Leakage of urine is called urinary incontinence. It is a common problem in women. Some women occasionally leak small amounts of urine. At other times, leakage of urine is frequent or severe. Often, women with this condition are too embarrassed to tell their health care providers about their symptoms. However, with proper diagnosis, urinary incontinence can most often be treated. This page explains:


“Urinary incontinence” is a general term. There are, in fact, different kinds of urinary incontinence. Sometimes, a woman may have more than one of the following types:


In addition to leaking urine, a woman with incontinence also may have other symptoms:

Incontinence does not always mean that a woman leaks large amounts of urine, or leaks often. For some women, leaking even a small amount, or having symptoms once a week or even less often, is a problem. Others do not consider urine leakage to be a problem and simply make changes in lifestyle, such as
wearing absorbent pads. If you have symptoms of urinary incontinence, tell your health care provider. If the symptoms bother you, and they are having a negative effect on your life, you may want to seek treatment.

The Female Urinary Tract

The urinary tract is made up of the kidneys, ureters, bladder, and urethra. During urination (also called voiding), the muscles around the urethra relax. The muscle that lines the bladder then contracts, and urine flows to the urethra and out of the body. When the bladder is almost empty, the muscles around the urethra contact. The bladder muscle relaxes, and the urine stops flowing.


There are many causes of urinary incontinence. Some are short-term and easier to treat than others. Sometimes, more than one cause is responsible for a woman’s urinary incontinence.

Short-term Causes

Long-term Causes


A number of steps may be needed to find the cause of urinary incontinence. Knowing the cause helps your health care provider suggest the best treatment for you.

Your health care provider will ask you about your past medical history. You also will be asked about factors that may affect your urination habits. A voiding diary or daily log of urination is a useful tool your health care provider may suggest. You may be asked to record the time and amount of urine leakage, often for 3 days. You also should note how much liquid you drank and what you were doing when a leak occurred.

Your health care provider may ask you to keep a voiding diary to record the time and amount of urine leakage.

A pelvic exam will be done to detect physical conditions that might be causing the incontinence, such as a pelvic support problem. Lab tests also may be done to look for signs of a urinary tract infection. The following tests also may be performed:


Options for treating incontinence include lifestyle changes, bladder training, physical therapy, the use of devices that are placed in the vagina, medications, bulking injections, and surgery. Your health care provider may first suggest nonsurgical treatment. Often, several treatments are used together for the best effect. If other treatments do not improve the problem, surgery may help.

Lifestyle Changes

Making the following changes in your lifestyle, if they apply to you, may help decrease the number of times you leak urine:

Kegel Exercises

Kegel exercises tone your pelvic muscles. They strengthen the muscles around the openings of the urethra, vagina, and rectum. Just like doing situps, these exercises work only if you use the right muscles, hold the “squeeze” long enough, and do enough of them.

Be careful not to squeeze the muscles of the leg, buttock, or abdomen. Do these exercises on a regular basis. It may take 4–6 weeks to notice an improvement in urinary incontinence symptoms.

Bladder Training

Bladder training has been shown to be helpful in treating urge urinary incontinence. The goal of bladder training is to learn how to control the urge to empty the bladder and increase the times between urinating to normal intervals (every 3–4 hours during the day and every 4–8 hours at night). After a few weeks of this training, you may leak urine less often.

Physical Therapy

Kegel exercises can help strengthen the pelvic muscles (see “Kegel Exercises”). These exercises are helpful in all types of incontinence. Kegel exercises, along with bladder training and modifying fluid intake, are often very successful in treating stress and urge incontinence.

If you have trouble doing Kegel exercises, you may want to see a physical therapist who specializes in women’s pelvic health. Biofeedback is a training technique that may be useful if you have problems locating the correct muscles. In biofeedback, sensors are placed inside or outside the vagina. These sensors measure the force of pelvic muscle contraction. When you contract the right muscles, you will see the measurement on a monitor. This feedback lets you know that you are doing Kegel exercises in the right way.

If your muscles are too weak and you cannot perform a Kegel contraction at all, other therapies, such as electrostimulation, can be done. In electrostimulation, the pelvic muscles are made to contract with special electrodes. These contractions strengthen the muscles so that Kegel exercises become possible.

Using a Pessary

A pessary is a device that is placed into the vagina. It supports the pelvic organs and may help prevent urine leakage.


A pessary is a device that is inserted into the vagina to treat pelvic support problems and urinary incontinence. Pessaries support the pelvic structures, and some compress the urethra. Pessaries come in all shapes and sizes. Most support pessaries are shaped like rings or dishes. There also are specially designed pessaries for urinary incontinence. They are useful for women who do not want or cannot have surgery to correct their incontinence.

Support pessaries generally can be removed and inserted by the patient. Pessaries cannot be used by everyone. However, for many women, pessaries provide relief of symptoms without surgery.


Drugs that help control muscle spasms or unwanted bladder contractions can help prevent leaks associated with urge incontinence. These medications also can help reduce the frequency of urination. Your health care provider will help you decide which drug is most likely to work best for you. Side effects of some of these drugs include the following:

Bulking Agents

These agents may be used when the sphincter muscle of the urethra is very weak and extensive surgery is not an option or has not worked. A substance is injected into the tissues around the urethra to add bulk. The urethra becomes narrowed, decreasing leakage. This procedure can be done in a doctor’s office or clinic.


Surgery can be done to treat stress urinary incontinence. You and your health care provider may discuss many factors before choosing the surgery that is right for you:

Surgical techniques to correct urinary incontinence involve the following approaches:


Loss of bladder control is a common problem and there are many treatment options available. If you have symptoms that affect your daily life, tell your health care provider. A complete and thorough exam is needed to find the cause of the problem. Most cases of urinary incontinence can be greatly improved with treatment.


Antibiotics: Drugs that treat infections.

Biofeedback: A technique in which an attempt is made to control body functions, such as heartbeat or blood pressure.

Bladder: A muscular organ in which urine is stored.

Catheter: A tube used to drain fluid or urine from the body.

Cystitis: An infection of the bladder.

Cystoscopy: A test in which the inside of the urethra and bladder are examined.

Diabetes Mellitus: A condition in which the levels of sugar in the blood are too high.

Diuretics: Drugs given to increase the production of urine.

Dysuria: Pain during urination.

Fistula: An abnormal opening or passage between two internal organs.

Hysterectomy: Removal of the uterus.

Nocturia: The need to urinate frequently during the night.

Pelvic Exam: A manual examination of a woman’s reproductive organs.

Pessary: A device inserted into the vagina to support sagging organs.

Polyps: Benign (noncancerous) growths that develop from tissue lining an organ, such as that lining the inside of the uterus.

Stroke: A sudden interruption of blood flow to all or part of the brain, caused by blockage or bursting of a blood vessel in the brain and often resulting in loss of consciousness and temporary or permanent paralysis.

Ultrasound: A test in which sound waves are used to examine internal structures.

Urethra: A tube-like structure through which urine flows from the bladder to the outside of the body.

Uterus: A muscular organ located in the female pelvis that contains and nourishes the developing fetus during pregnancy.

Vagina: A tube-like structure surrounded by muscles leading from the uterus to the outside of the body.

Voiding Diary: A daily log in which a woman keeps track of how many times she urinates, her fluid intake, and the number of times she leaks urine.

Source: acog.org