Mate tōngāmimi Bladder control problems (urinary incontinence)
Urinary incontinence is when you lose bladder control and you accidentally leak wee (urine). It may be occasionally leaking a few drops of wee to leaking enough to affect your daily activities.
Types of urinary incontinence
Types of urinary incontinence include:
- stress incontinence — this is leaking wee when you cough, sneeze, laugh or exercise
- urge incontinence — this is when you have a sudden, strong urge to wee, followed by accidentally leaking wee
- overflow incontinence — this is a constant dribbling of wee
- total incontinence — this is when your bladder cannot store wee at all.
You may have more than one type. For example, you might have both stress and urge incontinence.
Causes of urinary incontinence
Stress incontinence
Stress incontinence is caused by damage to your pelvic floor muscles, ligaments and tissues. Pelvic floor muscles run from your pubic bone to your tailbone and support your pelvic organs. The damage can be due to:
- childbirth, particularly a vaginal birth
- pregnancy
- obesity.
Urge incontinence
Urge incontinence is caused by overactive bladder muscles, which may be due to:
- a neurological (brain and nerve) condition such as a stroke or multiple sclerosis
- a urinary tract infection or painful bladder problem
- overactive bladder
- ageing.
Overflow incontinence
Overflow incontinence happens when your bladder does not empty completely. This can be due an obstruction affecting the flow of wee, such as:
- an enlarged prostate gland
- constipation.
Continuous incontinence
Continuous (total) incontinence can be caused by:
- bladder problems you were born with
- spinal cord injury.
Treating urinary incontinence without surgery
Treatment for urinary incontinence without using surgery includes:
- lifestyle changes
- pelvic floor muscle training
- bladder retraining
- medicines.
Lifestyle changes
- Avoid or reduce your caffeine intake — it increases the amount of wee your body makes. Limit drinks containing caffeine to 2 or 3 cups a day. Caffeine is in coffee, tea, energy drinks and cola drinks.
- Space your drinks throughout the day.
- Avoid drinking too much before bedtime.
- Stay a healthy body weight.
Pelvic floor muscle training
Pelvic floor exercises can help you retrain and strengthen weak or damaged pelvic floor muscles.
Bladder retraining
Bladder retraining aims to:
- overcome the feeling you need to wee urgently
- allow longer times between emptying your bladder
- increase the amount of wee your bladder can hold.
Medicines
If your symptoms continue, medicines may help your bladder control problems. The medicines should reduce your urge to wee as well as how often you wee.
Medicines used for bladder control problems include:
- oxybutynin
- solifenacin
- vaginal oestrogen, for postmenopausal women
- doxazosin, tamsulosin and finasteride for an enlarged prostate gland.
If you have urge incontinence, your healthcare provider or pharmacist may check all of your current medicines. Some of them could make urinary incontinence worse and you may be able to use alternatives.
Treating urinary incontinence using surgery and procedures
If non-surgical treatments do not help, your healthcare provider may refer you to see a specialist.
If you have urge incontinence, you may be offered Botox injections to the bladder.
There are several types of surgery that might help treat bladder control problems.