Urinary Incontinence

Uri­nary incon­ti­nence, also known as invol­un­tary uri­na­tion, is con­sid­ered any leak­age of urine or dif­fi­cul­ty with blad­der con­trol. This is a very com­mon and embar­rass­ing prob­lem and can range from occa­sion­al­ly leak­ing urine when you laugh, sneeze or cough to hav­ing such a sud­den, strong urge to uri­nate that you can’t get to the bath­room on time. Uri­nary incon­ti­nence is under-report­ed and affects more peo­ple than you might expect. Many peo­ple choose to just deal with uri­nary incon­ti­nence, and don’t know treat­ment is avail­able, or have no desire to seek treat­ment. Incon­ti­nence falls into two categories:

Urge Incon­ti­nence

Urge incon­ti­nence occurs when you have a strong or sud­den need to uri­nate. The blad­der spasms and you lose urine. Most peo­ple feel the urge to uri­nate when they have rough­ly 1 cup of urine in their blad­der. Two mus­cles help to pre­vent the flow of urine. With urge incon­ti­nence, you leak urine because your mus­cles con­tract at the wrong time. In many cas­es of urge incon­ti­nence, there is no spe­cif­ic cause. Stress Incon­ti­nence Stress incon­ti­nence is the invol­un­tary release of urine dur­ing any activ­i­ty that puts pres­sure on your blad­der and can occur in both men and women. Some activ­i­ties that place stress on your blad­der include:

  • Sneez­ing
  • Cough­ing
  • Laugh­ing
  • Lift­ing weights
  • Bend­ing over
  • Exer­cise

Stress Incon­ti­nence

Stress incon­ti­nence occurs when your pelvic floor mus­cles become weak­ened. These mus­cles work as a sling to sup­port your blad­der and con­trol the flow/​release of urine. Your pelvic floor mus­cles weak­en as you age, but pelvic surgery and injury to the pelvic area also con­tribute to incon­ti­nence For women, child­birth is a main con­tribut­ing fac­tor. Prostate can­cer and its treat­ment can cause stress incon­ti­nence in men.

Incon­ti­nence Treatments

Treat­ment for urge incon­ti­nence will depend on your symp­toms and how they affect your dai­ly life. There are five main treat­ment options:

Pelvic Floor Mus­cle Strength­en­ing (Kegels) & Biofeedback

You may be instruct­ed in a gen­er­al exer­cise pro­gram or you may be referred to a women’s health phys­i­cal ther­a­pist to learn spe­cif­ic exer­cis­es that are appro­pri­ate for you. These exer­cis­es tone and strength­en your pelvic mus­cles as well as mus­cles that sur­round the open­ing of the ure­thra, vagi­na and rec­tum. Spe­cif­ic exer­cis­es can be very effec­tive in con­trol­ling leak­age. Biofeed­back is some­times used to help retrain your pelvic floor mus­cles. If you have a sig­nif­i­cant amount of weak­ness, you may be a can­di­date for pelvic floor mus­cle stimulation.

Behav­ioral & Lifestyle Changes

  • Quit­ting smok­ing. Smok­ing can lead to a chron­ic cough that strains the pelvic floor muscles. 
  • Smok­ing may also dam­age the blad­der and urethra.
  • Los­ing weight. Excess weight puts extra pres­sure on the pelvic floor mus­cles and the blad­der and pelvic contents.
  • Mak­ing cer­tain dietary changes. Some foods and flu­ids may irri­tate your blad­der. You will learn what your blad­der irri­tants are and how to avoid them.
  • Learn­ing how to lift prop­er­ly. Heavy lift­ing can increase pres­sure in the abdom­i­nal cav­i­ty and on the blad­der. Lift­ing prop­er­ly can pro­tect your inter­nal organs and decrease urine leakage.

Blad­der Retraining

You will be taught about nor­mal and abnor­mal void­ing pat­terns and may be told to void at set times. You will also be taught urge con­trol tech­niques, why leak­age occurs and how to avoid it.


Med­ica­tion can be used to treat urge incon­ti­nence. There are no med­ica­tions that can treat stress incontinence.


In some cas­es of incon­ti­nence, surgery may be appro­pri­ate. You and your doc­tor will need to decide if surgery is the right option for you and what type will best suit your needs.