Emi Bretschneider, MD
What is urgency urinary incontinence?
“Urgency urinary incontinence” is leaking urine when you have a strong desire to go to the bathroom. You may have heard the term “overactive bladder”. Urgency urinary incontinence is overactive bladder with leaking. This problem is very common, and people can have it for different reasons.
If you have urgency urinary incontinence, you may also have other bladder issues such as:
- needing to go to the bathroom frequently (frequency)
- having a strong need to go to the bathroom (urgency)
- leaking when you laugh, sneeze, cough or do other activities (stress incontinence)
- getting up at night to use the bathroom more than twice, with or without leaking (nocturia)
- wetting the bed
Who can develop urgency urinary incontinence? Why do people develop it?
People of any age can have overactive bladder, with or without incontinence, but it is more common in older women. Those who drink a large amount of water or too much coffee or soda can have it, too. Some medications to treat conditions like high blood pressure can make it worse.
Some other things that may contribute to urgency urinary incontinence are:
- conditions that affect the nerves of the bladder such as diabetes
- conditions that affect the brain such as stroke
- family history of incontinence
Sometimes urgency urinary incontinence is a sign of a bladder infection. Sometimes there may be no clear cause.
Is urgency urinary incontinence dangerous?
While urgency urinary incontinence isn’t dangerous, it can really impact your quality of life. Leaking urine when you do not want to is embarrassing and stressful. People often have to spend money to buy pads for their leaking. Sometimes people have to miss work or skip out on activities because of leaking. If you leak a lot, then you might develop irritation of your skin because of always being wet from urine. Because urgency urinary incontinence can be related to a bladder infection, your provider will test your urine for signs of infection.
If I have urgency urinary incontinence or think I might have it, when should I go see a medical provider?
If you leak urine and it bothers you, please see a medical provider. This provider will check your urine for infection and sugar. They will ask about your medical problems and if you are taking any medications. Since there are different kinds of bladder leaking, your provider will ask you questions about your leaking to make sure they know which kind of leaking you have. Depending on your symptoms, your provider may need to perform a pelvic exam.
Your provider will help find ways to decrease your leaking episodes. They might recommend lowering the amount of fluid you drink each day and avoiding foods and beverages that can make your leaking worse. They may ask you to empty your bladder at scheduled times. Your provider may also ask you to change the time of day when you take certain medications that may make your leaking worse. You may be asked to complete a bladder diary which keeps track of the amount of fluid you drink, what kinds of fluids you drink and when you drink. This diary will also track when you leak and how much you leak. The diary can help find ways to change your habits to improve your leaking.
What treatments are available for urgency urinary incontinence?
If changing your habits does not improve your leaking, your provider may recommend pelvic floor exercises and/or consultation with a physical therapist. Pelvic floor physical therapy is a program that strengths your pelvic floor muscles to help you control your bladder. If you are postmenopausal, your provider may recommend starting vaginal estrogen therapy.
The next line of treatment for urgency urinary incontinence is medications. There are medications that help by increasing the bladder’s ability to hold urine. There are two different kinds of medications that can be used to treat urgency urinary incontinence. Depending on what medical problems you have, your provider will choose the best medication for you and will talk to you about the side effects to watch out for.
If medications do not help your leaking, then your medical provider may talk to you about other types of treatment which include procedures such as:
- Botulinum Toxin (Botox) injections in the bladder
- Electrical stimulation therapy
- Percutaneous Tibial Nerve Stimulation (PTNS), which involves placing an acupuncture-like needle by the ankle to provide electrical stimulation to the pelvic nerves
- Sacral Neuromodulation (SNM), a procedure which places electrical leads which directly stimulate the pelvic nerves
Take Home Points
- Urgency urinary incontinence is the leaking of urine associated with a strong desire to go to the bathroom (overactive bladder).
- Even though it is not a dangerous condition, urgency urinary incontinence can be really distressing. It can affect your quality of life in many ways.
- There are many ways to treat urgency urinary incontinence, some simple and others more complex. Talk to your medical provider about all the options and decide which one is the right one for you.
Emi Bretschneider, MD
Assistant Professor, Department of OB-GYN,
Urogynecology & Reconstructive Pelvic Surgery,
Northwestern Medicine, Chicago, IL, USA
No conflicts of interest to report.