How Do You Know if Your Bladder Is Leaking

Urinary incontinence

Urinary incontinence is the loss of bladder control. The two near common types of urinary incontinence that impact women are stress incontinence and urge incontinence, also called overactive bladder. Incontinence affects twice as many women as men. This may be considering pregnancy, childbirth, and menopause may make urinary incontinence more probable. Urinary incontinence is not a normal part of aging, and information technology can be treated.

What is urinary incontinence?

Urinary incontinence is the loss of float control, or leaking urine.

Urine is made by the kidneys and stored in the float. The float has muscles that tighten when you lot need to urinate. When the float muscles tighten, urine is forced out of your bladder through a tube called the urethra. At the same fourth dimension, sphincter muscles around the urethra relax to permit the urine out of your torso.

Incontinence can happen when the bladder muscles suddenly tighten and the sphincter muscles are not strong enough to pinch the urethra shut. This causes a sudden, strong urge to urinate that yous may non be able to control. Pressure caused by laughing, sneezing, or exercising tin cause you to leak urine. Urinary incontinence may as well happen if at that place is a trouble with the nerves that command the bladder muscles and urethra. Urinary incontinence tin hateful yous leak a small amount of urine or release a lot of urine all at one time.

Who gets urinary incontinence?

Urinary incontinence affects twice equally many women as men. This is considering reproductive health events unique to women, similar pregnancy, childbirth, and menopause, impact the bladder, urethra, and other muscles that support these organs.

Urinary incontinence tin can happen to women at any historic period, simply it is more mutual in older women. This is probably because of hormonal changes during menopause. More than than 4 in 10 women 65 and older have urinary incontinence.¹

Why does urinary incontinence affect more women than men?

Women take unique health events, such as pregnancy, childbirth, and menopause, that may affect the urinary tract and the surrounding muscles. The pelvic flooring muscles that support the bladder, urethra, uterus (womb), and bowels may become weaker or damaged. When the muscles that support the urinary tract are weak, the muscles in the urinary tract must work harder to concord urine until you are set to urinate. This extra stress or pressure on the bladder and urethra can crusade urinary incontinence or leakage.

Also, the female urethra is shorter than the male urethra. Whatever weakness or damage to the urethra in a woman is more likely to crusade urinary incontinence. This is because there is less muscle keeping the urine in until you are ready to urinate.

What are the types of urinary incontinence that affect women?

The two most mutual types of urinary incontinence in women are:

Stress incontinence. This is the nearly common type of incontinence. It is also the most common type of incontinence that affects younger women.^two Stress incontinence happens when there is stress or pressure on the bladder. Stress incontinence can happen when weak pelvic floor muscles put pressure on the float and urethra by making them piece of work harder. With stress incontinence, everyday actions that apply the pelvic floor muscles, such as coughing, sneezing, or laughing, can cause you to leak urine. Sudden movements and physical activeness can likewise cause yous to leak urine.
Urge incontinence. With urge incontinence, urine leakage usually happens after a strong, sudden urge to urinate and before you can go to a bathroom. Some women with urge incontinence are able to get to a bathroom in time but experience the urge to urinate more than than viii times a twenty-four hours. They as well exercise not urinate much once they get to the bath. Urge incontinence is sometimes chosen "overactive bladder." Urge incontinence is more than common in older women.^three Information technology can happen when y'all don't look it, such as during sleep, later drinking water, or when yous hear or touch running water.

Many women with urinary incontinence have both stress and urge incontinence. This is called "mixed" incontinence.

What are the symptoms of urinary incontinence?

Urinary incontinence is not a disease by itself. Urinary incontinence is a symptom of another health trouble, usually weak pelvic floor muscles. In addition to urinary incontinence, some women have other urinary symptoms:⁴

Pressure or spasms in the pelvic area that causes a strong urge to urinate
Going to the bathroom more than usual (more than 8 times a day or more than twice at night)
Urinating while sleeping (bedwetting)

What causes urinary incontinence?

Urinary incontinence is usually caused past bug with the muscles and nerves that aid the bladder agree or laissez passer urine. Certain wellness events unique to women, such as pregnancy, childbirth, and menopause, can cause problems with these muscles and nerves.

