You may leak urine after pelvic radiotherapy. This can happen if the valve that keeps the bladder closed and the pelvic floor muscles are weakened.
You may leak small amounts of urine when you laugh, sneeze or cough, or when you’re exercising. This is called stress incontinence. If you have an overactive bladder, you may find that you can’t always get to the toilet in time. This is called urge incontinence.
This page covers some of the ways in which incontinence can be treated and managed. Some of the treatments mentioned in the section on an overactive bladder can also help to improve urge incontinence.
Urine can irritate the skin so you will need to take extra care to look after your skin. Our section on coping with bowel and bladder changes has information on skincare, what to do when you’re not at home and getting support. There’s also advice on special products, such as pads and pull-ups, you can use while you’re waiting for treatment to work.
Pelvic floor exercises
The most common treatment for urinary incontinence is doing exercises to strengthen the pelvic floor muscles.
Pelvic floor exercises can be done while you are sitting or lying down and no one can tell you are doing them. You squeeze and relax the muscles around your back passage as if you are trying to prevent yourself passing wind. Practising this exercise slowly and quickly several times a day for at least 3 months can strengthen the muscles. This will help you to have more control over leakage of urine. It’s best to ask your doctor to refer you to a continence adviser to teach you how to do the exercises correctly. The Bladder and Bowel Foundation can also provide details of your nearest adviser and can send you leaflets showing you how to do pelvic floor exercises.
If you find it difficult to learn pelvic floor exercises you may be offered biofeedback training to help you. As you squeeze your pelvic floor muscles, the pressure is measured by sensors. This helps you to know when you’re squeezing in the right way. Ask you continence adviser for more information about this.
If incontinence problems don’t improve with the treatments we’ve mentioned, there are other options. Your doctor may talk to you about these:
Artificial Urinary Sphincter (AUS)
If you are leaking a lot of urine most of the time (severe incontinence) can be assessed for this treatment. While you’re under a general anaesthetic, a cuff is fitted around the urethra. Attached to the cuff is a small pump which is placed in the scrotum in men or in the tummy or leg in women. The cuff closes off the urethra to stop urine leaking. When you want to pass urine, you deflate the cuff by squeezing the pump. This takes pressure off the urethra, allowing it to open so you can pass urine.
Other treatments for women
Duloxetine (Yentreve®) This drug is sometimes prescribed to help reduce stress incontinence. As with most drugs, there may be side effects. So it’s not usually prescribed until other treatments have been tried.
Tape to support the urethra-This involves inserting a tape through the vagina and placing it behind the urethra. This supports the urethra and helps prevent urine leaking when there’s increased pressure on the bladder, such as when you cough or sneeze.
Bulking agents - These are materials that are injected into the tissue surrounding the urethra to help keep it closed and make it harder for urine to leak out. You may need several injections for them to work, and they lose their effectiveness over time.