HealthInfo Canterbury

Bladder control problems (urinary incontinence)

Mate tōngāmimi

Urinary incontinence is when you've lost bladder control, so you accidentally leak wee (urine).

Urinary incontinence can range from occasionally leaking a few drops of wee 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 can't 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
• overactive bladder
• ageing.

Overflow incontinence

Overflow incontinence happens when your bladder doesn't empty completely. This can be due an obstruction affecting the urine flow such as:

• prostate enlargement
• constipation.

Continuous incontinence

Continuous incontinence can be caused by:

• bladder problems from birth
• 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.

Medications for bladder control problems include solifenacin and if you're a post-menopausal woman, vaginal estrogen.

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 don't 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 Ministry of Health document Considering surgical mesh to treat stress urinary incontinence gives you information about treating stress urinary incontinence with surgery including mesh and other options.

  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

Page reference: 264391

Review key: HIURS-53047