Other causes of urinary incontinence include:

Overweight. Having overweight puts pressure on the bladder, which can weaken the muscles over time. A weak float cannot concord every bit much urine.
Constipation. Problems with bladder control can happen to people with long-term (chronic) constipation. Constipation, or straining to have a bowel movement, can put stress or force per unit area on the bladder and pelvic floor muscles. This weakens the muscles and can crusade urinary incontinence or leaking.
Nerve damage. Damaged nerves may send signals to the bladder at the wrong time or not at all. Childbirth and wellness issues such as diabetes and multiple sclerosis can crusade nerve impairment in the float, urethra, or pelvic floor muscles.
Surgery. Any surgery that involves a woman'southward reproductive organs, such as a hysterectomy, tin damage the supporting pelvic floor muscles, specially if the uterus is removed.^five If the pelvic flooring muscles are damaged, a woman'southward bladder muscles may not work similar they should. This can crusade urinary incontinence.

Sometimes urinary incontinence lasts only for a brusque time and happens because of other reasons, including:

Certain medicines. Urinary incontinence may exist a side effect of medicines such as diuretics ("h2o pills" used to treat center failure, liver cirrhosis, hypertension, and certain kidney diseases). The incontinence often goes abroad when you terminate taking the medicine.
Caffeine. Drinks with caffeine tin can cause the bladder to make full quickly, which can crusade you to leak urine. Studies suggest that women who potable more two cups of drinks with caffeine per twenty-four hours may be more than likely to have issues with incontinence.⁶ Limiting caffeine may aid with incontinence considering in that location is less strain on your bladder.
Infection. Infections of the urinary tract and bladder may cause incontinence for a short time. Bladder command often returns when the infection goes away.

How does pregnancy cause urinary incontinence?

As many equally four in 10 women get urinary incontinence during pregnancy.^vii During pregnancy, every bit your unborn baby grows, he or she pushes down on your bladder, urethra, and pelvic floor muscles. Over time, this force per unit area may weaken the pelvic floor muscles and lead to leaks or problems passing urine.

Most problems with bladder control during pregnancy become away after childbirth when the muscles have had some time to heal. If y'all're still having bladder problems six weeks afterward childbirth, talk to your doctor, nurse, or midwife.

How does childbirth cause urinary incontinence?

Problems during labor and childbirth, specially vaginal birth, tin can weaken pelvic floor muscles and impairment the fretfulness that control the bladder. Most problems with float control that happen equally a result of labor and delivery go abroad after the muscles have had some fourth dimension to heal. If yous're still having float bug 6 weeks after childbirth, talk to your md, nurse, or midwife.

How does menopause cause urinary incontinence?

Some women accept bladder command problems later they stop having periods. Researchers think having depression levels of the hormone estrogen afterwards menopause may weaken the urethra.⁸ The urethra helps go on urine in the bladder until you are set to urinate.

Also, like all muscles, the bladder and urethra muscles lose some of their strength as yous get older. This ways y'all may not be able to concord every bit much urine equally you get older.

What type of md or nurse should I get to for help with urinary incontinence?

If yous have urinary incontinence, you tin can brand an appointment with your chief care provider, your OB/GYN, or a nurse practitioner. Your doctor or nurse will work with you to treat your urinary incontinence or refer you to a specialist if you need different treatment.

The specialist may be a urologist, who treats urinary problems in both men and women, or a urogynecologist, who has special preparation in the female person urinary system. Yous might too need to see a pelvic floor specialist, a type of physical therapist, who will piece of work with you to strengthen your pelvic floor muscles that back up the urinary tract.

How is urinary incontinence diagnosed?

Your medico or nurse volition ask you about your symptoms and your medical history, including:

How often yous empty your bladder
How and when you leak urine
How much urine you leak
When your symptoms started
What medicines you take
If you have ever been pregnant and what your labor and delivery feel was like

Your doctor or nurse will practice a physical exam to await for signs of health issues that can cause incontinence.

