Urinary incontinence is peeing (passing urine) when you don’t want to. There are several kinds of urinary incontinence, and the best treatment for you will depend on which you have.
The most common types are stress incontinence – triggered by stress or pressure on your bladder, such as when you cough, sneeze or exercise – and urge incontinence, when you get an urgent need to pee.
Any kind of urinary incontinence may feel embarrassing, and it can affect many areas of your life. But the good news is that you don’t have to put up with it. There are lots of treatments that can help with symptoms, and in many cases it can be managed without surgery.
To start with, your doctor may suggest simple lifestyle changes, such as losing weight (if you need to) and limiting caffeinated drinks such as coffee and cola. There are also several non-surgical treatments they can recommend. So read on to learn more about how these treatments can help with urinary incontinence.
When to see a doctor about treatment for urinary incontinence
If you’re worried about any symptoms, you can try the Healthily Smart Symptom Checker to find out more.
However, you should see a doctor if you’re struggling with urinary incontinence. They can diagnose which kind you have, and check for any health conditions that could be causing it.
Your doctor will also advise you about what type of treatment is suitable for you. Lifestyle changes and the non-surgical treatments described below are usually tried first, before surgery is considered. (Read about surgical treatments for urinary incontinence.)
Everyone with urinary incontinence is different, and you may need to try several things to find the best treatment for you. This may involve a combination of some of the options below.
Pelvic floor muscle training for urinary incontinence
Your pelvic floor is a group of muscles around your bladder, bottom and vagina – and if it’s weak, this can lead to incontinence. So strengthening these muscles is often recommended as a first step for treating any type of urinary incontinence.
Pelvic floor strengthening can also be used alongside the other treatments detailed below. Here’s what you need to know.
Pelvic floor exercises
Also known as Kegel exercises, pelvic floor exercises can be done any time, without anyone else knowing you’re doing them, by squeezing (contracting) your pelvic floor muscles. Find out how to do pelvic floor exercises.
Your doctor or specialist may also give you an exercise programme to follow. You’ll typically need to do the exercises 3 times a day, for at least 3 months, to see if they help with your incontinence.
If you can’t contract your pelvic floor muscles yourself, electrical stimulation may be recommended. This involves a device you can use at home, as directed by a doctor or incontinence nurse.
You put a small probe into your vagina, through which an electrical current is passed. This makes your muscles contract, in a similar way to pelvic floor exercises, often following programmed routines. It’s not painful, but you may feel a tingling sensation inside your vagina.
Biofeedback is a way to check how well you’re doing your pelvic floor exercises. It involves using a device with sensors that are linked to a computer screen or an app.
Like electrical stimulation, it may be helpful if you can’t feel your pelvic floor muscles properly on your own. It can be used with guidance from a physiotherapist, to help you understand how to squeeze your muscles correctly, and may also help to motivate you to do your pelvic floor exercises at home.
You can also use vaginal cones to help train your pelvic floor muscles. These are small weights that you put into your vagina, and you then squeeze your pelvic floor muscles to stop them slipping out.
However, while some people find vaginal cones can help with pelvic floor training, there isn’t a lot of evidence that they’re more effective than doing pelvic floor exercises without weights.
Bladder training for urinary incontinence
Bladder training is often the first thing doctors recommend for treating urinary urge incontinence. It can also be used in combination with pelvic floor exercises if you have mixed urinary incontinence.
A course in bladder training will usually last at least 6 weeks. You’ll learn to follow a fixed routine for going to the toilet, rather than peeing as soon as you feel the need to.
To start with, for example, you may plan to go to the toilet once every 1 or 2 hours, and try to avoid going at other times (typically by practising relaxing and deep breathing techniques). Then as you get better at not needing to pee, you can gradually lengthen the gap between trips to the toilet.
Pessaries for urinary incontinence
A vaginal pessary can help stop leaks caused by stress incontinence. It’s a firm yet flexible device, usually made from silicone, that can be disposable or reusable.
When inserted into your vagina, it repositions and supports your urethra and/or womb (uterus), which leads to fewer leaks. Your doctor will examine you and decide whether this type of treatment is suitable for you.
Medication for urinary incontinence
If you’re still having problems despite trying lifestyle changes and exercises, your doctor may be able to prescribe urinary incontinence medication. This is more common for urge incontinence. With stress incontinence, it’s normally used only if you don’t want, or can’t have, surgery.
If you’d like to try medication for urinary incontinence, speak to your doctor. Before prescribing any of these treatments, your doctor will discuss any other medical conditions you have, and the possible side effects as well as the benefits of the medicine, to help decide if it’s suitable for you.
Medicines your doctor might be able to prescribe include:
- antimuscarinic medicines for urge incontinence. These work by blocking certain nerve impulses to your bladder, relaxing the muscles and increasing its ability to hold pee. Examples of these medicines include oxybutynin, solifenacin and tolterodine. It can take up to a month to get the maximum benefits
- mirabegron for urge incontinence. If antimuscarinics aren’t suitable or cause side effects, mirabegron may help by stimulating receptors in your bladder to relax the muscles. It can take 4 to 8 weeks to work effectively
- duloxetine for stress incontinence. If lifestyle changes and exercise don’t help with stress incontinence, you’ll usually be offered surgery as the next step, but duloxetine can be an option if you can’t have surgery. Although it’s mainly used to treat depression, it can also increase the muscle tone of your pee tube (urethra), helping to keep it closed when it needs to be. It can take 2 to 4 weeks to see any benefits
If these non-surgical treatments don’t help you or aren’t suitable, incontinence surgery is sometimes recommended. Read about surgical treatments and procedures for urinary incontinence.
Your health questions answered
What happens if urinary incontinence is untreated?
Answered by: Dr Roger Henderson
“Although urinary incontinence doesn’t always get worse if it’s left untreated, it can have a big affect your quality of life and may also lead to other problems, such as anxiety or loss of interest in sex. You might become less active due to a fear of exercising, which in turn can lead to weight gain and make incontinence worse.
If you’re worried about incontinence at work, this could affect your productivity, while it may have an impact on your relationships, if you try to hide the condition from your partner or close family. There’s also an increased risk of repeated urinary tract infections (UTIs) if your bladder isn’t being fully emptied.
All of this means you should never feel embarrassed to ask for help with urinary incontinence. There are things you can do to help without even seeing a doctor, but if you do need to see someone, there are also lots of options and it can be effectively treated.”