Bowel and bladder incontinence is a reality for many people - our adaptive clothes are here to make dressing and living with incontinence more manageable.



Incontinence can be very upsetting for people to deal with. Designed to Care is committed to offering you incontinence clothing solutions to handle it with more dignity and ease.

Our open back designs allow for easier assisted dressing with no lifting or standing, while they can also be worn ‘un done’ at the back allowing direct and hygienic access to incontinence pads and care. Likewise, our side opening skirts and trousers can be zipped off in a flash and again, provide easy access if seated or lying down.

In order to maintain hygiene, it is important to change clothing regularly or better still, wear back opening clothes when seated or lying to avoid contact and stay dry. Our back opening nightwear is particularly popular for the management of night time incontinence.

NHS choices
Incontinence, urinary

Read about the symptoms of urinary incontinence. Having urinary incontinence means you pass urine unintentionally.


Having urinary incontinence means you pass urine unintentionally.

When and how this happens varies depending on the type of urinary incontinence you have.

It's a good idea to see your GP if you have urinary incontinence. It's a common problem, and seeing your GP can be the first step towards finding a way to effectively manage it.

Common types of urinary incontinence

Most people with urinary incontinence have either stress incontinence or urge incontinence.

Stress incontinence

Stress incontinence is when you leak urine when your bladder is put under extra sudden pressure – for example, when you cough. It's not related to feeling stressed.

Other activities that may cause urine to leak include: 

  • sneezing 
  • laughing 
  • heavy lifting 
  • exercise

The amount of urine passed is usually small, but stress incontinence can sometimes cause you to pass larger amounts, particularly if your bladder is very full.

Urge incontinence

Urge incontinence, or urgency incontinence, is when you feel a sudden and very intense need to pass urine and you're unable to delay going to the toilet. There's often only a few seconds between the need to urinate and the release of urine.

Your need to pass urine may be triggered by a sudden change of position, or even by the sound of running water. You may also pass urine during sex, particularly when you reach orgasm.

This type of incontinence often occurs as part of group of symptoms called overactive bladder syndrome, which is where the bladder muscle is more active than usual.

As well as sometimes causing urge incontinence, overactive bladder syndrome can also mean you need to pass urine very frequently and you may need to get up several times during the night to urinate.

Other types of urinary incontinence

Mixed incontinence

Mixed incontinence is when you have symptoms of both stress and urge incontinence. For example, you may leak urine if you cough or sneeze, and also experience very intense urges to pass urine.

Overflow incontinence

Overflow incontinence, also called chronic urinary retention, occurs when the bladder cannot completely empty when you pass urine. This causes the bladder to swell above its usual size.

If you have overflow incontinence, you may pass small trickles of urine very often. It may also feel as though your bladder is never fully empty and you cannot empty it even when you try.

Total incontinence

Urinary incontinence that's severe and continuous is sometimes known as total incontinence.

Total incontinence may cause you to constantly pass large amounts of urine, even at night. Alternatively, you may pass large amounts of urine only occasionally and leak small amounts in between.

Lower urinary tract symptoms (LUTS)

The lower urinary tract comprises the bladder and the tube urine passes through out of the body (urethra).

Lower urinary tract symptoms (LUTS) are common in men and women as they get older.

They can include:

  • problems with storing urine, such as an urgent or frequent need to go to the toilet, or feeling like you need to go straight after you've just been
  • problems with passing urine, such as a slow stream of urine, straining to pass urine, or stopping and starting as you pass urine
  • problems after you've passed urine, such as feeling that you've not completely emptied your bladder or passing a few drops of urine after you think you've finished

Experiencing LUTS can make urinary incontinence more likely.


Incontinence, urinary

Read about diagnosing urinary incontinence. If you experience urinary incontinence, see your GP so they can determine the type of condition you have.


If you experience urinary incontinence, see your GP so they can determine the type of condition you have.

Try not to be embarrassed about speaking to your GP about your incontinence. Urinary incontinence is a common problem and it's likely your GP has seen many people with the condition.

Your GP will ask you questions about your symptoms and medical history, including:

  • whether the urinary incontinence occurs when you cough or laugh
  • whether you need the toilet frequently during the day or night
  • whether you have any difficulty passing urine when you go to the toilet 
  • whether you're currently taking any medication
  • how much fluid, alcohol or caffeine you drink 

Bladder diary

Your GP may suggest that you keep a diary of your bladder habits for at least three days so you can give them as much information as possible about your condition.

This should include details like:

  • how much fluid you drink
  • the types of fluid you drink
  • how often you need to pass urine
  • the amount of urine you pass
  • how many episodes of incontinence you experience 
  • how many times you experience an urgent need to go to the toilet

Tests and examinations 

You may also need to have some tests and examinations so your GP can confirm or rule out things that may be causing your incontinence. Some of these are explained below.

