Urge Incontinence: Causes, Symptoms, & Treatment

Reviewed by: Missy Nolan

If you suffer from urge incontinence, you aren't alone. This condition is a pervasive issue for approximately 13 million Americans. Of that 13 million, 85% are women. While most common in the elderly, anyone can find themselves impacted by incontinence, leading to disruptions to daily life, embarrassing accidents, and physical effects, such as urinary tract infections or skin irritation. 

Urge incontinence, in particular, causes a sudden, strong need to urinate, often followed by a spasm of the bladder causing urine to leak. It can be a few drops or result in a gush. Either way, it can be disruptive and cause people to stay home in an attempt to avoid embarrassing accidents in public or at work. 

The good news is that there are many ways to treat and manage incontinence to keep it from interrupting your life. Even if symptoms aren't completely eliminated, there are discreet incontinence products that can help you stay clean and dry without anyone knowing about your condition.

Causes of Urge Incontinence

The bladder can hold more than 2 cups of urine. However, most people start feeling the urge to relieve themselves with a little less than a cup of urine. Urge urinary incontinence can make that urge to go significantly more frequent, leading to several beelines to the nearest restroom in an attempt to avoid an accident. This can be caused by different conditions or symptoms, which a doctor can help you identify and treat.

Overactive Bladder Muscles

When your bladder muscles are overactive, you may feel a sudden and frequent need to urinate. You may not be able to control it, and the bladder can spasm, causing you to unintentionally urinate. This often happens eight or more times per day, and you may wake up several times at night to relieve yourself. It can also be common to lose urine overnight if you do not wake up quickly enough.

Neurological Disorders

Some neurological disorders can also result in unintentional loss of urine or sudden urges to go. Often, this is caused by physical injuries that damage the nerves, which can commonly happen in childbirth and pregnancy but may be caused by other conditions as well. Neurological disorders that can cause incontinence include:

• Alzheimer's disease
• Parkinson's disease
• Cerebral palsy
• Encephalitis
• Multiple sclerosis
• Tumors in the spinal cord or brain
• Birth defects in the spinal cord

Bladder Irritation

When the bladder is irritated, it may contract more than usual, leading to leakage. Some foods and drinks may be particularly irritating to the bladder, causing an increase in incontinence symptoms. These include:

• Coffee and other caffeinated drinks
• Carbonated drinks
• Alcohol
• Acidic fruits
• Spicy foods
• Tomato-based foods
• Chocolate

Other regular products may irritate the bladder, such as catheter use, certain hygiene products, or spermicide jelly.

Medications

Certain medications can increase the prevalence of incontinence because they either irritate the bladder or increase fluids. Diuretics, for example, can cause the bladder to fill up quicker, leading to an increased need to urinate and increasing the risk of leakage.

Other Causes

Some lifestyle choices can also lead to increased incontinence, such as smoking, being overweight or obese, or changes to your health. Incontinence also becomes more common as you age. Women are more at risk of incontinence due to hormonal fluctuations that weaken the pelvic muscles.

Types of Incontinence

Incontinence can occur in many forms, all stemming from different causes, even though the end result is the same. Knowing the type of incontinence you have can help you manage your symptoms by recognizing what's most likely to trigger leakage or when it is likely to occur. The most common types of incontinence include:

• Reflex incontinence. Reflex incontinence occurs when the bladder muscles contract suddenly and involuntarily without warning. Typically, this is caused by the same contraction of the bladder seen in urge incontinence but often causes more leakage.
• Mixed incontinence. Mixed incontinence is a combination of both urge and stress incontinence symptoms. 
• Pregnancy incontinence. Many pregnant women find themselves leaking urine as the growing baby creates pressure on the bladder and weakens the pelvic floor. This is called pregnancy incontinence, and it may be temporary, but some women experience incontinence postpartum as well.
• Functional incontinence. People who have functional incontinence recognize the urge to relieve themselves but cannot reach a toilet in time due to some sort of barrier, such as requiring mobility assistance or being unable to remove their clothes quickly enough on their own. It can also be caused by cognitive decline seen in Alzheimer's disease or other types of dementia.
• Stress incontinence. Stress incontinence occurs when activities that put stress on the pelvic floor, such as laughing, coughing, sneezing, or standing up, cause urine to leak.
• Overflow incontinence. Overflow incontinence is the result of being unable to fully empty the bladder. When the bladder muscles are weak or there is a blockage, urine cannot be fully eliminated, and the retained urine can leak out later without the urge to go.

Symptoms and Diagnosis

Recognizing the symptoms of incontinence can help you get the help you need when you need it. The symptoms will also help your doctor accurately diagnose your condition. 

Symptoms of Urge Incontinence

The primary symptom of all types of incontinence is experiencing uncontrollable urine leakage. How it occurs is relevant to diagnosing the specific type of incontinence you have. 

With urge incontinence, you also experience a sudden, uncontrollable urge to urinate that is then followed by leakage. You may also feel the need to urinate more frequently than usual.

Diagnosing Urge Incontinence

While it can be embarrassing to broach the subject of incontinence with a doctor, they will be your best support in finding a solution to manage your condition. Make sure that when seeking medical care, you are completely honest about symptoms and frequency so your doctor gets the whole picture. 

