Stress incontinence – leaking urine when you cough, laugh, sneeze, lift or exercise
Urge incontinence – a sudden, uncontrollable need to urinate which is often caused by an overactive bladder

Urinary incontinence can happen to anyone at any age but is more likely to develop as you get older. However, urinary incontinence is more common in women, with stress incontinence affecting three in ten women over 40.

In many cases, urinary incontinence can be improved with lifestyle changes, special exercises and bladder training. A range of medical and surgical treatments are also available.

Causes of urinary incontinence

Stress incontinence is often the result of weak or damaged pelvic floor muscles or urethral muscles. This can be caused by:

Childbirth – the more babies you have, the higher your risk of developing stress incontinence
Pregnancy or obesity – carrying additional weight on your abdomen (stomach) increases pressure on your bladder
Muscles becoming weaker as part of the aging process
Surgical removal of the womb (hysterectomy) or prostate gland in men causing bladder problems

Urinary incontinence is often caused by an overactive bladder, which can also trigger frequent urination, especially at night. An overactive bladder can be the result of:

Drinking too much caffeine or alcohol
Constipation
Urinary tract infections (UTIs)

However, sometimes the cause can't be determined.

Urinary incontinence can also be the result of:

Hormonal changes caused by the menopause
Side effects of some medications, including certain heart and blood pressure drugs, prostate cancer treatments and sedatives
Conditions affecting your brain and spinal cord, such as Parkinson’s disease, dementia and multiple sclerosis
Benign prostate enlargement (BPH) - a common condition which can cause frequent urination and affects two in 10 men over the age of 40
A blockage in your urinary tract, such as a kidney stone or, rarely, a tumour
Prostate cancer

Getting a diagnosis for urinary incontinence

Your GP will ask you about your urinary incontinence and how it’s affecting you. If possible, for a week, write down episodes of urinary incontinence, your fluid intake and how often you urinate.

Your GP will discuss any medication you’re taking and may test your urine and examine your abdomen, vagina and/or back passage (rectum). To help with diagnosis, they may refer you for:

An ultrasound scan – to check your bladder’s emptying properly
A cystoscopy – to check for bladder problems and examine your bladder and urinary system
Urodynamic tests – to measure urine flow and bladder capacity

Depending on your diagnosis, your GP may refer you to a consultant or to a continence clinic.

Treatments for urinary incontinence

To treat urinary incontinence, your GP or consultant may suggest:

Pelvic floor exercises - to strengthen the muscles controlling the flow of urine
Losing weight - to reduce pressure on your bladder
Reducing your fluid intake and, in particular, caffeine and alcohol
Inserting a special device in your urethra or vagina - to prevent leaking urine
Wearing disposable pants and pads - to absorb leaking urine

If there’s no improvement in your stress incontinence, your doctor may recommend surgery. This may be surgery to support the bladder, strengthen the muscles controlling urination or increase the size of your bladder.

If you continue to be affected by urge incontinence or frequent urination, your doctor may recommend bladder training. Other treatments for urge incontinence include: