Urge Incontinence

I'm a 48 year old woman with bladder problems. When I get the urge to urinate, I have to rush to the bathroom - otherwise I leak urine. Sometimes it gets so bad I have to wear pads. What can I do?

What you are describing is called urge incontinence--this occurs in about 10-20 percent of women. Common symptoms include frequent daytime urination (once an hour or more), getting up at night to urinate, and having triggers such as running water/garage door opening when you get home/key in the lock that cause an overwhelming urge to urinate. The screening question I ask in the office is: "When you feel the urge to urinate, do you need to get to the bathroom in a hurry, otherwise you'll leak?".

We still don't know why urge incontinence occurs. In contrast to stress incontinence (leakage of urine with a cough, sneeze, etc.), there is no loss of bladder or urethral support that can be surgically repaired. Urge incontinence is managed with medications or physical therapy. Common medications include tolterodine (Detrol) and oxybutinin (Ditropan)--both work to help the bladder relax. Physical therapy works on increasing vaginal and pelvic floor strength, delaying intervals between urination episodes, and reducing urge through relaxation techniques. Both methods have been shown to be equally effective in the short term.

Urge incontinence can be bothersome and even debilitating for some women, but it can be treated successfully. Gynecologists, urologists, and some primary care providers can help.

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