Symptoms and Signs of Urinary Incontinence

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 11/21/2022

Doctor's Notes on Urinary Incontinence

Incontinence refers to the involuntary loss of urine. This loss of urine is commonly due to weak muscles that control the exit of the bladder, or by the inability to hold urine when the urge to urinate occurs. Several types of incontinence exist, and the most common types include stress incontinence, which is associated with coughing, sneezing, or exercising, and urge incontinence, when the bladder feels as if it needs to be relieved immediately, regardless of how much urine is in the bladder. 

Symptoms of incontinence include

  • uncontrollable leakage of urine,
  • feeling the need to urinate immediately (urgency),
  • difficulty starting the urine stream (hesitancy),
  • urinating more than usual (frequency),
  • pain or burning with urination (often associated with infection),
  • blood in the urine,
  • having to get up at night to urinate (nocturia),
  • dripping or dribbling urine after urination is completed, and
  • bearing down to start the urine stream (straining). 

What Is the Treatment for Incontinence?

Treatment for incontinence depends on the type of incontinence and may include: 

  • Lifestyle changes
    • Change drinking habits 
      • Drink less liquid during the day
      • Stop drinking liquids a few hours before bedtime
      • Limit foods and drinks with caffeine and alcohol
      • Talk to your doctor about what to drink and when so you avoid dehydration
    • Exercise regularly
    • Maintain a healthy weight
    • Avoid constipation
    • Don’t smoke
    • Train your bladder
    • Do pelvic floor muscle exercises
    • Control the urge to urinate
  • Medications
    • For urgency incontinence 
      • Anticholinergics
      • Beta-3 agonists
      • Tricyclic antidepressants
      • Botulinum toxin A (Botox) injected into the bladder to relax it, which makes more room for urine and lowers the chance of leaks
    • For men who have an enlarged prostate:
      • Alpha-blockers
      • 5-alpha reductase inhibitors
      • Phosphodiesterase-5 inhibitors
  • Medical devices
    • Catheter for overflow incontinence 
    • Pessary for women for stress incontinence 
    • Bulking agents injected near the urinary sphincter to treat stress incontinence
  • Electrical nerve stimulation for urgency incontinence and other symptoms to help change the bladder’s reflexes

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.