Key points
- Researchers estimate that about half of all women have bladder leaks at some point, and as many as 1 in 3 men over 65.
- Leaks come in several kinds, and the kind decides what helps: a cough, a sudden urge, a bladder that does not empty, or a bathroom that is too far away.
- The National Institute on Aging advises trying the simplest and safest treatments first, such as Kegel exercises and bathroom trips on a schedule.
- Tell a doctor or nurse about any leaks, and go soon if urine is cloudy or bloody, if it hurts to urinate, or if you go eight or more times a day.
How common bladder leaks are
If you leak when you laugh, or rush to the bathroom and do not quite make it, you are in large company. Researchers estimate that about half of all women experience urinary incontinence, according to the National Institute of Diabetes and Digestive and Kidney Diseases. As many as 1 in 3 men over the age of 65 may lose urine by accident as well. The National Institute on Aging adds that leaks become more common with age, and in women most of all.
Common does not mean normal, though. The same federal institute is clear that incontinence is not a routine part of being a woman or of growing older. It is a condition rather than a disease, often tied to another health problem or to a life event. That is good news for you, because a cause can be looked for. In the words of the National Institute on Aging, incontinence can often be stopped or controlled, and plenty of people get there with small changes.
The kinds of leaks, and how each one feels
Doctors sort bladder leaks by what sets them off, and the kind you have points to what will help. Stress incontinence is the leak that comes with a cough, a sneeze, a laugh, a jump or a heavy bag lifted out of the car. Urgency incontinence starts with a sudden, strong need to go, and the leak arrives before you reach the toilet. Many people have both at once, which the kidney and urology institute calls mixed incontinence.
Three other kinds get talked about less. With overflow incontinence the bladder does not empty all the way, and small amounts dribble out through the day. Functional incontinence means the bladder itself works, but arthritis, a walker, the stairs or memory trouble keep a person from reaching the bathroom in time. Temporary incontinence comes from a short-lived cause such as a bladder infection or a medicine, and it tends to pass once that cause is dealt with.
| Kind of leak | What it feels like | A first step to ask about |
|---|---|---|
| Stress | A leak with a cough, sneeze, laugh, jump or lift | Kegel exercises for the pelvic floor |
| Urgency | A sudden strong urge, then a leak on the way | Bladder training and less caffeine |
| Mixed | Both of the above | Start with whichever leak bothers you more |
| Overflow | Frequent dribbling, a bladder that never feels empty | A visit soon, since the cause needs a diagnosis |
| Functional | The bathroom is too far, too slow or too hard to reach | A clear path and bathroom trips by the clock |
| Temporary | Leaks that start with an infection or a new medicine | Whether the cause can be treated or the medicine changed |
Things you can start on your own this week
The National Institute on Aging puts it simply: the simplest and safest treatments should be tried first. Many of them cost nothing and need no prescription. Kegel exercises strengthen the pelvic floor muscles that hold urine in. The kidney and urology institute notes that women who received pelvic floor muscle training had fewer leaks per day than women who did not. Men can do these exercises too. Ask your doctor or nurse to show you how, so you work the right muscles from the start.
What you drink matters as well. Limiting caffeine may help reduce leaks, and caffeine hides in more than coffee: chocolate, tea and carbonated drinks carry it too. The same institute lists cutting back on alcohol, keeping a healthy weight and avoiding constipation among the lifestyle steps that may ease leaks. Drinking less water is not on that list, so talk with your doctor before you cut back on fluids. A routine for the bathroom itself is the other half of the work.
- 1
For a few days, note when you go, when you leak and what you were doing. The pattern helps you and your doctor name the kind of leak.
- 2
Go to the bathroom by the clock, at set times, rather than waiting for the urge. The National Institute on Aging calls this timed voiding.
- 3
When an urge comes between those times, try to hold it back and let it pass instead of rushing. The institute calls this urgency suppression.
- 4
With your doctor or nurse, stretch the time between trips step by step. This is bladder training.
- 5
Do your Kegel exercises every day once someone has shown you how, and give them weeks rather than days.
What a doctor can treat
If the simple steps do not help enough, there is more on the table. Depending on the kind of leak, a health care professional may prescribe a medicine, a medical device or a bulking agent, the National Institute of Diabetes and Digestive and Kidney Diseases says. Surgery is kept as a last resort. Each of these works on a different cause. That is one more reason to get the kind of leak named at the first visit rather than guessing at home.
Treatment does not always mean every leak stops for good. Even after treatment, the same institute says, you may still leak urine from time to time. Here absorbent underwear, briefs with tabs, pads and large pads for beds and chairs come in. The institute lists all of them among the things that help people cope. None of them treats anything. Their job is to keep a leak private and your clothes and bed dry while treatment does its work, and for any leaks that remain afterward.
Signs that mean see a doctor soon
Any leak is worth a visit, and there is no need to wait until it gets bad. A doctor or nurse can sort out which kind you have and what to try first. Before the appointment, jot down for a few days when leaks happen, roughly how much, and what you were doing at the time. Bring a list of every medicine you take, since temporary incontinence can come from one of them.
Good questions to ask are short ones: which kind of leak is this, what should I try first, how long before I can tell whether it works, and what comes next if it does not. Some signs should not wait for a routine visit at all. The National Institute on Aging names these as reasons to see a health care provider, with leaks or without them:
- Urine that looks cloudy or has blood in it.
- Pain while you urinate.
- Urinating eight or more times in one day.
Living as usual while you sort it out
Treatment takes weeks, and life does not stop for it. The right absorbent product lets you keep going to work, to church or to a ballgame without planning the day around bathrooms. Pick it by the size of the leak and when it comes. A few drops with a cough or a laugh need only a thin pad in your own underwear, such as our Ultra Thin pads for women, which come in four levels.
When leaks are bigger or come without warning, a pull-up holds more and goes on like the underwear in your drawer. Our Extra Absorbency pull-up is made for a day out with moderate leaks, and its sides tear open so it comes off without pulling it down over your shoes. Many people still search for these as adult diapers, though a pull-up looks and feels far more like everyday underwear. For a choice by capacity, see how to choose absorbency.
Nights, and the parent you help
Leaks at night bring their own problems: broken sleep, a wet bed and a hurried walk to the bathroom in the dark. A deeper pull-up for bedtime, a booster pad inside it and a pad on the sheet can carry you to morning. Our guide to dry nights puts those pieces together with a safer path to the bathroom. Night leaks belong in the talk with your doctor too, next to the daytime ones.
Sometimes the person with leaks is your mother or father, and they may never raise it themselves. Naming it gently and offering to come along to the appointment is often the hardest step. Functional incontinence is worth a close look here: a long hallway, a dark corner or stiff buttons can turn a short walk into an accident. For someone who spends much of the day in bed or a chair, a brief with tabs goes on lying down. The caregiving guide covers changes in bed and skin care.
Every product named here is part of the LivDry range.
