This leaflet is a brief summary of incontinence.
Understanding urine and the bladder
The kidneys make urine all the time. A trickle of urine is constantly passing to the bladder down the ureters (tubes from the kidneys to the bladder). You make different amounts of urine depending on how much you drink, eat and sweat.
The bladder is mainly made of muscle and stores the urine. It expands like a balloon as urine comes down the ureters.
The outlet for urine (the urethra) is normally kept closed. This is helped by the muscles beneath the bladder that sweep around the urethra (the pelvic floor muscles).
When a certain amount of urine is in the bladder you become aware that the bladder is getting full. When you go to the toilet to pass urine, the bladder muscle squeezes (contracts) and the urethra and pelvic floor muscles relax.
Complex nerve messages are sent between the brain and the bladder and pelvic floor muscles. These make you aware of how full your bladder is and tell the right muscles to contract or relax at the right time.
If you have urinary incontinence it means that you pass or leak urine when you do not want to.
See the separate leaflet called Urinary Incontinence for more detail.
It is classified into different types, depending on the cause:
This is usually due to weak muscles beneath the bladder (the pelvic floor muscles):
- Urine leaks when you cough, laugh, jump, etc.
- Treatment is mainly by doing exercises to strengthen the pelvic floor muscles.
- A medicine called duloxetine is sometimes used. It helps the muscles around the urethra to contract more strongly.
- Surgery to tighten the tissues under the bladder is needed in some cases.
See the separate leaflet called Stress Incontinence for more detail.
This is due to an overactive bladder that squeezes (contracts) suddenly:
- Bladder training is the usual first treatment. This trains you to hold on for longer.
- Medication can help to relax the bladder muscle.
See the separate leaflet called Urge Incontinence for more detail.
Stress incontinence with urge incontinence
A combination of stress and urge incontinence commonly occurs.
Bedwetting (nocturnal enuresis)
This occurs in many children, but some adults are affected.
See the separate leaflet called Bedwetting (Nocturnal Enuresis) for more detail.
This is due to damage to nerves supplying the bladder. For example, as a result of spinal cord problems, multiple sclerosis, etc.
This is due to a blockage of the urine outlet, which upsets the normal control of passing urine. Urine pools in the bladder behind the blockage, but small amounts of urine bypass the blockage and trickle down the urethra. The most common example is incontinence caused by an enlarged prostate gland in men which partly blocks the bladder outlet.
Further help & information
Dr Tim Kenny
Dr Laurence Knott
Dr Hayley Willacy