Your doctor or nurse also may practice other tests such equally:

Urine test. Subsequently you lot urinate into a cup, the doctor or nurse will ship your urine to a lab. At the lab, your urine will be checked for infection or other causes of incontinence.
Ultrasound . Your md will use an ultrasound wand on the exterior of your abdomen to take pictures of the kidneys, bladder, and urethra. Your doc volition wait for anything unusual that may be causing urinary incontinence.
Bladder stress examination. During this exam, you will coughing or bear downwardly equally if pushing during childbirth every bit your doctor watches for loss of urine.
Cystoscopy . Your doctor inserts a thin tube with a tiny camera into your urethra and bladder to look for damaged tissue. Depending on the blazon of cystoscopy yous need, your doctor may apply medicine to numb your skin and urinary organs while yous are nevertheless awake, or you may be fully sedated.
Urodynamics . Your md inserts a thin tube into your bladder and fills your float with water. This allows your doctor to measure the pressure in your bladder to see how much fluid your bladder can hold.

Your doctor or nurse may enquire you lot to keep a diary for 2 to 3 days to track when you empty your float or leak urine. The diary may aid your doctor or nurse encounter patterns in the incontinence that give clues about the possible cause and treatments that might piece of work for you.

How is urinary incontinence treated?

You and your doctor or nurse will piece of work together to create a treatment program. You may first with steps yous can accept at dwelling house. If these steps do non improve your symptoms, your doctor or nurse may recommend other treatments depending on whether you accept stress incontinence or urge incontinence or both.

Be patient equally yous work with your doctor or nurse on a handling program. It may take a calendar month or longer for different treatments to begin working.

What steps tin I take at domicile to treat urinary incontinence?

Your doctor or nurse may propose some things you can do at home to help treat urinary incontinence. Some people do not recollect that such simple actions can care for urinary incontinence. Just for many women, these steps brand urinary incontinence get abroad entirely, or assist leak less urine. These steps may include:

Doing Kegel exercises. If you have stress incontinence, Kegel exercises to strengthen your pelvic floor muscles may help. Some women have urinary symptoms because the pelvic flooring muscles are always tightened. In this situation, Kegel exercises will not help your urinary symptoms and may cause more issues. Talk to your physician or nurse near your urinary symptoms earlier doing Kegel exercises.
Preparation your bladder. You can help control overactive float or urge incontinence past going to the bathroom at set times. Get-go by tracking how oft y'all get to the bathroom each twenty-four hour period in a float diary (PDF, 499 KB). Then slowly add about 15 minutes between bathroom visits. Urinate each fourth dimension, even if you exercise not experience the urge to go. By gradually increasing the amount of time between visits, your float learns to concur more urine before it signals the demand to get again.
Losing weight. Actress weight puts more than pressure level on your bladder and nearby muscles, which can lead to problems with bladder control. If you have overweight, your medico or nurse can assist you lot create a programme to lose weight by choosing salubrious foods and getting regular physical action. Your medico or nurse may refer you to a dietitian or physical therapist to create a healthy eating and exercise plan.
Irresolute your eating habits. Drinks with caffeine, carbonation (such as sodas), or alcohol may make bladder leakage or urinary incontinence worse. Your doctor might suggest that you stop drinking these drinks for a while to see if that helps.
Quitting smoking. Smoking can brand many health problems, including urinary incontinence, worse.
Treating constipation. Your doctor might recommend that you lot swallow more fiber, since constipation can make urinary incontinence worse. Eating foods with a lot of fiber (PDF, 166 KB) tin make yous less constipated.

You can also buy pads or protective underwear while you lot take other steps to care for urinary incontinence. These are sold in many stores that likewise sell feminine hygiene products similar tampons and pads.

What are Kegel exercises?

Kegel exercises, too called Kegels or pelvic floor muscle grooming, are exercises for your pelvic floor muscles to assistance prevent or reduce stress urinary incontinence. Your pelvic floor muscles back up your uterus, float, small intestine, and rectum.

Four in x women improved their symptoms after trying Kegels.⁹ Kegels can be washed daily and may be especially helpful during pregnancy. They can assistance forbid the weakening of pelvic floor muscles, which often happens during pregnancy and childbirth. Your pelvic floor muscles may too weaken with age and less concrete action.

Some women have urinary symptoms because the pelvic floor muscles are always tightened. In this situation, Kegel exercises volition not help your urinary symptoms and may cause more problems. Talk to your doctor or nurse near your urinary symptoms earlier doing Kegel exercises.

How do I do Kegel exercises?

