Urinary incontinence is the unintentional passing of urine (peeing). It's a common problem that affects millions of people.
Types of urinary incontinence
There are several types of urinary incontinence, including:
- stress incontinence - when urine leaks out when physical pressure is placed on your bladder (for example, when you cough or laugh)
- urge incontinence - when urine leaks as you feel a sudden, intense urge to pee, or soon afterwards
- overflow incontinence - when you're unable to fully empty your bladder, causing pee to spill out
- continuous incontinence - when your bladder cannot store any urine at all, causing you to leak all the time
It's also possible to have a mix of stress incontinence and urge incontinence.
When to seek medical advice
Non-urgent advice: Talk to your GP if:
you have any type of urinary incontinence
Urinary incontinence is a common problem. Try not to feel embarrassed talking about your symptoms. This can be the first step towards finding a way to manage the problem.
Urinary incontinence can usually be diagnosed after a consultation with your GP. They will ask about your symptoms. They may carry out a pelvic examination (in women) or rectal examination (in men).
Your GP may also suggest you keep a diary to write down:
- how much fluid you drink
- how often you have to pee
Causes of urinary incontinence
The following things can cause urinary incontinence.
This can happen when the muscles that prevent peeing are weakened or damaged. For example, the pelvic floor muscles and urethral sphincter.
This can be caused by overactivity of the native detrusor muscles of the bladder. These muscles normally control the storage and releasing of urine from the bladder.
This is often caused by an obstruction or blockage to your bladder. The blockage prevents it emptying fully, causing urine to overflow from the full bladder.
This may be caused by:
- a problem with the bladder from birth
- a spinal injury
- a bladder fistula (a small, tunnel-like hole that can form between the bladder and a nearby area, such as the vagina, in women)
Certain things can increase your chances of developing urinary incontinence.
- pregnancy and vaginal birth
- a family history of incontinence
- increasing age - but incontinence is not always part of ageing
- brain and spinal cord disease
Treating urinary incontinence
Your GP may suggest some simple measures to improve your symptoms. They may also refer you to an advisor on urine incontinence or a hospital specialist.
- lifestyle changes such as losing weight or cutting down on caffeine and alcohol
- pelvic floor exercises – taught by a specialist, this involves squeezing your pelvic floor muscles to exercise them
- bladder training – where you learn ways to wait longer between needing to pee and peeing
You can also use incontinence products, such as absorbent pads and handheld urinals.
Medicine may also be recommended if you're still unable to manage your symptoms.
Surgery for urinary incontinence
Surgery may also be considered. The type of procedure will depend on the type of incontinence you have.
Surgery such as sling procedures are used to reduce pressure on the bladder. They may also be used to strengthen the sphincter muscles that control peeing.
You can have surgery to enlarge your bladder or implant a device. The device stimulates the nerve that controls the detrusor muscles. Muscle relaxants may also be injected directly into the bladder muscle.
Preventing urinary incontinence
It's not always possible to prevent urinary incontinence. But there are steps you can take that may help to reduce your chances of developing it.
- controlling your weight
- avoiding or cutting down on alcohol
- keeping fit – in particular, making sure that your pelvic floor muscles are strong
Being obese can increase your risk of developing urinary incontinence. To lower your risk, keep a healthy weight through regular exercise and healthy eating.
Use the Safe Food Ireland BMI calculator to see if you are a healthy weight for your height.
Depending on your bladder problem, your 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. These can cause your kidneys to produce more urine and irritate your bladder.
If you have to pee a lot during the night (nocturia), try drinking less in the hours before you go to bed. But make sure you still drink enough fluids during the day.
Pelvic floor exercises
Being pregnant and giving birth can weaken the bladder muscles. If you're pregnant, strengthening your pelvic floor muscles may help prevent urinary incontinence.
Men may also benefit from strengthening their pelvic floor muscles.
Content supplied by the NHS and adapted for Ireland by the HSE