Urge incontinence occurs when you have a sudden urge to urinate. In urge incontinence, the bladder contracts when it should not, causing some urine to leak through the sphincter muscles. It is also known as overactive bladder, bladder spasms, spasmodic bladder, irritable bladder, or detrusor instability.
While this is a common issue and can affect anyone, women and the elderly are at a higher risk of developing it.
It is important to remember that urge incontinence is not a disease in itself. It is 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 to overactive bladder. Your doctor can diagnose your specific type of incontinence, its cause, and provide possible treatment options.
In many cases of urge incontinence, your doctor will be unable to pinpoint any exact cause. Some potential causes could include:
- bladder infection
- bladder inflammation
- bladder stones
- obstruction of the opening of the bladder
- enlarged prostate (in men)
- bladder cancer
- diseases of the nervous system (such as multiple sclerosis)
- injury to the nervous system (such as a stroke or trauma to the spinal cord)
For many people, urge incontinence is merely an inconvenience that does not require a doctor visit. However, if urge incontinence is impeding on your daily activities, you may want to visit your doctor to discuss treatment options or other ways to manage your condition.
Treatments are varied and they depend on your unique symptoms and condition. Each patient will have a slightly different treatment plan. In general, your doctor will try behavioral treatments, such as bladder retraining and Kegel exercises, before suggesting more invasive treatments.
If you have a serious case of urge incontinence, you will want to seek treatment right away. Your symptoms could be signaling a bladder infection, inflammation, obstruction, or stones in the bladder or kidney. Some symptoms to watch out for are urge incontinence together with:
- pain in the pelvic region (lower stomach)
- burning or pain with urination
- symptoms that continue for several days
Most people with urge incontinence can live normally without treatment. However, the condition could affect your daily life, and you may want to consider trying some of the many treatment options for urge incontinence.
Some treatments are self-administered and can be done at home. Others require the assistance of your doctor.
You might want to try some of these at-home remedies:
Dietary changes: These can reduce the irritation on your bladder. You should limit your intake of alcohol, caffeine, and other irritating foods that are spicy, acidic, or high in sugar. In addition, try to lose weight if you are overweight, or adjust your lifestyle habits to be healthier overall.
Kegel exercises: This is normally the first treatment option for urinary incontinence. The process aims to strengthen the muscles involved with urination, specifically the pelvic floor muscles.
Try contracting the pelvic floor for five to 10 seconds, then rest for the same amount of time. The motion of contracting the pelvic floor is like stopping the flow of urine midstream. If you are unsure if you are doing it correctly, try stopping your urine mid-stream. The Kegel 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. Kegels can be done at any time and in any location. If overseen by a doctor, you may use Kegelcones, which are weighted cones held in the vagina by contracting the pelvic floor. As the muscles get stronger, you use heavier weights.
One option for pelvic floor strengthening is an electric version of Kegels. Here a probe is inserted into the vaginal or anal openings to send a shock to the pelvic floor muscles. This helps strengthen them. However, it takes several months and many treatments to be effective.
Bladder retraining: This is designed to strengthen the muscles involved with urination. One technique involves urinating at only specific, scheduled times each day. You cannot urinate at other times, even if you have the urge to go.
At first, you will go every hour and then increase the wait time by half-hour intervals until you can make it three to four hours without leakage. Another process is to delay urination when the urge strikes. This strengthens your ability to hold urine. You may also try urinating, then going again immediately to learn how to empty the bladder completely.
Lifestyle changes: These changes can also improve your condition. You should try to eat more fiber to prevent constipation that puts pressure on the bladder. You should also quit smoking so that you cough less.
You may want to wear an absorbent pad while you do activities that increase leakage.
Your doctor can also provide you with a urethra insert or a pessary. These inserts are like small tampons that you can insert into the urethra before specific activities where leakage is likely to occur. They are not meant for everyday use. A pessary is inserted into the vagina to help hold up the bladder and limit urinary leakage. You wear it all day and can insert it yourself.
Your doctor can provide you with additional treatment options, such as medication or surgery to help with muscle strength and sphincter functioning. There are many surgical options your doctor can discuss with you. The following are some of those options.
Collagen implants: These are injections into your urethra wall to help control urine leakage that is due to weak sphincter muscles. This is a relatively simple and effective option for treating urinary incontinence.
Nerve stimulators: These are small devices that resemble Pacemakers. The device is inserted under the skin of the buttocks and hooked up to the sacral nerve. It sends light pulses to the nerve to help control your bladder’s functioning.
Catheters: These are another at-home option, specifically for those who suffer from overflow incontinence. Your doctor will teach you how to insert the catheter, which will help empty your bladder completely when you urinate.
Tension-free vaginal tape: This is used to treat urinary incontinence in women when it caused by stress incontinence. A piece of synthetic tape is secured under the urethra and adjusted for tension to ensure it will not leak. This surgery is likely to decrease leakage, but the results may not be permanent.
Vaginal sling procedures: These use tissue (either your own or synthetic) to create a supportive sling from the bladder neck—where the urethra connects to the bladder—to the lower stomach muscles. This procedure helps to close your urethra and is used to treat urinary incontinence in women when it is caused by stress incontinence. This surgery is likely to decrease leakage, but the results may not be permanent.
Inflatable artificial sphincters: These synthetic devices help control urine leakage that is caused by stress incontinence. When your sphincters do not work properly, they may be replaced with artificial ones. This surgery is likely to decrease leakage, but the results may not be permanent.
Retropubic urethral suspension: This is a surgery that helps control urine leakage caused by stress incontinence. Specifically, the surgery closes off the urethra and bladder neck (where the urethra connects to the bladder) so that less urine can pass through. This surgery is likely to decrease leakage, but the results may not be permanent.
Because urge incontinence is normally a chronic condition that does not 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 is little risk.
However, you need to see a doctor if your incontinence is caused by or accompanied by an infection, bladder stones, or inflammation. Infection could spread to the kidneys or other areas of the body.