When you go to the doctor for incontinence, you can expect your doctor to discuss your medical history with you to try to identify the cause. You will likely also have an internal pelvic exam to see how your pelvic organs and muscles are doing. You may also be asked to keep a bladder diary to track symptoms, what you were doing when the symptoms arose, and how much urine you lost. This information is often enough to diagnose the specific type of incontinence you have, but you may also need other tests, such as:

• Bladder stress test. This test will help determine if the cause of your incontinence is due to activities, often leading to a diagnosis of mixed or stress incontinence.
• Pelvic ultrasound. A pelvic ultrasound allows doctors to view your bladder, urethra, and other organs to see if there is a physical cause for your incontinence, such as a blockage.
• Urine test. A urine test can help doctors identify infections or kidney problems that may be exacerbating incontinence symptoms.
• Urodynamic testing. Urodynamic testing encompasses a range of tests that are designed to test how the bladder functions, including identifying bladder capacity, urine flow, and the pressure within the bladder.
• Cystoscopy. A cystoscopy allows doctors to view your urethra and bladder. A tiny camera is inserted through the urethra with a tube-shaped scope and can identify inflammation or blockages.

Persistent Urinary Incontinence

• Pregnancy and childbirth: Both pregnancy and childbirth put an extreme strain on a woman's body. Especially if vaginally delivering large babies, it is possible to damage the nerves responsible for controlling urination and causing persistent urinary incontinence.
• Enlarged prostate: As men age, the prostate can enlarge, leading to a condition called benign prostatic hyperplasia, also known as BPH. This can cause incontinence.
• Cancer: Both stress and urge incontinence in men are associated with prostate cancer. However, they can also occur if the treatment for prostate cancer damages nerves or muscles in the pelvic area.
• Hormonal fluctuations and menopause: Estrogen is responsible for maintaining the lining of the bladder and urethra. After menopause, women's estrogen levels decline, which can cause problems with these tissues and lead to incontinence.
• Obstruction: Any sort of obstruction in the urinary tract can block urine flow and cause overflow incontinence.
  
  

Risk Factors and Complications of Urge Incontinence

While you may not be able to completely eliminate incontinence from your life, you can understand the risk factors and manage them in an effort to control symptoms. 

Risk Factors

• Gender: Incontinence is more common in women due to hormonal and physiological differences. 
• Family history: Incontinence may be genetic, causing those with a family history of incontinence to be at an increased risk of developing the condition.
• Age: While incontinence can happen at any age, it is most prevalent in those 80 or older. However, many middle-aged people also experience incontinence, and it can increase in prevalence over the years.
• Weight: Being overweight or obese can put additional pressure on the pelvic floor, causing an increase in incontinence symptoms
• Childbirth: Childbirth can be damaging to the nerves and muscles in the pelvic area, increasing the risk of incontinence.
• Smoking: Smoking acts both as a bladder irritant and as a cause of stress incontinence because it causes chronic coughing.
  
  

Complications

Unmanaged incontinence can cause several complications. These include:

• Skin irritation. Urine left in contact with the skin for too long can cause it to get inflamed and eventually even break down. This can lead to painful infections.
• Urinary tract infections. Incontinence is associated with an increased risk for urinary tract infections, which can also cause bladder irritation and exacerbate symptoms.
• Impacts on mental health and personal life. Incontinence can be embarrassing, causing those impacted to withdraw from friends and family. 
  
  

Treatment Options

Thankfully, several treatment options exist to help you mitigate your symptoms and keep you dry. If you've been experiencing urge incontinence, speak to your doctor about these treatment options to determine which is right for you.

Behavioral Modifications

Several behavioral modifications can help minimize urge incontinence. Some of the most common include:

• Bladder training. Bladder training works to increase the intervals between how frequently you relieve yourself after the first urge occurs. 
• Biofeedback. Biofeedback helps teach you to control bodily functions that normally are not consciously managed. This treatment option requires a therapist, as it relies on electrical activity in the pelvic region to be recorded.
• Kegels. Kegels and other pelvic floor exercises can help strengthen your pelvis to reduce urinary leakage. However, they aren't safe for everyone, so check with your provider before starting a home exercise routine involving Kegels. 
• Eliminate exacerbating factors. If you smoke, are overweight, or consume alcohol, caffeine, or other items that can irritate the bladder, removing these from your day-to-day life can help limit incontinence.

Incontinence Products

Because some people won't be able to eliminate urge incontinence fully, many choose to use incontinence products, such as Nexwear's pads or underwear. These discreet products absorb urine to keep you dry, and with odor neutralizers, they leave you feeling fresh. The pads are worn similarly to menstrual pads inside your underwear, while absorbent underwear can stand alone as an undergarment.

Medications

Some medications are available for bladder control issues, such as unmanageable urge incontinence. These medications work to soothe overactive bladders. Anticholinergics, for example, block acetylcholine, which is the chemical that tells your brain to contract the bladder.

Botox can also be used in the bladder to help paralyze the muscle and reduce symptoms of urge incontinence. 

Estrogen may be used for women whose incontinence came on with menopause. Applied as a low-dose topical cream, estrogen can help strengthen the tissues in the area and alleviate some symptoms, but it may not be safe if you have a history of breast or uterine cancer.

Nerve Stimulation Therapy

Some people may receive nerve stimulation therapy to assist with their urinary incontinence. This involves sending a mild electric current in the lower back to affect muscles related to urination. This treatment works similarly to performing Kegels, causing the pelvic muscles to contract and strengthening them.

Surgery

In some severe cases, doctors may recommend you get surgery to treat your incontinence. However, it is not commonly used for urge incontinence and may exacerbate symptoms. Surgeries are typically used for stress incontinence to provide support for the bladder and urethra to prevent leakage.

The Bottom Line

Urge incontinence is unpleasant for anyone affected by it. However, you don't have to let it control your life. Through treatments and supportive products like Nexwear's absorbent incontinence pads and underwear, you can live your life your way, without fear of leaking through your clothes. If you're tired of hiding near the closest bathroom and letting your incontinence control your life, check out Nexwear's selection of products and subscribe for easy, reliable incontinence protection where you need it most.