Written by Dr Sonya N. Ephraim Published on 10th February 2023

Why do I suddenly need to pee and can't hold it? If you’re asking yourself this question, there’s a good chance you’re suffering from urge incontinence. Characterized by a sudden, frequent need to pee that’s hard to keep under control, urge incontinence can be a major inconvenience and cause embarrassment for anyone suffering from it.

But it shouldn’t be a taboo. Urge incontinence is surprisingly common, and nothing to be ashamed about. In this guide, we’ll break down the causes, symptoms, and urge incontinence treatment options — from pelvic floor exercises to bladder training techniques.

What is urge incontinence?

Urge incontinence is when you have a sudden urge to pee and can't hold it. You may find yourself needing to pee several times a day (8 or more times in 24 hours) and involuntarily leaking urine before you can make it to the bathroom. You may also need to get up more than once during the night due to a sudden need to urinate.

Urge incontinence is just one type of urinary incontinence. Others include stress incontinence — where you leak urine due to pressure on the bladder from laughing, sneezing, coughing, or physical exercise — and overflow incontinence, where you leak urine because you’re unable to fully empty your bladder when you go to the bathroom.

While urge incontinence can be inconvenient and a little embarrassing, it’s actually pretty common, especially in women and older people: around 4 in 10 women and 3 in 10 men will experience urge incontinence at some point in their lives.

What causes an urgent urge to urinate?

The main cause of urge incontinence is an overactive bladder. An overactive bladder occurs when the bladder muscles contract involuntarily, even when the volume of urine in the bladder is low. This creates an urgent and often frequent need to go to the bathroom.

An overactive bladder may be caused by a number of factors, which may include inflammation of the bladder, a bladder infection, bladder stones, or a blockage preventing urine from leaving the bladder. Age is also a factor, therefore you’re more likely to experience urge incontinence as you get older.

There are a number of additional risk factors that can increase the likelihood of experiencing urge incontinence. These include:

  • Pregnancy and childbirth (particularly vaginal birth).

  • Hormonal changes (e.g. menopause).

  • Diabetes.

  • Stroke.

  • Urinary tract infections (UTIs).

  • A hysterectomy or other pelvic surgery.

  • Neurological disorders such as Alzheimer’s, Parkinson’s or multiple sclerosis (MS).

  • Obesity.

  • Smoking.

  • Caffeine and alcohol.

  • Medications such as antidepressants, diuretics and blood pressure treatment.

  • In men, prostate problems such as prostate cancer or an enlarged prostate (benign prostatic hyperplasia).

Why can't I hold my pee all of a sudden?

If your incontinence has come on suddenly, it’s possible that it's the result of a recent medical procedure or because you’ve started taking a new medication. In either of those scenarios, you should consult your doctor. However, it’s more likely that you’ve had mild symptoms for a while, but that you’ve only started to notice your incontinence now that your symptoms have become more severe.

What are the main symptoms of urge incontinence?

As the name suggests, urge incontinence is characterised by an urge to urinate which comes on suddenly and is hard (sometimes impossible) to control. Signs you’re suffering with urge incontinence include:

  • A sudden, uncontrollable need to urinate.

  • An inability to hold your pee for longer than a few seconds.

  • An involuntary leaking of urine before you make it to the bathroom.

  • A frequent need to urinate (going to the bathroom 8 or more times in a 24-hour period).

  • Waking up at least twice during the night to urinate (nocturia).

Is sudden incontinence an emergency?

While urge incontinence is undoubtedly inconvenient, it’s generally not cause for too much concern, and in most cases it can be treated fairly easily. That said, if your constant urge to pee is significantly impacting your daily life, it might be time to book an appointment with your doctor to discuss ways to treat urge incontinence and manage the condition.

Additionally, if your urge incontinence is accompanied by symptoms such as pelvic pain or a burning sensation when urinating, you should seek medical attention as this might be a sign of a bladder infection, an obstruction, or bladder or kidney stones.

Can you cure urge incontinence?

While urge incontinence can’t be cured as such, the condition can be treated and managed through a number of at-home remedies. Kegel exercises are typically the first recommended treatment for urge incontinence, as these involve strengthening the pelvic floor muscles to prevent urine leakage.

