What is urge incontinence?
Urge incontinence occurs when you have a sudden urge to urinate. In urge incontinence, the urinary bladder contracts when it shouldn’t, causing some urine to leak through the sphincter muscles holding the bladder closed. Other names for this condition are:
- overactive bladder (OAB)
- bladder spasms
- spasmodic bladder
- irritable bladder
- detrusor instability
While this is a common issue and can affect anyone, women and older adults are at a higher risk of developing it.
It’s important to remember that urge incontinence isn’t a disease per se. It’s a symptom of lifestyle or medical issues or physical problems.
Urge incontinence is one piece of the larger framework of urinary incontinence. There are several forms of urinary incontinence, ranging from leaking small amounts of urine with a cough or sneeze to an overactive bladder (OAB).
Your doctor can diagnose your specific type of incontinence and its cause, and they can suggest possible treatment options.
In many cases of urge incontinence, a doctor isn’t able to pinpoint an exact cause. However, some potential causes could include:
- bladder infection
- bladder inflammation
- bladder stones
- obstruction of an opening of the bladder
- enlarged prostate
- bladder cancer
- diseases of the nervous system, such as multiple sclerosis (MS)
- an injury to the nervous system, such as trauma to the spinal cord or a stroke
For many people, urge incontinence is merely an inconvenience that doesn’t require a doctor’s visit.
However, if you have a serious case of urge incontinence, you should seek treatment right away. Your symptoms could be signaling:
- bladder infection
- bladder inflammation
- an obstruction
- stones in the bladder or kidney
Some symptoms to watch out for alongside your urge incontinence are pain in the pelvic region, burning or pain with urination, or symptoms that continue for several days.
In addition, if urge incontinence impedes your daily activities, you may want to visit your doctor to discuss treatment options or other ways to manage your condition.
To diagnose incontinence and develop a treatment plan, your healthcare provider will ask you about your medical history and history of incontinence. They will likely perform a physical exam, including a pelvic exam, and take a urine sample.
Your healthcare provider may also perform additional tests if necessary, including:
- Pelvic floor assessment. This tests the strength of your pelvic floor muscles.
- Urinalysis. This test checks for signs of infection or other problems
- Urine culture. If a urinary tract infection is suspected, this test can determine the strain of bacterium present.
- Urinary bladder ultrasound. This allows your doctor to view the anatomy of the bladder and see how much urine is left in the bladder after urinating.
- Cystoscopy. A tiny camera on a fiberoptic scope is inserted into your urethra and used to examine your urethra and bladder.
- X-ray studies. Various X-ray studies allow your doctor to diagnose incontinence:
- Intravenous pyelogram (IVP). Dye is injected into your bloodstream, and fluoroscopic X-rays are taken of your urinary tract to follow the dye as it moves over to and through your urinary system.
- Kidney, ureter, and bladder (KUB) study. This plain film X-ray study can be used to diagnose conditions affecting the urinary and gastrointestinal systems.
- CT scan. Computers and rotating X-ray machines are used to take detailed pictures of your organs.
- Urodynamic studies. These studies are used to evaluate how your bladder and urethra are functioning.
- Stress testing. Your healthcare provider will ask you to perform activities that cause your incontinence symptoms.
Your healthcare provider may also ask you to keep a bladder diary to track your fluid intake and urine output. This information can help reveal activity patterns that could influence your treatment plan.
Treatments are varied and depend on your unique symptoms and condition. Each person will have a slightly different treatment plan.
Your doctor will likely recommend that you try behavioral treatments, such as bladder retraining and bladder relaxation exercises, before suggesting more invasive treatments. Your doctor may also recommended doing Kegel exercises.
Most people with urge incontinence can live without treatment. However, the condition could be very uncomfortable and adversely affect your daily life. You may want to consider trying some of the many treatment options available for urge incontinence.
Some treatments can be self-administered at home. Talk to your doctor if your symptoms worsen or don’t improve.
Changing the foods you eat can reduce bladder irritation. You should limit your intake of alcohol, caffeine, and foods that are spicy, acidic, or contain artificial sweeteners.
Try to eat more fiber to prevent constipation, which can put pressure on the bladder or make you have the urge to empty your bladder.
In addition, try to lose weight if you have overweight. If you have diabetes mellitus, you will want to try to maintain a stable and acceptable blood glucose level.
If you smoke tobacco, consider quitting. The coughing that can result may lead to stress incontinence on top of urge incontinence.
You may want to wear an absorbent pad while you do activities that increase your risk of leakage.
Adjust your lifestyle habits to be healthier overall.
Kegel exercises are usually the first treatment option for urinary incontinence. The process strengthens the muscles involved in holding urine, specifically the pelvic floor muscles.
Try contracting the pelvic floor for 5 to 10 seconds, and then rest for the same amount of time. Contracting the pelvic floor is the same mechanism used when you voluntarily stop the flow of urine midstream.
If you’re unsure if you’re doing it correctly, try stopping your urine midstream. Doing a Kegel exercise should replicate that sensation of stopping your urine.
Simply concentrating on your pelvic floor region and contracting will activate the correct muscles. Repeat this sequence for as many repetitions as you can, three or more times per day.
You can do Kegel exercises at any time and in any location. If overseen by a doctor, you may use Kegel cones, which are weighted cones held in the vagina by contracting the pelvic floor. As your muscles get stronger, you use heavier weights.
One option for pelvic floor strengthening is an electric version of Kegel exercises. Here a doctor will insert a probe into the vaginal or anal openings to stimulate the pelvic floor muscles to contract. This helps strengthen them. However, it takes several months and many treatments to be effective.
Retraining your bladder can strengthen the muscles involved with urination. One technique involves urinating at only specific, scheduled times each day. You can’t urinate at other times, even if you have the urge to go.
At first, you may go every hour and then increase the wait time by half-hour intervals until you can make it 3 to 4 hours without leakage.
Another technique is to delay urination when the urge strikes. This strengthens your ability to hold urine. You may also try urinating and then going again immediately afterward to learn how to empty the bladder completely.
Your doctor can provide you with additional treatment options, such as medication or surgery, to help with muscle strength and sphincter functioning. Here are a few other options:
Small amounts of Botox (botulinum toxin) can stop the bladder muscles from overcontracting. Multiple injections may be needed. This helps to relax the urinary bladder muscles, but it also runs the risk of potential urinary retention.
Nerve stimulators are small devices that resemble pacemakers. The permanent device, inserted under the skin of your abdomen, has a lead wire that hooks up to the sacral nerve. It sends light pulses to the nerve to help control your bladder’s functioning.
A urinary catheter is another at-home option that’s specifically for those who have certain types of incontinence, including overflow incontinence. Your doctor will teach you how to insert the catheter, which will help empty your bladder completely when you urinate.
Because urge incontinence is typically a chronic condition that doesn’t have serious complications, there are few risks associated with not seeking treatment.
As long as you have no other symptoms along with your urge incontinence, such as pain or burning while urinating, there’s little risk.
But untreated urge incontinence may get worse, and it could interfere with daily life activities and relationships.
Additionally, you need to see a doctor if an infection, bladder stones, or other source of inflammation is the suspected cause of your incontinence. If present, a bladder infection could spread up to the kidneys, bloodstream, and other areas of the body.