What is urinary incontinence?

What is urinary incontinence?

Urinary incontinence is when pee (urine) leaks out accidentally. Urinary incontinence is common, affecting millions of people in the UK. That does not mean you have to just live with it. There are lots of things you can do to help your incontinence. There are also changes you can make to stop it happening.

There are different types of urinary incontinence. The most common are:

• Stress urinary incontinence. Pee leaks out when you sneeze, cough or exercise.
• Urgency urinary incontinence. You leak when you urgently need to pee. Other signs of this are peeing more often by day and at night.

What causes urinary incontinence? 

Different types of incontinence have different exact causes.

Stress incontinence can be caused by weakened muscles around the urethra. These are called the pelvic floor muscles. They can be damaged during pregnancy or childbirth. You may also have weaker pelvic floor muscles if you have a high body mass index (BMI). This is because extra weight puts pressure on the muscles.

Urge incontinence can happen when the muscles that control your bladder (detrusor muscles) suddenly become too active. However, the cause is often unknown.

You might be more at risk of incontinence if you:

• have been pregnant, especially if you had a vaginal birth,
• have had surgery in your pelvis (for example a hysterectomy)
• have a high BMI
• are going through or have been through the menopause

Some medications and medical or physical conditions can also cause bladder problems.

Urinary incontinence is more common in older people. But it does not mean it has to be a part of getting older. You can get help whatever age you are.

Can urinary incontinence be prevented?

You might not be able to stop all urinary incontinence from happening. But there are things that can help reduce your risk of having incontinence.

You’re less likely to have urinary incontinence if you:

• Keep to a healthy weight
• Cut down on drinks containing alcohol or caffeine
• Do pelvic floor exercises

You can learn more about your pelvic floor and how to do pelvic floor exercises in our webinar:

How is urinary incontinence diagnosed?

If you have any kind of urinary incontinence, go and see your GP. They will:

• Ask you more about it and your medical history.
• Examine you. They may check your vagina. Your GP should talk you through what this involves and ask if you are comfortable with this. They will also ask if you would like someone else in the room with you during the examination.
• Do a urine test to rule out a UTI (urinary tract infection).
• Ask you to keep a diary of your symptoms.

The GP might refer you on for further tests and scans at the hospital. This could be to check how well your bladder and urethra are working.

How is it treated?

There are treatments that can help improve urinary incontinence.

These include:

• Pelvic floor muscle training
• Medication
• Bladder training

What can I do to help myself?

If you’re diagnosed with incontinence, your GP will suggest some lifestyle changes to help improve your symptoms. They may suggest you:

• Cut down on caffeine and alcohol
• Drink six to eight glasses of fluids a day
• Be as active as possible
• Eat a balanced diet to help you keep to a healthy weight
• Stop smoking. The coughing that smoking causes puts pressure on your pelvic floor muscles.

If lifestyle changes and treatments are not helping, go back and speak to your GP. You could ask for a referral to a hospital specialist, such as a urologist or gynaecologist.

Some people may need to have an operation.

Living with urinary incontinence 

Being diagnosed with urinary incontinence can be upsetting. Aside from all the changes you can make to help yourself, there is other help available.

Your local NHS trust should run a continence service to give you the support you need. You can do a web search for your local service and may be able to ask for help from them yourself (self-refer). Or you could ask your GP to refer you. A trained specialist can do a full assessment and provide free incontinence pads, incontinence pants or other products. These can be a big help, especially if you are waiting for other treatments.

You can also get a Just Can’t Wait Card, so you can use toilets in cafes and shops when you’re out.

Getting support

The NHS has lots of information about urinary incontinence.

You can get more advice and tips on lifestyle changes from NHS Better Health

If you need support, Bladder & Bowel UK runs a closed Facebook group.

Our health information pages are reviewed by medical experts and people with personal experience of health conditions. We are grateful to Sue McClenaghan for reviewing this page.