Physical examination

Your GP may examine you to assess the health of your urinary system. If you're female, your GP will carry out a pelvic examination, which usually involves undressing from the waist down. You may be asked to cough to see if any urine leaks out.

Your GP may also examine your vagina. In over half of women with stress incontinence, part of the bladder may bulge into the vagina.

Your GP may place their finger inside your vagina and ask you to squeeze it with your pelvic floor muscles.

These are the muscles that surround your bladder and urethra, the tube urine passes through out of the body. Damage to your pelvic floor muscles can lead to urinary incontinence.

If you're male, your GP may check whether your prostate gland is enlarged. The prostate gland is located between the penis and bladder, and surrounds the urethra.

If it's enlarged, it can cause symptoms of urinary incontinence, such as a frequent need to urinate.

You may also need a digital rectal examination to check the health of your prostate gland. This will involve your GP inserting their finger into your bottom. 

Dipstick test

If your GP thinks your symptoms may be caused by a urinary tract infection, a sample of your urine may be tested for bacteria.

A small chemically treated stick is dipped into your urine sample. It will change colour if bacteria are present. The dipstick test can also check the blood and protein levels in your urine.

Residual urine test

If your GP thinks you may have overflow incontinence, they may suggest a test called a residual urine test to see how much urine is left in your bladder after you go for a wee.

This is usually done by carrying out an ultrasound scan of your bladder, although occasionally the amount of urine in your bladder may be measured after it's been drained using a catheter.

A catheter is a thin, flexible tube that's inserted into your urethra and passed through to your bladder.

Further tests

Some further tests may be necessary if the cause of your urinary incontinence isn't clear. Your GP will usually start treating you first and may suggest these tests if treatment isn't effective. 

Cystoscopy

A cystoscopy involves using an instrument called an endoscope to look inside your bladder and urinary system. This test can identify abnormalities that may be causing incontinence.

Urodynamic tests

These are a group of tests used to check the function of your bladder and urethra. This may include keeping a bladder diary for a few days and then attending an appointment at a hospital or clinic for tests.

Tests can include:

  • measuring the pressure in your bladder by inserting a catheter into your urethra
  • measuring the pressure in your tummy (abdomen) by inserting a catheter into your bottom
  • asking you to urinate into a special machine that measures the amount and flow of urine

Incontinence, urinary

Read about non-surgical treatments for urinary incontinence. The treatment you receive will depend on the type of incontinence you have and the severity of your symptoms.


The treatment you receive for urinary incontinence will depend on the type of incontinence you have and the severity of your symptoms. 

If your incontinence is caused by an underlying condition, you may receive treatment for this alongside your incontinence treatment.

Conservative treatments, which don't involve medication or surgery, are tried first. These include:

  • lifestyle changes
  • pelvic floor muscle training (Kegel exercises)
  • bladder training

After this, medication or surgery may be considered.

This page is about non-surgical treatments for urinary incontinence. Find out about surgery and procedures for urinary incontinence.

The various non-surgical treatments for urinary incontinence are outlined below.

You can also read a summary of the pros and cons of the non-surgical treatments for urinary incontinence, allowing you to compare your treatment options.

Lifestyle changes

Your GP may suggest you make simple changes to your lifestyle to improve your symptoms. These changes can help improve your condition, regardless of the type of urinary incontinence you have.

For example, your GP may recommend:

  • reducing your caffeine intake – caffeine is found in tea, coffee and cola, and can increase the amount of urine your body produces
  • altering how much fluid you drink a day – drinking too much or too little can make incontinence worse
  • losing weight if you are overweight or obese – use the healthy weight calculator to find out if you're a healthy weight for your height

Pelvic floor muscle training

Your pelvic floor muscles are the muscles you use to control the flow of urine as you urinate. They surround the bladder and urethra, the tube that carries urine from the bladder outside the body.

Weak or damaged pelvic floor muscles can cause urinary incontinence, so exercising these muscles is often recommended.

Your GP may refer you to a specialist to start a programme of pelvic floor muscle training.

Your specialist will assess whether you're able to squeeze (contract) your pelvic floor muscles and by how much.

If you can contract your pelvic floor muscles, you'll be given an individual exercise programme based on your assessment.

Your programme should include doing a minimum of eight muscle contractions at least three times a day and the recommended exercises for at least three months. If the exercises are helping after this time, you can keep on doing them.

Research suggests women who complete pelvic floor muscle training experience fewer leaking episodes and report a better quality of life.

In men, some studies have shown pelvic floor muscle training can reduce urinary incontinence, particularly after surgery to remove the prostate gland.

