Urge incontinence

Urge incontinence is a widespread variety of incontinence that occurs when you get an uncontrollable urge to urinate and your bladder may leak before you can get to a toilet. It is usually due to involuntary bladder contractions.

About urge incontinence (overactive bladder)

Urge incontinence is the second most common variety of incontinence after stress incontinence. Women are more likely to suffer from urge incontinence than men are. This type of incontinence occurs when your bladder contracts without you intentionally wanting it to, leaving you little or no time to get to the bathroom.

Urge incontinence causes your bladder to contract and leak without you wanting it to. If your bladder is fully functioning, the bladder muscle is generally relaxed while the bladder is filling. When it gets to about 50% full, you may start to feel an urge to use the toilet. Once you have felt the need to go urinate, you still have some time to get to the bathroom before your bladder is so full it starts to leak. However, in people who suffer from urge incontinence, the bladder seems to give the incorrect message to the brain. It sends a message to the bladder telling it to contract even though it is not particularly full. As a result you will suddenly need to use the toilet.

One of the reasons that urge incontinence may develop without a medical reason to do so is that the part of the brain in the frontal lobe that controls urination may undergo changes that impair its functions.

What causes urge incontinence?

Urge incontinence is normally caused by an underlying ailment such as bladder stones, MS, effects from a stroke or a bladder infection. In some cases, the cause of urge incontinence may not be known. In women who have gone through menopause, a lack of oestrogen may cause urge incontinence to develop.

These conditions may cause urge incontinence:

  • UTI’s (urinary tract infections)
  • Parkinson’s 
  • Alzheimer’s
  • As resulting from a stroke
  • Constipation
  • Multiple sclerosis

If there is no identified cause, urge incontinence is also called an overactive bladder syndrome or unstable bladder. Urge incontinence can cause you to leak large amounts of urine and this can often happen when you are asleep.

If at any time, you notice a burning sensation accompanied by a strange odour when you urinate, there is a good chance that a urinary infection is causing your urge incontinence. Age is often a key factor for incontinence sufferers, so those enjoying their twilight years may find they are more prone to urge incontinence.

Urge incontinence treatment

Just because you suffer from urge incontinence doesn’t mean that you have to look out for a bathroom wherever you go or take a spare pair of pants or underwear in case your bladder acts up. Urge incontinence cannot always be cured but 99% of the time it can be managed with the right incontinence treatment options.

What treatment option you choose for your urge incontinence will normally depend on the severity of the affliction affecting you and the quantity of urine you leak each day. Your doctor will usually start treating the ailment with the least invasive treatment option. One of the main things your doctor needs to get right in terms of successfully managing your urge incontinence is a correct diagnosis. As urge incontinence is normally a result of another underlying condition, that underlying condition needs to be correctly identified and treated. If left untreated, urge incontinence can affect the sufferers social, professional and sex life, so it’s best to get treatment sooner rather than later.

Here are the most commonly used urge incontinence treatment techniques, exercises and tips:

  • Bladder training: This widely used technique strengthens and enhances the bladder’s elasticity. If done correctly, bladder training can also increase the bladder’s capacity and stop it from being ‘overactive’. This means that the time between the feeling that you need to go to the toilet and actually going can be increased. The basic crux of bladder training is gradually increasing the amount of time between your visits to the bathroom. For example, if you discover you go to the bathroom every hour, try hold on for an extra 5 minutes, then an extra 10 minutes and so on. The longer the interval you can achieve between feeling the urge to urinate and actually going to the toilet, the greater your bladder’s capacity will become. The optimum amount of times to urinate in 24 hours is between 5-6 times (or every 3-4 hours) for your average person.
  • Pelvic floor exercises: Essentially these exercises help strengthen the muscle tissue surrounding the bladder and can help alleviate an overactive bladder in some circumstances. You may feel your pelvic floor muscles if you try to stop the flow of urine when you go to the toilet.
    • To strengthen your pelvic floor muscles squeeze the muscles 10-15 times in a row. Try to avoid holding your breath, or tightening your stomach, buttock, or thigh, muscles
  • Lifestyle changes: There are several things you can change in your everyday life to lessen the severity of urge incontinence. These changes are the following:
    • Make the route to your toilet as easy and simple as possible
    • Try avoiding caffeine as much as possible. Caffeine is a diuretic, which means it will make you urinate more. It can also irritate your bladder.
    • Although this might seem counter-intuitive, don’t cut down on the amount of liquid your drink. If you do this, your urine may become concentrated which can also irritate your bladder
    • Try only going to the toilet when you really need to. If you go too often your bladder may become used to holding less and less urine
    • Being overweight may increase the severity of urge incontinence. If you can, lose some weight by keeping fit and active and eating a healthy, balanced diet
  • Medication: A group of medicines called antimuscarinics have been found to be effective in combating urge incontinence. These medications block certain nerve impulses, which in turn relax the bladder. Normally medication is used in conjunction with one of the other remedies listed here. Before starting a course of medication, make sure you talk with your health care professional to ensure it is right for you. 
  • Surgery: Surgery can be fairly effective in treating urge incontinence. Either the surgery is performed to increase the size of the bladder or reduce the activity of the bladder. In most cases, surgery is a last resort option if all other incontinence treatment options have failed. 
  • Products: Depend has a wide variety of incontinence products to help you manage your urge incontinence.

Recent studies put the number of people worldwide suffering from urge incontinence at between 50 and 100 million, which is a comforting fact if you suffer from an overactive bladder. So remember you aren’t alone. Urge incontinence can cause a great amount of stress and disruption to anyone suffering from the ailment. However, with the afore-mentioned treatment techniques, along with advice from your urologist, you can lead a relatively incident free life. So don’t see urge incontinence as an inevitable part of your life, fight back and regain control over your bladder.