Urinary Incontinence: Causes, Symptoms & Treatment Options

Urinary incontinence is more than a minor inconvenience; it’s the involuntary loss of bladder control that can impact daily comfort and confidence. It results in the unintentional passing of urine. It can range from small, occasional leaks during physical activity to a sudden, intense urge to urinate. Depending on the type, it can happen because the muscles that hold urine have weakened, because the bladder contracts on its own before it's full, or because something is blocking the bladder from emptying properly.

Many people quietly manage urinary incontinence, often delaying a conversation with their doctor due to embarrassment. However, it's a recognised medical condition with several effective ways to manage it. First, it helps to understand the different types and what causes them.

Different Types of Incontinence and Symptoms

Urge Incontinence

Urge Incontinence is when a person feels a sudden, intense need to urinate and cannot hold it in before reaching the toilet. It’s often caused by an overactive bladder, a urinary infection, or a neurological condition. 

Stress Incontinence

This involves the involuntary leakage of urine due to pressure on intra-abdominal muscles, especially during physical activities and even after coughing, sneezing or laughing. This is a result of weakened or damaged pelvic floor muscles or the urethral sphincter. Stress incontinence is common in women, particularly after childbirth. 

Overflow Incontinence 

Overflow incontinence happens when the bladder doesn’t empty completely, which leads to frequent dribbling. It is often caused by an obstruction at the bladder outlet or by a bladder muscle that doesn’t contract properly to empty it, which can happen with spinal cord injuries, multiple sclerosis or diabetes. 

Mixed Incontinence 

This happens when a person experiences symptoms of both stress and urge incontinence together, for example leaking during physical exertion as well as feeling a sudden, urgent need to urinate.

While urinary incontinence is more common in people over 50, the following individuals are also at higher risk:

• Those with a chronic or neurological health condition such as diabetes, multiple sclerosis, long-term constipation, an overactive bladder or Parkinson’s disease.
• Those with an enlarged prostate or who have had prostate surgery.
• Women who have given birth and/or are postmenopausal.
• Women who get frequent urinary tract infections (UTIs) or have weakened pelvic floor muscles.
• People who are overweight and obese.

When looking at the causes of urinary incontinence, diabetes deserves a closer look, since it's one of the most common yet least discussed contributors to incontinence. Prolonged high blood sugar can damage the nerves that control the bladder, a condition known as diabetic neuropathy, making it harder to sense when the bladder is full or to empty it completely. Certain medications, including diuretics and antidepressants, can also cause temporary incontinence.

Common symptoms of urinary incontinence:

• Need to urinate frequently
• Waking up more than twice a night to urinate 
• Bedwetting
• Frequent UTIs

How is Urinary Incontinence Diagnosed?

A doctor will review symptoms and medical history and may carry out a physical exam. Tests such as urinalysis, a bladder ultrasound, cystoscopy, a digital rectal exam or urodynamic testing can help identify the type and severity of the incontinence.

Practical Ways to Manage Urinary Incontinence:

Treatment depends on the type and severity of incontinence, and may include lifestyle changes, pelvic floor therapy, medication to relax or stabilize the bladder, or in some cases, surgery.

Simple changes that can help day to day:

• Practise timed voiding by scheduling bathroom trips at regular intervals rather than waiting for urgency.
• Cut back on caffeine and alcohol.
• Maintain a healthy weight.
• Practise pelvic floor exercises regularly.
• Wear well-fitted, absorbent adult diapers or pants designed for urinary incontinence, for added confidence through the day or night.

Living with urinary incontinence doesn’t mean withdrawing from everyday life. With the right information, diagnosis and support, it’s entirely possible to manage the condition and stay active.