
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:
Overflow incontinence
Overflow incontinence happens when your bladder doesn't 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
- 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) 375‑4273 or (03) 375‑4200. If your call goes to voicemail, leave a message. Messages are checked Monday to Friday.
Written by HealthInfo clinical advisers. Last reviewed April 2023.
Sources
The information in this section comes from the following sources, some of which may be clinically complex or not available to the general public
BPAC – Urinary continence in adults. Retrieved March 2019.
BPAC – Urinary incontinence in women: the management of urinary incontinence in women, Retrieved February 2019.
Canterbury Community HealthPathways – Urinary incontinence in women. Retrieved February 2019.
Continence Foundation of Australia. Retrieved February 2019.
Continence Foundation of Australia – Pelvic floor muscles in men. Retrieved February 2019.
Continence New Zealand. Retrieved March 2019.
KidsHealth – Urinary tract infection. Retrieved September 2021.
NHS – Bedwetting in children. Retrieved September 2021.
NHS – Cystitis, Retrieved February 2019.
NHS – Interstitial cystitis, Retrieved January 2019.
NHS – Urinary incontinence. Retrieved March 2019.
The British Association of Urological Surgeons. Retrieved March 2019.
The British Association of Urological Surgeons – Urinary infection (adult). Retrieved February 2019.
Urological Society of Australia and New Zealand. Retrieved January 2019.
Image and embedded video sources
Female pelvic floor muscles animated video from Continence Foundation of Australia on YouTube.
Female pelvic floor muscles illustration from Shutterstock (image ID 200938985). June 2018.
Image of elderly couple from Shutterstock (image ID 705198691). September 2019.
Image of woman holding her abdomen from Shutterstock (image ID 1802606767). April 2023.
Image of woman in pain sitting on couch from Shutterstock (image ID 403461826). October 2019.
Image of women reading the newspaper from jk1991 at FreeDigitalPhotos. March 2017.
Male pelvic floor muscles animated video from Continence Foundation of Australia on YouTube.
Urinary system illustration from Shutterstock (image ID 179481320). April 2019.
Page reference: 264391
Review key: HIURS-53047