To do Kegels:

Lie down. It may be easier to acquire how to do Kegels correctly while lying down. You lot don't accept to lie down once you learn to do Kegels correctly.
Squeeze the muscles in your genital area as if y'all were trying to stop the menstruation of urine or passing gas. Attempt not to squeeze the muscles in your belly or legs at the same time. Effort to squeeze only the pelvic muscles. Be extra careful not to tighten your breadbasket, legs, or buttocks (considering then you will not exist using your pelvic floor muscles).
Relax. Squeeze the muscles again and concord for 3 seconds. So relax for 3 seconds. Work upwardly to three sets of 10 each solar day.
Practice Kegels anywhere. When your muscles get stronger, try doing Kegels while sitting or standing. You tin do these exercises at any fourth dimension, such as while sitting at your desk-bound or in the motorcar, waiting in line, or doing the dishes. Don't do Kegel exercises at the aforementioned time you are urinating. This tin weaken your pelvic floor muscles over fourth dimension.^ten

If you are uncomfortable or uncertain well-nigh doing Kegel exercises on your own, a dr. or nurse tin can also teach you how to exercise Kegels. A pelvic floor physical therapist or other specialist may also be available in your area to help teach y'all how to strengthen these muscles.

How soon after starting Kegel exercises will urinary incontinence go better?

It may take 4 to six weeks before you discover any improvement in your symptoms.^x

Kegel exercises work differently for each person. Your symptoms may go away totally, you may observe an improvement in your symptoms but still have some leakage, or you lot may non see whatever improvement at all. Merely even if your symptoms don't get better, Kegel exercises tin help prevent your incontinence from getting worse.

You may need to continue doing Kegel exercises for the residuum of your life. Even if your symptoms amend, urinary incontinence tin come back if you stop doing the exercises.

Should I beverage less h2o or other fluids if I take urinary incontinence?

No. Many people with urinary incontinence think they need to drinkable less to reduce how much urine leaks out. But you need fluids, especially water, for skillful health. (But alcohol and caffeine can irritate or stress the bladder and make urinary incontinence worse.)

Women demand 91 ounces (virtually 11 cups) of fluids a twenty-four hour period from nutrient and drinks.¹¹ Getting enough fluids helps proceed your kidneys and bladder healthy, prevents urinary tract infections, and prevents constipation, which may make urinary incontinence worse.

Afterward age 60, people are less likely to go plenty water, putting them at adventure for dehydration and weather condition that make urinary incontinence worse.¹²

What are some medical treatments for stress incontinence?

If steps you lot tin can take at dwelling do not work to amend your stress incontinence, your doctor may talk to you about other options:

Medicine. After menopause, applying vaginal creams, rings, or patches with estrogen (called topical estrogen) can help strengthen the muscles and tissues in the urethra and vaginal areas. A stronger urethra will help with float control. Learn more about menopause treatments.
Vaginal pessary. A reusable pessary is a small plastic or silicone device (shaped like a band or modest donut) that you put into your vagina. The pessary pushes up against the wall of the vagina and the urethra to back up the pelvic floor muscles and assistance reduce stress incontinence. Pessaries come in unlike sizes, so your doctor or nurse must write a prescription for the size that will fit y'all. Another type of pessary looks like a tampon and is used in one case and so thrown away. You can go this blazon of pessary at a store that also sells feminine hygiene products.
Bulking agents. Your doctor can inject a bulking amanuensis, such as collagen, into tissues around the float and urethra to cause them to thicken. This helps keep the bladder opening closed and reduces the amount of urine that can leak out.
Surgery. Surgery for urinary incontinence is not recommended if yous program to get meaning in the future. Pregnancy and childbirth tin can cause leakage to happen once more. The two most common types of surgery for urinary incontinence are:¹³
- Sling procedures. The mid-urethral sling is the virtually common type of surgery to treat stress incontinence. The sling is either a narrow slice of synthetic (man-made) mesh or a slice of tissue from your own body that your doctor places under your urethra. The sling acts like a hammock to support the urethra and agree the float in place. Serious complications from the sling process include hurting, infection, pain during sex, and damage to nearby organs, such every bit the bladder. The Food and Drug Administration (FDA) reports that in i out of every l patients who have synthetic mesh for urinary incontinence, the mesh moves after surgery and stick outs, into the vagina, causing pain.¹⁴ The FDA recommends discussing treatment options with your doctor before surgery, and asking specific questions about side effects.
- Colposuspension. This surgery also helps hold the bladder in place with stitches on either side of the urethra. This is often referred to as a Burch process.

