If you feel as though your bladder is very full and you need to pee so urgently you only have a few seconds to get to the toilet, or you leak urine as soon as you feel you need to pee, that‘s urge incontinence.
A type of urinary incontinence, urge incontinence is more common in women and as you age. Some figures suggest nearly 20% of women experience it from their mid-40s, but it can happen at any age. It’s actually a symptom of an overactive bladder but not everyone with this condition has urge incontinence. It’s estimated around a third of people with an overactive bladder experience leaking.
And although urge incontinence can be distressing and impact your day-to-day life (and even your sleep), there are many self-care steps you can take and medical treatments you can try to make sure it doesn’t control you. Discover all you need to know about coping effectively with urge incontinence.
What triggers urge incontinence?
It can happen at any time, often without warning, so it can get in the way of your working day, being out and about with friends, running errands or even watching TV.
You might also notice you have triggers for that sudden need to pee, such as the sound of running water or unlocking your front door, which is known as ‘latchkey incontinence’.
Or you might be caught short in your sleep – frequently needing to wake up to pee at night (nocturia) is common if you have an overactive bladder. And 1 small study found 26% of women with an overactive bladder experience leaks while they sleep (known commonly as bed-wetting, or medically as nocturnal incontinence).
How can urge incontinence affect your daily life?
Urge incontinence can be unpredictable and distressing if you don’t get treatment for it. You may end up feeling anxious about being too far from a toilet for any period of time. This can mean lots of everyday activities become challenging – from travelling by car or on public transport to going for walks or sitting in meetings.
Some women get to a point where they tightly plan all outings around where toilets are easily available. Others start to avoid going far from home, which can be very limiting.
Urge incontinence that’s left untreated can have a serious impact on your mental health and quality of life, with 1 study suggesting up to a third of those with an overactive bladder may experience depression, although no link is proven as yet. And around 1 in 3 women with urinary incontinence have both urge incontinence and stress incontinence (when leaks are caused by pressure on your bladder from physical acts like running, laughing or sneezing). Known as mixed incontinence, this results in a double blow of hard-to-live-with symptoms.
But it's important to know there are lots of self-care measures and treatments that can make a real difference to your symptoms and stop urge incontinence ruling your life.
What’s going on with my bladder?
Normally, the muscles in the walls of your bladder – called detrusor muscles – relax, allowing it to fill with urine. You should start to feel the need to pee when you have about 240ml of urine in your bladder, with this urgency building gradually (most people can hold double this amount of urine). When you’re ready to go to the toilet, the detrusor muscles contract to let the urine out.
But when your bladder’s overactive, the detrusor muscles contract too often, regardless of how much urine you’re holding. The result? A frequent need to pee suddenly, with possible leaks.
The causes of urge incontinence
In most cases of urge incontinence, no clear cause is found. But the following can all be risk factors:
- urinary tract infections (UTIs) – these common infections, which are usually caused by bacteria, can cause inflammation that may be linked to an overactive bladder
- being overweight or obese
- side effects of medicines, such as diuretics – also known as water pills, diuretics help remove salt and water from your body and are a common treatment for reducing high blood pressure
- older age – your risk of urinary incontinence rises with age, and urge incontinence is the most common form in older people, although the reasons for this aren’t well understood
What you can do to help urge incontinence
General self-care measures for urinary incontinence may help. For urge incontinence, it may be particularly important to:
- pace your drinking – try having regular, smaller amounts of fluid throughout the day
- avoid diuretic drinks like alcohol, tea and coffee – these drinks remove fluids from your body by making you pee more often, and they can irritate your bladder
- try cutting down on foods and drinks that can irritate your bladder, including spicy and acidic foods, chocolate and fizzy drinks
- lose weight if you need to – it's thought that weight loss reduces incontinence, possibly by decreasing pressure on your bladder and pelvic floor muscles. If you’re very overweight, get advice from your doctor about how to lose weight safely
- strengthen your pelvic floor muscles (a group of muscles around your bladder, bottom and vagina) with exercises to support your bladder and prevent leaks. Also known as Kegel exercises, these simple exercises are helpful for anyone with urinary incontinence. Learn how to do pelvic floor exercises.
Read more about urinary continence treatment without surgery.
What your doctor can do
It’s worth seeing a doctor if you have urge incontinence symptoms. Try not to be embarrassed – it’s a common issue and your doctor may be able to refer you for support, through continence services or specialist physiotherapy. Once you’ve been referred, there are a number of treatments that may be offered to help you, including the below.
Bladder training is the mainstay of treatment for urge incontinence – it involves training yourself to go for longer between peeing, and is usually done under professional guidance, for example, with a physiotherapist or continence nurse. Usually you’ll need to do the exercises for around 6 weeks.
Certain medicines – such as mirabegron and what is known as antimuscarinic medicines – may sometimes be prescribed by doctors to help urge incontinence alongside bladder training and lifestyle measures. These generally work by relaxing the muscles of your bladder. Read more about medication for urge incontinence.
Your doctor will discuss any other medical conditions you may have to work out whether these medicines are safe for you, and will also discuss their side effects with you.
Surgery and other procedures
You may be offered injections of Botox (botulinum toxin A) into your bladder muscles – again, it’s all about helping them relax by using this medicine. Other procedures may include nerve stimulation targeting the muscles you use when you pee.
Very rarely, if nothing else has helped, you may be offered surgery to either increase the size of your bladder or bypass it altogether.
Find out all you need to know about surgery for incontinence.
When to see a doctor
If urge incontinence is having an effect on your quality of life or self-care steps haven’t worked, see a doctor. They’ll be able to diagnose the type of incontinence you have and may refer you for specialist help.
You should always see a doctor if you have other symptoms alongside your urge incontinence, including:
- tummy or bladder pain
- blood in your urine
- feeling tired and lacking the energy you need to do normal activities (fatigue)
- losing weight without meaning to
- you feel you can’t completely empty your bladder when you pee
- you have trouble peeing
- you constantly leak urine
Find out more about when to see a doctor about urinary incontinence, plus when to get emergency medical help.
You can also use our Smart Symptom Checker to find out more about your symptoms.
Your health questions answered
Is urge incontinence all in the mind?
"We know there’s a connection between anxiety and an overactive bladder. It’s a chicken-and-egg situation because a frequent and urgent need to pee can make you feel more anxious, so it’s hard to say what comes first. But whatever the psychological element, urge incontinence is very real, as are its effects on your wellbeing and quality of life. So never feel you can’t ask for help – it should never be dismissed, and treatments are available to help you."