What is urinary incontinence?

Urinary incontinence, or poor bladder control, is very common. It’s when you have accidental loss of urine (wee) from your bladder.

Urinary incontinence can affect people of all ages, but it’s most common in females and older people.

There are different types of urinary incontinence, each with different causes and treatments.

Stress incontinence

If you have stress incontinence, you may have small leaks of urine when you:

• cough
• sneeze
• laugh
• exercise

Stress incontinence is more common in females but can also affect males. It’s often related to weak pelvic floor muscles.

Urge incontinence

Urge incontinence causes a sudden and strong need to urinate (wee). You may also:

• need to urinate often
• need to urinate at night

Urge incontinence is often caused by an overactive bladder.

Mixed incontinence

Mixed urinary incontinence is a combination of stress and urge incontinence. This type is most common in older females.

Overflow incontinence

If your bladder doesn’t empty properly, it can leak urine. You may have leaks now and then, or all the time.

Functional incontinence

Functional incontinence affects people who can’t get to the toilet in time. This may be due to:

• mobility problems
• problems with realising you need to urinate, such as if you have dementia

What symptoms are related to urinary incontinence?

Symptoms can range from occasionally leaking some urine to completely losing control of your bladder (when you wet yourself).

Other symptoms can include:

• needing to visit the toilet urgently or frequently
• leaking urine when you laugh, sneeze, cough or exercise
• feeling that you need to strain to pass urine
• a weak or slow urine stream
• feeling as if your bladder is not empty just after going to the toilet
• waking up twice or more during the night to do a wee

What causes urinary incontinence?

Your risk of urinary incontinence is higher if you:

• are pregnant or have ever been pregnant
• are overweight or obese
• have constipation
• have an enlarged prostate
• have a urinary tract infection (UTI)
• are having problems with mobility (which can stop you getting to and using the toilet)

Other risk factors for urinary incontinence include:

• having had surgery to remove some or all of your prostate
• having had a hysterectomy (removal of your uterus)
• having a condition that affects your nerves or muscles
• some other health conditions, such as diabetes or an ongoing (chronic) cough
• some medicines

How is the cause of urinary incontinence diagnosed?

Your doctor will ask about your symptoms, how often you have problems, and how much they affect your life. Your doctor will also examine you, ask about your medical history and any medicines you are taking.

You may be asked to keep a diary of your bladder habits to see what type of urinary incontinence you have. For example, you might need to write down how much you drink, how many times you go to the toilet, and when you leak.

Your doctor may recommend some tests, such as a:

• urine test
• bladder ultrasound scan

Your doctor may refer you to:

• a specialist for further testing and treatment, if needed
• a continence health professional

When should I see my doctor?

See your doctor if you are having trouble controlling your bladder.

How is urinary incontinence treated?

Treatment for urinary incontinence will depend on what is causing it. There are effective treatments available.

Self-care at home

Some lifestyle changes can help to treat and prevent urinary incontinence. These include:

• Avoiding or cutting down on foods and drinks can irritate your bladder, such as alcohol, fizzy drinks, caffeine and spicy or acidic foods.
• Drinking enough fluids evenly throughout the day.

• Treating and avoiding constipation — which can involve drinking plenty of fluids, eating a healthy diet with plenty of fibre and exercising.
• Maintaining a healthy weight
• Quitting smoking and vaping

Some medical conditions may require you to limit your fluid intake, so ask your doctor if you’re unsure how much water you should drink each day.

Medicines for urinary incontinence

There are some medicines that can help with certain types of urinary incontinence. Talk to your doctor about whether medicine is right for you.

Other treatment options

If the problem is with your pelvic floor muscles, physiotherapy and pelvic floor exercises can make a big difference.

If lifestyle changes, medicines and physiotherapy and have not helped your symptoms, surgery may an option. Talk to your doctor about whether surgery may be a suitable treatment for your type of urinary incontinence.

You can also try to train your bladder to improve control and increase the amount of urine you can hold. Talk to your doctor or incontinence health professional about a bladder training program.

Tips for living with urinary incontinence

Incontinence products

There are many products available to help you live with incontinence, such as:

• disposable pads and pants
• washable, reusable protective underwear
• bedding protection

Some people may need a catheter (a tube that is placed in your bladder) to help with incontinence. Catheters are only used when other options haven’t been helpful.

The Australian Government and state and territory governments may subsidise some of these products, if you are eligible. Your continence nurse can help you apply.

Planning your day

It can help to get into a routine. Plan for outings, and make sure you have enough products and spare clothes in case you have an accident.

Know how to find the nearest toilet. The National Public Toilet Map shows the location of more than 22,000 public toilets across Australia.

Caring for someone with incontinence

If you are caring for someone with incontinence, make sure they can access the toilet easily. Make sure their clothing is easy to remove. Also, monitor their routine so you can remind them to go to the toilet regularly.

You can read more about caring for someone with incontinence on the Continence Foundation of Australia website.

Complications of urinary incontinence

Some complications of urinary incontinence are:

• local skin irritation
• emotional distress, which can lead to a reduced quality of life
• depression

Talk with your doctor or continence nurse if you need emotional or psychological support. There are also support groups for people with incontinence — see below.

Resources and support

The Continence Foundation of Australia has information and support for people with incontinence, including:

• Easy to understand booklets.
• Resources for Aboriginal and/or Torres Strait Islander people.
• Incontinence information in other languages.
• Incontinence in Confidence, which offers advice and support for young people with incontinence.
• The National Public Toilet Map, which shows the location of more than 22,000 public toilet facilities across Australia.
• Information about caring for someone with incontinence.

You can call the National Continence Helpline on 1800 33 00 66.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.