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If you frequently have a sudden, strong urge to pee — and then accidentally leak urine — you might have urge incontinence (UI). Both men and women experience UI, which is also called overactive bladder. It’s different from stress incontinence, which refers to urine leaks when you sneeze, cough, or exercise.

What Is Urge Incontinence?

UI is an urgent “gotta go” feeling followed by leaking urine. It happens when your brain sends signals to your bladder that it’s time to pee, even when your bladder isn’t full. It can also occur when there’s damage to the bladder that makes the muscles contract at the wrong times.

According to the Urology Care Foundation, as many as 40% of women and 30% of men in the U.S. have UI symptoms. It occurs more often in older adults.

What Are the Symptoms of Urge Incontinence?

The signs that you have UI include:

• A sudden, urgent need to urinate (that “gotta go” feeling).
• Accidental leaks when you can’t make it to the bathroom in time.
• Getting up several times a night to go to the bathroom.
• Feeling “triggered” to urinate by sensations, such as the sound of running water or walking past a bathroom.

What Causes Urge Incontinence?

Some medical conditions can result in UI. They include:

• Bladder cancer.
• Bladder stones.
• Inflammation of the urinary tract.
• Brain or nerve problems, including stroke or multiple sclerosis.
• Spinal cord injury.
• Hormonal changes, such as menopause, in women.
• Enlarged prostate in men.

Sometimes, doctors can’t find a specific cause for UI. Even then, they can still treat the symptoms.

Treatment for Urge Incontinence

Your treatment depends on how severe your UI is, or if there is another problem causing the UI. Your doctor may recommend the following to reduce symptoms of UI.

Lifestyle changes

For some people, simple changes in diet and hydration can make a big difference in managing UI. Your doctor may recommend that you:

• Limit soda and coffee. Fluids with high caffeine, acidity, and carbonation can irritate the bladder and make UI worse. So go easy on coffee, tea, orange juice, lemonade, and colas.
• Drink plenty of water. Don’t limit your water intake to reduce leaks, as urine can become concentrated and irritate the lining of the bladder. A good rule of thumb is to drink half your body weight (in pounds) in ounces of water. For example, a 140-pound woman should drink 70 ounces of water daily.
• Manage constipation. A full bowel can put pressure on the bladder, and hard stool can cause nerves in the pelvic floor to become overactive. To soften stool, eat high fiber fruits and vegetables, stay hydrated, and ask your doctor if you need stool-softening medication.
• Bladder training. Bladder training is a physical and mental method of controlling UI. It might include keeping a diary of how much and how often you urinate, learning relaxation techniques, and doing exercises called Kegels.
  • If you are experiencing urinary symptoms along with pelvic pain, Kegels may not be right for you and should be fully evaluated by a pelvic floor specialist before initiating pelvic floor strengthening exercises.
• Get on a schedule. For some people, scheduling bathroom breaks helps reduce UI symptoms by improving their control over the urge to urinate. You can gradually increase the length of time between trips to the bathroom.

Pelvic floor training

A physical therapist can help relieve UI with:

• Pelvic floor training. A “sling” of muscles and tissue called the pelvic floor supports the urinary tract and other pelvic organs. Muscles that are too loose — or too tight — make it hard for the organs to function properly, which can lead to leaks. A physical therapist can help teach you exercises to both strengthen and relax these muscles.
• Electrical stimulation. Your therapist can place electrodes on your back or pelvic floor. They produce electrical currents that help calm an overactive bladder and reduce urgency.

Medication

Some drugs can help calm an overactive bladder. Your doctor might give you medicine to take by mouth. They may also inject medicine directly into the bladder.

Surgery

If your UI doesn’t respond to other treatments, your doctor may recommend surgery as a last resort. A urologist can implant a device that sends a mild electrical current to your bladder. It calms your urge to urinate.