What should you know about urinary incontinence and overactive bladder?

Urinary incontinence may happen when coughing, sneezing, laughing, lifting, or exercising; this is often called stress incontinence. Leakage can also follow a strong urge that is difficult to defer, known as urgency incontinence. Some people have both patterns.

Overactive bladder describes urinary urgency, often with frequent daytime urination or waking at night to pass urine. It can occur without leakage. Bladder symptoms may be influenced by pelvic-floor weakness, constipation, excess weight, pregnancy or childbirth, prostate enlargement, nerve conditions, diabetes, bladder irritation, or a urinary infection. The symptom does not by itself identify one cause.

Keep a short bladder diary: record drinks, urination, urgency, leakage, and triggers. A clinician may ask about medicines, bowel habits, childbirth or pelvic surgery, mobility, thirst, and sleep. A urine test can help check for infection, and further examination depends on the pattern and your medical history.

Helpful measures may include pelvic-floor muscle training, timed toilet visits, gradually extending the interval between visits, managing constipation, reducing bladder irritants such as caffeine, and adjusting fluids rather than stopping them altogether. Absorbent products can protect clothing while the cause is being assessed. Treatment is selected for the type of symptoms and may include prescribed medicine or specialist care.

Arrange a medical review for new, persistent, worsening, or bothersome leakage, urgency, night-time urination, or difficulty emptying your bladder. Seek prompt care for painful urination, fever, pain in the side or back, blood in the urine, or feeling acutely unwell, as these can occur with a urinary tract problem.

Seek urgent help if you suddenly cannot pass urine, develop new loss of bladder control with leg weakness or numbness around the genitals, or become confused or severely unwell. Do not assume leakage is an inevitable part of ageing; an assessment can identify reversible contributors.

Ask: Which type of leakage or bladder symptom do I have? Could my medicines, constipation, diabetes, prostate symptoms, or a urinary infection be contributing? Should I keep a bladder diary or have a urine test? Which pelvic-floor or bladder-training plan suits me, and when should we review progress?