Urge Incontinence

Condition Basics

What is urge incontinence?

Urge incontinence is a need to urinate that is so strong that you can't get to the toilet in time. It can occur when the bladder contains only a small amount of urine. Some people have no warning before they accidentally leak urine. Others may leak when they drink water or hear running water.

What causes it?

Causes of urge incontinence include age-related changes, medical conditions such as stroke, and the side effects from medicines. Urge incontinence may be caused by an obstruction to the bladder outlet (such as from an enlarged prostate) or with overactive bladder. Overactive bladder makes a person feel the need to urinate often.

What are the symptoms?

If you have urge incontinence, you may feel a sudden urge to urinate and the need to urinate often. The urge is so strong that you can't reach the toilet in time. With this bladder problem, you may leak a large amount of urine that can soak your clothes or run down your legs.

How is urge incontinence treated?

Urge incontinence is often first treated with:

• Bladder training. This helps you slowly increase how long you can wait before you have to urinate.
• Pelvic floor muscle exercises (Kegels). They help strengthen some of the muscles that control the flow of urine. Biofeedback can also help with this.

Your doctor may talk to you about making changes in your diet and lifestyle. For example, limit caffeine, carbonated drinks, and alcohol. They make you urinate more.

Medicines may also be used. These include:

• Medicines like darifenacin and mirabegron that reduce the urge to urinate and how often you urinate.
• A type of antidepressant that may help with bladder control.
• Estrogen cream used in the vagina.
• Alpha-blockers and other medicines that help relax the muscles in the prostate and bladder.

For urge incontinence that hasn't been controlled by exercises or medicine, treatments include:

• Botulinum toxin injections. You may need to get bladder injections every 3 to 12 months.
• Electrical stimulation. Small electrodes send a mild electric current to nerves in the lower back or the pelvic muscles that are involved in urination.
• Surgery to treat an enlarged prostate, to make the bladder bigger (augmentation cystoplasty), or to make another way to store and pass urine (urinary diversion).