Incontinence - Definitive Guide

Urinary incontinence is a condition where you pass urine involuntarily (when you don’t want to). 

It is a common condition, but the exact number of people with urinary incontinence is unknown. Many people feel embarrassed by their condition or assume it’s a normal part of getting older and cannot be treated. For this reason, many people don’t talk about their condition, even with their GP. 

Urinary incontinence can greatly impact your quality of life as it may prevent you from leaving the house and participating in activities you enjoy.

Risk factors for urinary incontinence include: 

• obesity
• pregnancy
• vaginal birth
• increasing age
• family history of urinary incontinence 

There are several different types of urinary incontinence: 

• Stress incontinence —this is one of the most common types of urinary incontinence. It is caused by weak pelvic floor muscles and causes you to leak urine when coughing, sneezing, laughing or during exercise. Stress incontinence is more common in women than men. 
• Urge incontinence (overactive bladder) —with this type of incontinence, you need to pee as soon as you feel the urge and may need to pass urine frequently. Urge incontinence is caused by overactivity of the detrusor muscles which control the bladder. It is more common in men with prostate problems and women after menopause. 
• Mixed incontinence —is a combination of stress incontinence and urge incontinence
• Overflow incontinence  (chronic urinary retention) —occurs when you cannot fully empty your bladder causing you to leak small amounts of urine. It may be caused by muscle or nerve damage due to illness, previous injury or surgery. 
• Total incontinence —is when the bladder is unable to store urine resulting in constant leaking of urine. It may be due to bladder problems that were present at birth, spinal injury, or a hole (fistula) between the bladder and a nearby area. 

Sometimes urinary incontinence is temporary and may occur due to a urinary tract or vaginal infection, or as a side effect of medication. This type of urinary incontinence normally goes away when the underlying cause is resolved.

Under UK law, urinary incontinence is classed as a disability. This means you are protected by law from discrimination and harassment due to your condition. 

Should I tell my employer about my incontinence? 

Whether or not you tell your employer about your condition is a personal decision that only you can make. 

It may benefit you to tell your employer to allow them to make any necessary adjustments like regular toilet breaks or time off for hospital appointments. 

It’s against the law for your employer to discriminate against you because of your incontinence.

There are many treatments for urinary incontinence including lifestyle changes, medication, and surgery. 

Some lifestyle changes that may help with incontinence include: 

• losing weight if you need to
• avoiding food and drinks that can irritate the bladder like alcohol, caffeine, and spicy or acidic food
• making sure you drink the right amount of fluid, as drinking too much or not enough can make urinary incontinence worse

See your doctor if you experience any type of incontinence. GPs are used to helping people with urinary incontinence and there is no need to feel embarrassed about this common condition. 

Your GP will ask about your symptoms and perform an examination to check for a physical cause. They may run some tests like blood and urine tests to see if you have an underlying health condition such as diabetes or a urinary tract infection. 

In addition to the lifestyle changes listed above, your GP may suggest some simple exercises to see if they help. These may include: 

• pelvic floor exercises are exercises where you strengthen your pelvic floor muscles by squeezing them. 

bladder training is where you train your bladder by gradually increasing the amount of time you wait before passing urine

In some cases, your GP may prescribe medications to help with urinary incontinence. 

Medicines for stress incontinence

• Duloxetine —is an antidepressant that is thought to stimulate the nerve to strengthen the sphincter muscle, to help control the flow of urine. 

Medicines for urge incontinence

• Antimuscarinics —work by reducing muscle contractions in the bladder
• Mirabegron —relaxes the bladder, helping it to fill up and store urine

Medicines for nocturia (getting up during the night to pee) 

• Desmopressin —reduces the amount of urine produced by the kidneys
• Diuretics —if taken in the afternoon, diuretics cause you to pass more urine during the day and may make you pass less urine at night 

If lifestyle changes and medications haven’t helped, your GP may refer you for surgery. 

Surgery for stress incontinence 

• Colposuspension —is a procedure where the neck of the bladder is lifted and stitched into place helping to prevent involuntary leaks 
• Sling surgery —a sling is placed around the neck of the bladder or end of the urethra to support the bladder and prevent leaking 
• Vaginal mesh surgery —a strip of synthetic mesh is inserted behind the urethra to support it and help prevent leaking
• Urethral bulking agent —is a substance that is injected into the walls of the urethra to increase their size and help them to stay closed
• Artificial urinary sphincter —is a procedure where the urinary sphincter (the ring of muscle that stops urine passing from the bladder to the urethra) is replaced with an artificial one

Surgery for urge incontinence

• Botulinum toxin A (Botox)  —is injected into the bladder to relax the muscles 
• Sacral nerve stimulation —in this procedure the sacral nerves (nerves in your lower back that carry signals to the brain when you need to pass urine) are stimulated with an electrical current to improve communication between the bladder and the brain
• Augmentation cystoplasty —is an operation to make the bladder bigger by adding tissue to the bladder wall. This operation is rarely recommended as it has many secondary consequences.
• Urinary diversion —is a procedure where the ureters (the tubes that take urine from the kidneys to the bladder) are redirected to the outside of the body where the urine is collected in bags.
• Catheterisation —a tube is inserted into the urethra and bladder and urine drains out of the body into a bag. A catheter can remain in the body all the time or may be inserted at regular intervals to drain urine.

An online doctor can help with urinary incontinence by asking you some questions about your symptoms and advising you on lifestyle changes and some ways in which you can manage your condition. They can also refer you to a private specialist for investigations and treatments. 

It’s easy to book an appointment with an NHS-trained GP at Medicspot. Simply click the link and select an appointment at a time and day that suits you. Appointments are often available the same day. 

A pharmacist can help with incontinence by advising on incontinence products such as pads, chair and bed protection and skin care. Your pharmacist can also advise you on when to see a GP.

Find a pharmacy near you 

Urinary incontinence is a distressing, but common condition that can prevent you from living your life to the full. There are many treatments available for urinary incontinence and the condition is often manageable with the right treatment and support. 

If you have symptoms of urinary incontinence and would like to talk to a doctor, make an appointment today.

NHS: Urinary incontinence November 7th 2019 (Accessed December 3rd 2022) 

Urology Care Foundation: What is Urinary Incontinence?  (Accessed December 3rd 2022) 

Bladder and Bowel Community: Incontinence And Discrimination  (Accessed December 3rd 2022) 

NIH National Institute of Diabetes and Digestive and Kidney Diseases: Prevention of Bladder Control Problems (Urinary Incontinence) & Bladder Health July 2021 (Accessed December 3rd 2022) 

PubMed: Urinary incontinence in women  July 2017 (Accessed December 3rd 2022)