HealthInfo Waitaha Canterbury
Bladder control problems (urinary incontinence)
Mate tōngāmimi
Urinary incontinence is when you have lost bladder control, so you leak wee (urine).
Urinary incontinence can range from occasionally leaking a few drops to leaking enough to affect your daily activities.
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, irresistible urge to wee (urinate), followed by involuntarily 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. It can be due to:
- childbirth, particularly a vaginal birth
- pregnancy
- obesity.
Urge incontinence
Urge incontinence is caused by overactivity of your bladder muscles, which may be due to:
- a neurological condition such as a stroke or multiple sclerosis
- a urinary tract infection or painful bladder syndrome
- an overactive bladder
- ageing.
Overflow incontinence
Overflow incontinence happens when your bladder does not empty completely. This can be due an obstruction affecting the urine flow such as:
Continuous incontinence
Continuous incontinence can be caused by:
- bladder problems from birth
- a spinal cord injury.
Treating urinary incontinence with non-surgical methods
Non-surgical treatment for urinary incontinence includes lifestyle changes, pelvic floor muscle training, bladder retraining and medication.
Lifestyle changes
- Avoid too much caffeine as it can increase the amount of wee your body makes. Limit caffeinated drinks to two to three cups per day. Caffeine is in coffee, tea, energy drinks and cola drinks.
- Space drinks throughout the day.
- Avoid drinking too much before bedtime.
- Stay a healthy 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 urinary urgency
- increase the amount of time between emptying your bladder
- increase the amount of fluid your bladder can hold.
Medication
If your symptoms continue, medications may help treat your bladder control problems. The medications aim to reduce your urge to wee (urinate) as well as how often you wee.
Common medications for bladder control problems are oxybutynin and solifenacin. Other medications include alpha-1 blockers (doxazosin, tamsulosin and finasteride) for men with enlarged prostates and vaginal estrogen for post-menopausal women.
Review all your medications with your general practice team or pharmacist. Some medications can make incontinence worse and there may be alternatives.
Treating urinary incontinence with surgical methods
If non-surgical treatments do not help, your general practice team may refer you to the hospital to see a specialist.
The specialist may consider Botox treatment. There are also several types of surgery that might help treat bladder control problems. For information on Botox treatment and surgery for bladder control problems, see Urinary incontinence surgery and procedures from the United Kingdom's NHS.
The Te Whatu Ora page Patient decision guides gives you information about options for treating stress urinary incontinence.
HealthInfo recommends the following pages
- Continence New Zealand – Continence information for adults
Detailed information about the types of urinary incontinence, the causes and what can be done. Continence New Zealand also provides a freephone helpline for people with continence problems. Call 0800‑650‑659.
- NHS – Urinary incontinence
Information about incontinence, symptoms and treatments.
- Nurse Maude – Continence advisory service
The Nurse Maude continence advisory service provides support, assessment with a continence advisor, and products for people with continence issues. Your general practice team can refer you, but you can also contact the service directly – phone (03) 375‑4200 or email info@nursemaude.org.nz.
Written by HealthInfo clinical advisers. Last reviewed April 2023.
Sources
See also:
Review key: HIURS-53047