What are some nonsurgical treatments for urge incontinence?

If steps you can have at home exercise not work to better your urge incontinence, your physician may suggest one or more of the following treatments:

Medicines. Medicines to treat urge incontinence aid relax the bladder muscle and increase the amount of urine your bladder can hold. Common side furnishings of these medicines include constipation and dry out eyes and mouth.
Botox. Botox injections in the bladder can aid if other treatments don't work. Botox helps relax the bladder and increases the amount of urine your bladder tin can concord. You may demand to go Botox treatments about in one case every three months.
Nerve stimulation. This handling uses mild electrical pulses to stimulate fretfulness in the bladder. The pulses may increment blood menstruum to the bladder and strengthen the muscles that help control the bladder. Talk to your doctor about the unlike types of nerve stimulation.
Biofeedback. Biofeedback helps y'all encounter how your bladder responds on a screen. A therapist puts an electrical patch on the pare over your bladder and urethral muscles. A wire connected to the patch is linked to a screen. You and your therapist watch the screen to see when these muscles contract so you can learn to control them.
Surgery. If you accept astringent urge incontinence, your doc may recommend surgery to help increase the amount of urine your float can hold or to remove your bladder. Removing your bladder is a serious surgery and is an option only when no other treatments work and the quality of your life is seriously affected.

How tin can I prevent urinary incontinence?

Although you can't always prevent urinary incontinence, you can accept steps to lower your risk:

Exercise Kegels daily, particularly during pregnancy and after talking to your physician, nurse, or midwife.
Reach or stay at a healthy weight.
Swallow foods with fiber to help foreclose constipation.

Did we answer your questions about urinary incontinence?

Sources

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Reddy, J., & Paraiso, M.F.R. (2010). Principal Stress Urinary Incontinence: What to Exercise and Why. Reviews in Obstetrics & Gynecology; 3(4): 150–155.
Stewart, West.F., et al. (2003). Prevalence and Burden of Overactive Bladder in the Us. Earth Journal of Urology; 20(vi): 327–336.
American Higher of Obstetricians and Gynecologists. (2016). Urinary Incontinence (PDF, 84 KB).
Altman, D., Granath, F., Cnattingius, Due south., & Falconer, C. (2007). Hysterectomy and Gamble of Stress-Urinary-Incontinence Surgery: Nationwide Cohort Report. Lancet; 370(9597): 1494–1499.
Gleason, J.50., Richter, H.E., Redden, D.T., Goode, P.S., Burgio, K.L., & Markland, A.D. (2013). Caffeine and Urinary Incontinence in Women. International Urogynecology Journal; 24(2): 295–302.
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Kim, D.K., & Chancellor, M.B. (2006). Is Estrogen for Urinary Incontinence Practiced or Bad? Reviews in Urology; 8(2): 91–92.
Health Resource and Services Administration, Bureau for Healthcare Research and Quality. (2012). Nonsurgical Treatments for Urinary Incontinence in Adult Women: Diagnosis and Comparative Effectiveness (PDF, 12.nine MB). Comparative Effectiveness Review; 36.
U.S. National Library of Medicine. (2017). Kegel exercises – self-intendance.
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Nutrient and Drug Administration. (2018). Considerations about surgical mesh for SUI.

The Office on Women'south Health is grateful for the medical review by:

Tamara G. Bavendam, M.D., Thou.S., Senior Scientific Officeholder and Program Director, Sectionalisation of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases
Douglas Thousand. Van Drie, M.D., Director of Female Pelvic Medicine & Urogynecology Institute, Grand Rapids Women'due south Health

All material contained on these pages are costless of copyright restrictions and may be copied, reproduced, or duplicated without permission of the Function on Women'southward Health in the U.South. Department of Health and Human Services. Citation of the source is appreciated.

Folio last updated: Jan 31, 2019

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Source: https://www.womenshealth.gov/a-z-topics/urinary-incontinence