Bladder training may also be recommended, which involves ‘training’ the bladder by going to the bathroom at predetermined intervals. There are also a number of lifestyle changes you can make to treat urge incontinence, such as making some simple dietary adjustments. 

In extreme cases, surgery might be discussed as an option — but this will only be considered if your symptoms are severe and/or non-surgical treatment methods have proved ineffective.

How is urinary urge treated?

Urge incontinence treatment typically involves a combination of pelvic floor exercises, lifestyle changes, and bladder training techniques — all of which can be done from home with no medical treatment involved. Unless your symptoms are severe — or the result of an underlying condition — these at-home remedies are generally very effective at preventing and managing urinary incontinence.

Exercises for urge incontinence

The first recommended treatment for urge incontinence is a type of pelvic floor therapy known as Kegel exercises. Kegels involve contracting and relaxing the pelvic floor muscles, which are involved in holding in urine when you need to go. Strengthening these muscles can help prevent urine leakage by increasing your ability to resist the urge to pee.

To locate the pelvic floor muscles, try stopping your urine midstream — doing Kegel exercises should replicate the sensation you feel when holding on to your pee. To perform a Kegel, contract the pelvic muscles for 5 to 10 seconds and then relax them for the same amount of time. Perform as many repetitions as you can at least 3 times per day.

Kegel exercises are pretty simple to perform once you get the hang of them, but it can be difficult to master the technique. If you’re struggling to locate or engage the right muscles during your Kegel exercises, Elvie Trainer can help you visualise these hidden muscles and ensure you’re performing Kegels effectively — getting the most from each workout.

Lifestyle changes for urge incontinence

There are a number of lifestyle factors that can trigger or worsen urge incontinence symptoms. In addition to performing Kegel exercises regularly, you can reduce your symptoms and combat urine leakage by making some fairly simple lifestyle adjustments. These include:

  • Reducing caffeine and alcohol intake: Caffeine, alcohol and fizzy drinks can irritate the bladder and increase your urge to pee. Try to limit your intake of these where possible.

  • Eating more fibre: Introducing more fibre into your diet can help prevent constipation, which can put added pressure on the bladder and increase your need to pee. 

  • Avoiding spicy or acidic foods: Spicy and acidic foods can irritate the lining of the bladder, which can amplify the symptoms of urge incontinence. Try to avoid these where you can, or at least limit your intake.

  • Losing weight: Being overweight can weaken the pelvic floor muscles and increase pressure on the bladder, so try to switch to a healthier diet and exercise regularly if you’re overweight.

  • Quitting smoking: Studies have shown that smokers have a greater risk of incontinence. Smoking can irritate the bladder, increasing your urge to go to the bathroom, so you should try to quit if possible.

  • Using absorbent pads: While these aren’t used to treat urge incontinence, they can help manage the symptoms and increase your confidence when you’re out and about.

Bladder training for urge incontinence

You can also manage your urge incontinence symptoms using bladder training techniques, which can help you resist the urge to pee and reduce the number of times you’re rushing to the bathroom daily. Bladder training techniques include:

  • Scheduling your bathroom visits: This bladder training method involves going to the bathroom only at predetermined intervals, such as every 2 to 4 hours. This may be challenging at first, but over time you’ll be able to resist the urge to urinate for longer.

  • Delaying urination: When you feel the need to pee, try to resist the urge to go straight away. Waiting 10 to 15 minutes can increase your bladder’s ability to hold in urine. If you’re struggling to fight the urge, try distracting yourself by counting backwards from 100 to 1.

  • Double voiding: After you’ve been for a pee, wait a couple of minutes and see if you’re able to go again. This ensures your bladder is fully emptied each time, reducing pressure on the bladder and decreasing the frequency of your bathroom visits.

There’s no shame in incontinence

Urinary incontinence is common, particularly in women. And even more so in women who are pregnant, have recently given birth, or are going through menopause. But it’s certainly nothing to be ashamed about. If you’re suffering from a frequent and urgent need to pee, rest assured: you’re not alone, and there are a number of ways to treat it. Incontinence? What incontinence?

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The medical information in this article is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. Please consult your doctor for guidance about a specific medical condition.
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