What it is
Incontinence means the involuntary loss of urine. There are two main types: stress incontinence, when leaks happen with coughing, sneezing, laughing or physical activity; and urge incontinence, when the need to go comes on suddenly and cannot be held. The two often occur together.
Overactive bladder is a set of symptoms, such as urgency and frequent urination during the day and night, which may occur with or without leakage. In men, incontinence can also appear after prostate surgery.
Draft diagram: to be validated by Dr. Greco before launch.
Bladder, sphincters and pelvic floor
- Detrusor muscle · the bladder wall, which contracts to empty it
- Bladder neck · with the internal sphincter
- External sphincter · the muscle that holds urine in
- Pelvic floor · supports the bladder and helps continence
- Urethra
Simplified diagram, not to scale.
Common signs
- Leaking when coughing, sneezing or straining
- Sudden urges that are hard to put off
- Needing to pass urine many times a day
- Waking up at night to pass urine
- Routinely using pads or liners because of leaks
How it is diagnosed
Each type has different causes and treatments, so the assessment is thorough:
- an examination including a pelvic floor assessment
- a bladder diary: for a few days you note what you drink, when you pass urine and any leaks
- urinalysis, ultrasound and, where useful, uroflowmetry
- urodynamic testing, when the way the bladder works needs to be studied in detail
Treatment options
There are several options, often combined:
Frequently asked questions
Is it normal to leak urine after childbirth or menopause?
It is common, but it is not something you have to accept. The pelvic floor can be retrained and several treatments are available: an assessment shows which type of incontinence is present and where to start.
What is a urodynamic test?
It studies how the bladder fills and empties by measuring pressure and flow through a thin catheter. It is done in the clinic and is generally well tolerated; it is mainly used before deciding on certain treatments or procedures.
What if I leak urine after prostate surgery?
It is a possible consequence of prostate surgery. Pelvic floor rehabilitation is often the first step, and the plan is adapted to the type of operation and the time since surgery.
This page provides general information and does not replace a consultation: every situation needs to be assessed by a specialist.