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UI is also known as 'loss of bladder control' or 'urinary leakage.' UI is when urine leaks out before you can get to a bathroom. If you have UI, you are not alone. Millions of women have this problem, especially as they get older.
Some women may lose a few drops of urine when they cough or laugh. Others may feel a sudden urge to urinate and cannot control it. Urine loss can also occur during sexual activity and can cause great emotional distress.
UI is usually caused by problems with muscles and nerves that help to hold or pass urine.
Urine is stored in the bladder. It leaves the body through a tube that is connected to the bladder called the urethra. Look at the images below to see how this process works.
Muscles in the wall of the bladder contract to force urine out through the urethra. At the same time, sphincter (ss-FINK-ter) muscles around the urethra relax to let the urine pass out of the body.
Incontinence happens if the bladder muscles suddenly contract or the sphincter muscles are not strong enough to hold back urine.
UI is twice as common in women as in men. Pregnancy, childbirth, and menopause are major reasons why. But both women and men can become incontinent from brain injury, birth defects, stroke, diabetes, multiple sclerosis, and physical changes associated with aging.
Other causes of UI that can affect women and men are:
Many women do not want to talk to their doctor about such a personal topic. But UI is a common medical problem. Millions of women have the same problem. Many have been treated successfully. Your doctor has probably heard many stories like yours.
Even if you feel shy, it is up to you to take the first step. Some doctors don't treat bladder control problems, so they may not think to ask about it. They might expect you to bring up the subject.
Family practitioners and internists can treat bladder problems. If your doctor does not treat such problems, ask for help finding a doctor who does, such as a urologist, OB/GYN, or urogynecologist.
Here are some questions to ask your doctor:
Schedule a visit with your doctor. Your doctor will ask you about your symptoms and take a medical history, including:
Your doctor will do a physical exam to look for signs of health problems that can cause incontinence. Your doctor also will do a test to figure out how well your bladder works and how much it can hold. For this test, you will drink water and urinate into a measuring pan. The doctor will then measure any urine still in the bladder. Your doctor also may order other tests such as:
Your doctor may ask you to write down when you empty your bladder and how much urine you produce for a day or a week.
There are many ways to treat UI. Your doctor will work with you to find the best treatment for you.
Types of treatments include:
By changing some basic behaviors, you may be able to improve your UI. Behavioral treatments include:
Exercising your pelvic floor muscles regularly can help reduce or cure stress leakage. A doctor or nurse can teach you the right way to do the exercises if needed. A pelvic floor physical therapist may be available in your area to help teach you how to strengthen these muscles or help you with other treatments. To do Kegel exercises:
See your doctor, nurse, or physical therapist to learn how to do these exercises correctly. Kegel exercises are most effective when the patient has received proper instruction from a health care professional. Simply trying to stop your urine flow or trying to do the exercises hundreds of times a day without instruction from a health professional will not help.
You may regain bladder control by going to the bathroom at set times, before you get the urge to urinate. You can slowly increase the time between set bathroom trips as you gain control.
Extra weight puts more pressure on your bladder and nearby muscles. This can cause bladder control problems. Work with your doctor to plan a diet and exercise program if you are overweight.
Some foods and beverages are thought to contribute to bladder leakage. While doctors do not know if these foods really do cause UI, it is reasonable to see if stopping one or all of these items is helpful:
Other changes include drinking fewer fluids after dinner and eating enough fiber to avoid constipation. Also, avoid drinking too much. Six 8-ounce glasses of fluid a day is enough for most people.
Researchers are still looking at the link between incontinence and cigarette smoking. Studies show that smokers have more frequent and severe urine leaks.
Medicines for bladder control
Medications can reduce some types of leakage. Some medicines, for example, help relax the bladder muscles and prevent bladder spasms. Talk to your doctor to see if medication is right for you.
It is always important to take your medicine exactly as your doctor tells you to. Also, all drugs have side effects and may affect people differently. Always tell your doctor about any over-the-counter medicines you are taking.
A pessary (PESS-uh-ree) is the most common device used to treat stress incontinence. It is a stiff ring that a doctor or nurse inserts into the vagina. The device pushes up against the wall of the vagina and the urethra. This helps reposition the urethra to reduce stress leakage. See your doctor regularly if you use a pessary.
Some people with urge incontinence may not respond to behavioral treatments or medicine. In this case, electrical stimulation of the nerves that control the bladder may help.
You will be tested to see if this treatment, called neuromodulation (ner-roh-mod-yoo-LAY-shun), can work for you. The doctor will first place a device outside your body to deliver a pulse. If it works well, a surgeon will implant the device.
Biofeedback helps you learn how your body works. A therapist puts an electrical patch over your bladder and urethral muscles. A wire connected to the patch is linked to a TV screen. You and your therapist watch the screen to see when these muscles contract, so you can learn to control these muscles.
Biofeedback can be used with pelvic muscle exercises and electrical stimulation to help control stress incontinence and urge incontinence.
Surgery is most effective for people with stress UI who have not been helped by other treatments. Talk to your doctor about whether surgery would help you, and what type of surgery is best for you.
The doctor may suggest a catheter if you are incontinent because your bladder never empties completely (overflow incontinence). This is also an option if your bladder cannot empty because of poor muscle tone, past surgery, or a spinal cord injury. A catheter is a thin tube that is placed in the bladder by a doctor or by you. It drains the bladder into a bag that you can attach to your leg.
For more information about urinary incontinence, call womenshealth.gov at 800-994-9662 (TDD: 888-220-5446) or contact the following organizations:
Urinary incontinence fact sheet was reviewed by:
Magda Barini-García, M.D., M.P.H.
Office of Minority Health and Health Disparities
Health Resources and Services Administration (HRSA)
Content last updated: July 16, 2012.