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Urinary incontinence

7-minute read

It's not normal to unexpectedly leak urine from your bladder – but it is quite common. If you have trouble controlling your bladder, a simple lifestyle change or treatment may be all that’s needed to cure or improve it, or to help you manage.

Types of urinary incontinence

Urinary incontinence, or poor bladder control, is very common in Australia. It affects children, men and women, but is most common in older people.

There are different types of urinary incontinence, each with different causes and treatments:

Stress incontinence: Someone leaks small amounts of urine when they cough, sneeze, laugh or play sport. This happens because increased pressure inside the tummy presses down on the bladder.

It’s more common in women around the time of childbirth or after menopause. It can also happen in people who have diabetes, a chronic cough (due to asthma, smoking or bronchitis), constipation or obesity.

Urge incontinence: The person suddenly and urgently need to wee. This condition is sometimes called an unstable or overactive bladder. People with urge incontinence feel like their bladder is fuller than it actually is. They may need to wee very often, including during the night.

Urge incontinence often gets worse as they age, and can be triggered by stress or by drinking caffeine in tea, coffee and fizzy drinks or alcohol. It’s also linked to stroke, Parkinson's disease, multiple sclerosis and other health conditions that interfere in the messages sent between the bladder and the brain.

Incontinence associated with chronic retention: The bladder doesn’t empty properly so it leaks small amounts of urine. This can happen due to a blockage in the urethra (the tube leading from the bladder out of the body), an enlarged prostate, a prolapse, or damage to the nerves around the bladder or pelvic floor muscles.

The condition can be caused by some medicines and is also linked to diabetes, multiple sclerosis, stroke and Parkinson's disease.

Functional incontinence: The person can’t go to the toilet properly due to physical, intellectual or other problems – for example, they can’t walk to the toilet or can’t communicate that they need to go.

This is most common in people who have problems walking caused by conditions such as arthritis or cerebral palsy, or in people who have brain conditions such as dementia or intellectual disability.

Symptoms of urinary incontinence

Symptoms range from occasionally leaking some urine, to completely losing control of your bladder (when you wet yourself).

Other symptoms include:

  • often needing to visit the toilet urgently or frequently
  • having 'accidents'
  • leaking urine when you laugh, sneeze, cough or exercise
  • feeling that you need to strain to pass urine
  • a weak or slow urine stream
  • feeling as if your bladder is not empty just after going to the toilet
  • having little or no warning when you need to pass urine
  • passing urine while asleep
  • having a lot of urinary tract infections
  • 'dribbling' more urine after visiting the toilet

How urinary incontinence is diagnosed

The first step is to visit your doctor. They will examine you and talk about your medical history. You may need to keep a diary of your bladder habits to see what type of urinary incontinence you have. For example, you might need to write down how much you drink, how many times you go to the toilet, and when you leak.

You might also have special tests to monitor what happens to your bladder when it’s filled with water. This is called urodynamic testing.

Your doctor will rule out other health conditions that might be affecting your bladder.

Treatment for urinary incontinence

The most appropriate treatment for urinary incontinence will depend on what is causing it.

Treatment can be as simple as managing constipation or treating a urinary tract infection. You might be advised to change your lifestyle – for example by cutting back on caffeine or alcohol, losing weight, or making changes to your home so it’s easier to access the bathroom.

If the problem is with your pelvic floor muscles, physiotherapy can make a big difference. Medicine can help to relax the bladder muscles, which can help with urge incontinence.

If either medicine or physiotherapy don’t work, surgery to support your bladder and urethra is an option for some types of urinary incontinence.

There are also things you can do to reduce the impact of urinary incontinence. You can train your bladder to improve control and increase the amount of urine you can hold. Talk to your doctor or incontinence health professional about a bladder training program.

If you are caring for someone with incontinence, make sure they can access the toilet easily and that it’s clearly signposted. Make sure their clothing is easy to remove and monitor their routine so you can remind them to go to the toilet regularly. You can read more about caring for someone with incontinence on the Continence Foundation of Australia website.

Tips for living with urinary incontinence

With a little planning, you can manage your urinary incontinence so it doesn’t affect your life too much. There are many products available to help you live with incontinence, such as pads, catheters or bedding protection. Some of these are subsidised by the government.

It can help to get into a routine. Plan for outings, make sure you have enough products and spare clothes in case you have an accident, and know how to find the nearest toilet. It’s also a good idea to work out how your diet and fluids affect your symptoms.

Help and support

You can also look for local services, or visit the continence resource centre in your state:

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Last reviewed: December 2018

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