Urinary Incontinence, Female (Adult)

Types of incontinence

There are different types of incontinence. The main types are described here. You can have more than 1 type.

• Stress incontinence. With this type, urine leaks when pressure (stress) is put on the bladder. This may happen when you cough, sneeze, or laugh. Stress incontinence most often occurs because the pelvic floor muscles that support the bladder and urethra are weak. This can happen after pregnancy and vaginal childbirth or a hysterectomy. It can also be due to excess body weight or hormone changes.

• Urge incontinence (also called overactive bladder). With this type, a sudden urge to urinate is felt often. This may happen even though there may not be much urine in the bladder. The need to urinate often during the night is common. Urge incontinence most often occurs because of bladder spasms. This may be due to bladder irritation or infection. Damage to bladder nerves or pelvic muscles, constipation, and certain medicines can also lead to urge incontinence.

• Mixed incontinence. This type is when a person has both stress and urge incontinence.

• Overflow incontinence. This type occurs when the body makes more urine than the bladder can hold. Or the bladder is full and can't empty, causing urine to leak. This type is rare in women and is more common in men who have prostate problems. A common symptom is frequent urinating of small amounts.

• Functional incontinence. With this type, urine loss is from thinking or physical problems. It may be from dementia or stroke, or environmental issues. People with this type may not recognize the need to urinate.

Treatment depends on the cause. Further evaluation is needed to find the type you have. This will likely include an exam and certain tests. Based on the results, you and your healthcare provider can then plan treatment. Until a diagnosis is made, the home care tips below can help ease symptoms.

Home care

• Do pelvic floor muscle exercises, if they are prescribed. Pelvic floor muscles help support the bladder and urethra. Many women find that their symptoms improve when doing special exercises that strengthen these muscles. To do the exercises, contract the muscles you would use to stop your stream of urine. But do this when you’re not urinating. Hold for 10 seconds, then relax. Repeat 10 to 20 times in a row, at least 3 times a day. Your healthcare provider may give you other instructions for how to do the exercises and how often.

• Keep a bladder diary. This helps track how often and how much you urinate over a set period of time. Bring this diary with you to your next visit with your provider. The information can help your provider learn more about your bladder problem.

• Lose weight, if advised to by your provider. Extra weight puts pressure on the bladder. Your provider can help you create a weight-loss plan that’s right for you. This may include exercising more and making certain diet changes.

• Don't have foods and drinks that may irritate the bladder. These can include alcohol and caffeinated drinks.

• Quit smoking. Smoking and other tobacco use can lead to a long-term (chronic) cough that strains the pelvic floor muscles. Smoking may also damage the bladder and urethra. Talk with your provider about treatments or methods you can use to quit smoking.

• If drinking large amounts of fluid makes you have symptoms, you may be advised to limit your fluid intake. You may also be advised to drink most of your fluids during the day and to limit fluids at night.

• If you’re worried about urine leakage or accidents, you may wear absorbent pads to catch urine. Change the pads often. This helps reduce discomfort. It may also reduce the risk of skin or bladder infections.

• Limit how much fluid you have about 2 to 3 hours before you go to bed.

Follow-up care

Follow up with your healthcare provider as directed. It may take some to find the right treatment for your problem. But healthy lifestyle changes can be made right away. These include such things as exercising on a regular basis, eating a healthy diet, losing weight (if needed), and quitting smoking. Your treatment plan may include special therapies or medicines. Certain procedures or surgery may also be options. Talk about any questions you have with your provider.

When to get medical advice

Call the healthcare provider right away if any of these occur:

• Fever of 100.4°F (38°C) or higher, or as directed by your provider

• Bladder pain or fullness

• Belly swelling

• Nausea or vomiting

• Back pain

• Weakness, dizziness, or fainting