The British Association of Urological Surgeons (BAUS) has more information on: 

Pelvic floor exercises in women (PDF, 163kb)

Pelvic floor exercises in men (PDF, 174kb)

Electrical stimulation

If you're unable to contract your pelvic floor muscles, using a device that measures and stimulates the electrical signals in the muscles may be recommended. This is called electrical stimulation.

A small probe will be inserted into the vagina in women or the anus in men. An electrical current runs through the probe, which helps strengthen your pelvic floor muscles while you exercise them.

You may find electrical stimulation difficult or unpleasant to use, but it may be beneficial if you're unable to complete pelvic floor muscle contractions without it.

Biofeedback

Biofeedback is a way to monitor how well you're doing the pelvic floor exercises by giving you feedback as you do them.

There are several different methods of biofeedback:

  • a small probe could be inserted into the vagina in women or the anus in men – this senses when the muscles are squeezed and sends the information to a computer screen
  • electrodes could be attached to the skin of your tummy (abdomen) or around the anus – these sense when the muscles are squeezed and send the information to a computer screen

There isn't much good evidence to suggest biofeedback offers a significant benefit to people using pelvic floor muscle training for urinary incontinence, but the feedback may help motivate some people to carry out their exercises.

Speak to your specialist if you would like to try biofeedback.

Vaginal cones

Vaginal cones may be used by women to assist with pelvic floor muscle training. These small weights are inserted into the vagina.

You hold the weights in place using your pelvic floor muscles. When you can, you progress to the next vaginal cone, which weighs more.

Some women find vaginal cones uncomfortable or unpleasant to use, but they may help with stress or mixed urinary incontinence.

Bladder training

If you've been diagnosed with urge incontinence, one of the first treatments you may be offered is bladder training.

Bladder training may also be combined with pelvic floor muscle training if you have mixed urinary incontinence.

It involves learning techniques to increase the length of time between feeling the need to urinate and passing urine. The course will usually last for at least six weeks.

Incontinence products

While incontinence products aren't a treatment for urinary incontinence, you might find them useful for managing your condition while you're waiting to be assessed or for treatment to take effect.

Incontinence products include:

  • absorbent products, such as incontinence pants or pads
  • handheld urinals
  • a catheter, a thin tube that is inserted into your bladder to drain urine
  • devices that are placed into the vagina or urethra to prevent urine leakage – for example, while you exercise

For more information, see Can I get incontinence products on the NHS?

Medication for stress incontinence

If stress incontinence doesn't significantly improve, surgery for urinary incontinence will often be recommended as the next step.

However, if you're unsuitable for surgery or want to avoid having an operation, you may benefit from a medication called duloxetine. This can help increase the muscle tone of the urethra, which should help keep it closed.

You'll need to take duloxetine by mouth twice a day, and will be assessed after two to four weeks to see if the medicine is beneficial or causing any side effects.

Possible side effects of duloxetine can include:

Don't suddenly stop taking duloxetine, as this can also cause unpleasant side effects. Your GP will reduce your dose gradually.

Duloxetine isn't suitable for everyone, however, so your GP will discuss any other medical conditions you have to determine if you can take it.

Medication for urge incontinence

Antimuscarinics

If bladder training isn't an effective treatment for your urge incontinence, your GP may prescribe a type of medication called an antimuscarinic.

Antimuscarinics may also be prescribed if you have overactive bladder syndrome, which is the frequent urge to urinate that can occur with or without urinary incontinence.

A number of different antimuscarinic medications can be used to treat urge incontinence, but common ones include oxybutynin, tolterodine and darifenacin.

These are usually taken by mouth two or three times a day, although an oxybutynin patch that you place on your skin twice a week is also available.

Your GP will usually start you at a low dose to minimise any possible side effects. The dose can then be increased until the medicine is effective.

Possible side effects of antimuscarinics include:

  • dry mouth
  • constipation
  • blurred vision
  • fatigue

In rare cases, antimuscarinic medication can also lead to a type of glaucoma, a build-up of pressure within the eye, called angle-closure glaucoma.

You'll be assessed after four weeks to see how you're getting on with the medication, and every 6 to 12 months thereafter if the medication continues to help.

Your GP will discuss any other medical conditions you have to determine which antimuscarinics are suitable for you.

Mirabegron

If antimuscarinics are unsuitable for you, they haven't helped your urge incontinence or have caused unpleasant side effects, you may be offered an alternative medication called mirabegron.

Mirabegron causes the bladder muscle to relax, which helps the bladder fill up with and store urine. It is usually taken by mouth once a day.

Side effects of mirabegron can include:

Your GP will discuss any other medical conditions you have to determine whether mirabegron is suitable for you.

Medication for nocturia

A low-dose version of a medication called desmopressin may be used to treat nocturia, which is the frequent need to get up during the night to urinate, by helping to reduce the amount of urine produced by the kidneys.

