Urinary incontinence

What is urinary incontinence

Urinary incontinence is when you pee by accident, or leak urine. It’s more common in older people but can happen at any age.

Some people rush to the toilet to avoid an accident, which can lead to slips, trips or falls, especially at night.

Many women feel anxious or ashamed of their symptoms, but with the right treatment and support you can live a normal life.

Signs and symptoms

You might only leak a little bit of pee, or a lot – it can depend on the type of incontinence you have. It’s also possible to have several types.

Stress incontinence

In stress incontinence, you might leak when you laugh, sneeze, cough or exercise. This happens when there’s pressure on the parts the body that help you pee (bladder and urethra). If the muscles that stop you peeing are weak (pelvic floor and urinary sphincter), pee can leak out.

Urge incontinence

In urge incontinence, your bladder muscles tighten all of a sudden and you might:

• get a sudden urge to pee
• pee often – 8 or more times a day
• wake up to pee – 2 or more times a night.

Common causes are an overactive bladder, nerve damage and diabetes.

Overflow incontinence

In overflow incontinence, your bladder doesn’t empty when you pee. When it gets too full you may leak or dribble out urine.

You might:

• find it hard to pee, or need to strain
• have a weak or slow stream of urine
• feel like your bladder isn’t empty after you pee
• have UTIs (urinary tract infections) often.

Common causes are a blocked urethra tube or weak bladder muscles.

Functional incontinence

Functional incontinence happens when:

• you can’t physically get to the toilet in time
• you can’t tell someone you need to pee
• you don’t know you need to pee.

It could happen if you have disability or trouble communicating.

Read more about urinary incontinence on the healthdirect website.

Having a baby

Pregnancy can weaken your pelvic floor muscles and make you incontinent, but this should stop a few weeks after birth. See your GP if you still have symptoms after 6 weeks.

Read more about pelvic floor exercises during pregnancy on the Pregnancy, Birth and Baby website.

Menopause

Your symptoms might start or get worse after menopause. Having lower levels of oestrogen can weaken your bladder muscles, and make it harder to keep urine in.

When to get help

See your GP if you have any common symptoms, especially if:

• it's affecting your daily life
• you miss out on doing certain activities
• you feel anxious, stressed, depressed, or have poor mental health
• your symptoms stop you sleeping.

There are also other health professionals who can support you including nurse continence specialists and pelvic health physiotherapists. Read more about how they can help on the National Continence website. You can also call their helpline on 1800 330 066 for advice and support.

Before your appointment

Your GP will ask about your symptoms, how long you’ve had them, and how they affect you. It’s important to give them as much information as possible.

Before your appointment, write down:

• how much you drink
• how often you pee
• how much urine there is when you pee
• when and how much urine you leak
• any other symptoms – for example, trouble or pain when you pee.

Digital bladder apps can help you keep track when you're not at home. Some also pair with devices that record how much urine you have, and how fast or how often you pee.

Diagnosis

To help find out what's happening, your GP might do:

• urine tests
• a bladder stress test, to see if your bladder leaks when there's pressure on it
• a pelvic exam, where they check inside your vulva, vagina and cervix
• medical imaging tests like an ultrasound or MRI.

You might see a specialist and have more tests to confirm your diagnosis.

Talk to your GP if you don’t agree with your diagnosis. If you need more help, see another GP for a second opinion.

Treatment

Treatment can depend on your age, your symptoms and how they affect you, and might include:

• exercises or hormone therapy (oestrogen) to strengthen your pelvic floor muscles
• medicines that help with bladder control
• bladder training, so you can hold more urine
• draining urine from your bladder into a bag (catheter)
• drinking more or less fluid
• seeing a counsellor.

Surgery can also improve some types of incontinence.

Care at home

There are things you can do to help manage your symptoms at home so they don't get worse.

Caring for your bladder

Losing weight and eating a healthy diet with plenty of fibre will help you poo often and reduce pressure on your bladder. It’s important to drink enough water, and your GP can tell you how much to drink each day. Don't have anything that can irritate or stimulate your bladder. Smoking, vaping, alcohol and caffeine can all make you need to pee more often.

Strengthening your pelvic floor muscles

Your pelvic floor muscles support your bladder and help you control when you pee. The Continence Health Australia website has pelvic floor exercises you can do to strengthen your muscles and improve your symptoms.

Talk to your GP, midwife or another health professional before starting any new exercise program, especially if you have a medical condition.

Sit correctly on the toilet

Check that you’re sitting correctly on the toilet. Rest your elbows on your knees and lean forward. You can use a footstool if your feet don’t reach the floor. Try not to strain or hold your breath. Let your tummy bulge forward and relax your back.

How to manage your leaks

Knowing how to manage any leaks can help you feel in control and live a full life.

Continence aids

You can use a range of products to manage urine leaks, including:

• wipes, pads, nappies and pull on pants
• washable bed pads and chair pads
• urinals and bed pans for women.

You can also get special stretch pants and clothing to fit over incontinence aids.

The Medical Aids Subsidy Scheme helps with the cost of continence aids. Learn more and check if you're eligible.

Finding public toilets

If you're not at home, use the National Public Toilet Map or download their app to help you find nearby toilets.