million people in the UK experience urinary incontinence – so if you do, you're not alone. It can be uncomfortable to talk about, but it's nothing to be embarrassed about.

What are the types of urinary incontinence?

There a number of different types of urinary incontinence. We've explained the 2 most common types below. 

Stress incontinence 

Stress incontinence is when you pee a bit when you cough, sneeze, laugh or exercise – including more gentle exercise such as walking. It’s caused by a weak bladder outlet and weakness of the pelvic floor muscles that support it.

Urge incontinence 

Urge incontinence is when you need to pee so suddenly and urgently that it’s difficult to get to the toilet in time. You might also need to go more often than usual (known as ‘increased frequency’), which might wake you several times at night.

What causes urinary incontinence?

There are many causes of incontinence, some of which differ for men and women.

What causes stress incontinence?

Men may develop stress incontinence after a prostate operation. However, stress incontinence is more common in women because the pelvic floor muscles, which support the bladder, uterus and large bowel, can be stretched and weakened during childbirth. This can lead to a prolapse (when these organs slip). After menopause, the body stops producing the hormones that help keep the vagina and bladder outlet healthy too.

What causes urge incontinence?

Urge incontinence is often caused by an overactive bladder. As you get older, it’s common to find that your bladder needs emptying more often and gives you less warning. This is normal – until it affects your everyday life or starts to cause incontinence. Then it’s time to talk to a healthcare professional.

The reason for an overactive bladder is often unknown. Sometimes it happens after a stroke. You can also be prone to urge incontinence if you have a condition that affects the nerves linked to the bladder, such as Parkinson’s.

It’s possible to experience symptoms of both stress and urge incontinence – this is called mixed incontinence.

Some other common causes of urinary incontinence include: 

• being overweight
• certain medications
• enlarged prostate (in men)
• certain health conditions that impact the brain or nervous system (such as Parkinson's).

What are the symptoms of urinary incontinence?

The symptoms of urinary incontinence differ from person to person – some people have the occasional leak, while others can completely lose control of their bladder. 

Common symptoms of urinary incontinence include the following: 

• peeing a little when coughing, sneezing, laughing or exercising 
• not being able to get to the toilet in time
• needing to pee frequently or urgently 
• finding it difficult to start peeing 
• wetting the bed when asleep 
• a feeling that the bladder doesn't empty completely.

How is urinary incontinence diagnosed?

If you have a problem with your bladder, talking to a doctor or other healthcare professional is the best way to get help.

At your appointment, you'll be asked questions about your symptoms and you might be examined. You'll also find out about what treatment or exercises may help cure or tackle the problem – or at the very least minimise its effect on your daily life.

A healthcare professional might ask you some questions and do some tests to help them understand how your bladder works. These can include:

• a diary of your bladder habits
• a physical examination to assess your bladder, pelvic floor muscles or prostate
• a sample of your pee for testing
• a blood test to check the health of your kidneys
• an ultrasound scan of your bladder.

In some cases, your doctor might find that the cause of your incontinence is a temporary problem, such as a urine infection, which can often be treated quickly and easily with antibiotics.

How is urinary incontinence treated?

The solutions your doctor or other health professional suggests will depend on the type of problem you’re experiencing. What works will vary from person to person, and sometimes more than one treatment will be needed.

We've listed some common types of available treatment below. 

Pelvic floor exercises

These help you strengthen the muscles surrounding the bladder. A specialist nurse or continence physiotherapist can help you get the hang of these exercises, but there's also equipment that can help you if you find them difficult. 

Bladder training

Bladder training involves learning techniques to hold pee for longer so that you need to use the toilet less often and gain greater control of your bladder. This is often best for people with urge incontinence.

Medication

Talk to your doctor or pharmacist about what medication might help your problem and what side effects there might be.

Surgery

For some people, surgery may be an option if other treatments haven’t worked.

How can incontinence products help me?

Treatment doesn’t always stop incontinence completely – but the right continence products can help you manage the problem and reduce its impact on your daily life. Some unisex products include the following:

• washable products such as re-usable pads, which often come as part of a pair of pants
• disposable pads which are held in place by close-fitting pants
• disposable pants, or all-in-one pads with plastic backing and adhesive patches to seal the sides (these are generally more suitable for heavy incontinence)
• bed or chair protectors in the form of disposable or washable pads
• for men, there are a range of products that fit over the penis and collect pee into a bag strapped to the leg.

You can buy many continence products in pharmacies and supermarkets – but you should seek professional advice before using them permanently. It’s important to identify the cause of your problem as there may be treatment that can help.

To qualify for free incontinence products provided by the NHS, you’re likely to need to meet criteria set out by your local NHS continence service. If you're assessed as eligible, you should receive a supply of continence products free of charge. The doctor or healthcare professional will explain what type of products and devices are available.

What are some tips for living well with incontinence?

There are lots of things you can do to manage your incontinence problems and live well on a daily basis. 

Be prepared

Try thinking of practical solutions to problems that might arise while you’re out. You could take some spare pads and pants with you. Scented bags for soiled pads or pants could be useful if you’re worried about smell.

You may find a toilet card helpful. The ‘I Can’t Wait’ Toilet Card states clearly that you have a medical condition and that you need to use a toilet urgently. Showing this card can help you avoid the queue for a public toilet.

Order your free 'I Can't Wait' Vivactive Toilet card on Age Co

Take care of your skin

Washing regularly and drying carefully with a soft towel will help to keep your skin healthy. It's also a good idea to make sure you change pads regularly.

If your skin becomes red or sore, make sure that any pad fits properly and isn't rubbing. If your skin becomes raw, speak with your doctor or a nurse immediately as this could lead to a skin infection.

Change pads frequently to avoid smell

Fresh pee shouldn't smell unpleasant unless there's an infection. However, it might start to smell if it's left for long periods. Good-quality pads help to absorb some smell, but make sure to change wet pads and clothes as soon as possible.

Stay hydrated

Drink normally, unless your doctor or nurse has told you otherwise. You should aim to drink 6 to 8 cups of liquid each day. Tea, coffee and fizzy drinks can make bladder symptoms worse. It's a good idea to cut down on these drinks or try decaffeinated versions of them. Alcoholic drinks and drinks with artificial sweeteners can also irritate your bladder.

Prevent constipation

Constipation (irregular bowel movements) can put pressure on your bladder or bowel and worsen incontinence. Make sure you're eating plenty of fibre-rich foods (such as fruit and vegetables) and drinking plenty of liquid. Keeping active and exercising regularly can also help you keep regular bowel movements.

Dress for ease

Try to wear clothing with elasticated waists, or fastenings with Velcro instead of zips and buttons, as this can make it easier to dress and undress.

Plan before you travel

If you’re going on a long journey with family or friends, and you know you’ll need to use the toilet frequently, let them know beforehand. That way you can plan extra stops so you won't have to worry.

Consider home adaptations

If equipment or home adaptations, such as handrails in the bathroom or a commode, might help with your incontinence, speak to social services. You’re eligible for a free care needs assessment, conducted by your local authority, to find out what help and support you need at home.

Find out more about care needs assessments