Another type of medication taken late in the afternoon, called a loop diuretic, may also prevent you getting up in the night to pass urine.

Diuretic medicine increases the production and flow of urine from your body. By removing excess fluid from your body in the afternoon, it may improve symptoms at night.

Loop diuretics are not licensed to treat nocturia. This means that the medication may not have undergone clinical trials, a type of research that tests one treatment against another, to see if it's effective and safe in the treatment of nocturia.

However, your GP or specialist may suggest an unlicensed medication if they think it's likely to be effective and the benefits of treatment outweigh any associated risk. 

If your GP is considering prescribing a loop diuretic, they should tell you it's unlicensed and discuss the possible risks and benefits with you.

Incontinence, urinary

Read about the causes of urinary incontinence. Urinary incontinence occurs when the normal process of storing and passing urine is disrupted.


Urinary incontinence occurs when the normal process of storing and passing urine is disrupted. This can happen for a number of reasons.

Certain factors may also increase your chance of developing urinary incontinence.

Some of the possible causes lead to short-term urinary incontinence, while others may cause a long-term problem. If the cause can be treated, this may cure your incontinence.

Causes of stress incontinence

Stress incontinence occurs when the pressure inside your bladder as it fills with urine becomes greater than the strength of your urethra to stay closed. The urethra is the tube urine passes through out of your body. 

Any sudden extra pressure on your bladder, such as laughing or sneezing, can then cause urine to leak out of your urethra.

Your urethra may not be able to stay closed if the muscles in your pelvis (pelvic floor muscles) are weak or damaged, or your urethral sphincter – the ring of muscle that keeps the urethra closed – is damaged.

These problems may be caused by:

  • damage during childbirth – particularly if the child was born vaginally, rather than by caesarean section
  • increased pressure on your tummy – for example, because you are pregnant or obese
  • damage to the bladder or nearby area during surgery – such as the removal of the womb (hysterectomy) in women, or removal of the prostate gland in men
  • neurological conditions – that affect the brain and spinal cord, such as Parkinson's disease or multiple sclerosis
  • certain connective tissue disorders – such as Ehlers-Danlos syndrome
  • certain medications

Causes of urge incontinence

The urgent and frequent need to pass urine can be caused by a problem with the detrusor muscles in the walls of the bladder.

The detrusor muscles relax to allow the bladder to fill with urine, then contract when you go to the toilet to let the urine out.

Sometimes the detrusor muscles contract too often, creating an urgent need to go to the toilet. This is known as having an overactive bladder. 

The reason your detrusor muscles contract too often may not be clear, but possible causes include:  

  • drinking too much alcohol or caffeine
  • poor fluid intake – this can cause strong, concentrated urine to collect in your bladder, which can irritate the bladder and cause symptoms of overactivity
  • constipation
  • conditions affecting the lower urinary tract (urethra and bladder) – such as urinary tract infections (UTIs) or tumours in the bladder
  • neurological conditions
  • certain medications

Causes of overflow incontinence

Overflow incontinence, also called chronic urinary retention, is often caused by a blockage or obstruction of your bladder.

Your bladder may fill up as usual, but as it's obstructed you won't be able to empty it completely, even when you try.

At the same time, pressure from the urine that's still in your bladder builds up behind the obstruction, causing frequent leaks.

Your bladder can become obstructed as a result of:

Overflow incontinence may also be caused by your detrusor muscles not fully contracting, which means your bladder doesn't completely empty when you go to the toilet. As a result, the bladder becomes stretched.

Your detrusor muscles may not fully contract if:

  • there's damage to your nerves – for example, as a result of surgery to part of your bowel or a spinal cord injury 
  • you're taking certain medications 

Causes of total incontinence

Total incontinence occurs when your bladder can't store any urine at all. It can result in you either passing large amounts of urine constantly, or passing urine occasionally with frequent leaking.

Total incontinence can be caused by:

  • a problem with your bladder from birth 
  • injury to your spinal cord – this can disrupt the nerve signals between your brain and your bladder 
  • a bladder fistula – a small, tunnel-like hole that can form between the bladder and a nearby area, such as the vagina, in women

Medications that may cause incontinence

Some medicines can disrupt the normal process of storing and passing urine, or increase the amount of urine you produce.

These include:

Stopping these medications, if advised to do so by a doctor, may help resolve your incontinence.

Risk factors

In addition to the causes mentioned above, some things can increase your risk of developing urinary incontinence without directly being the cause of the problem. These are known as risk factors.

Some of the main risk factors for urinary incontinence include:

  • family history – there may be a genetic link to urinary incontinence, so you may be more at risk if other people in your family have experienced the problem
  • increasing age – urinary incontinence becomes more common as you reach middle age, and is particularly common in people over the age of 80
  • having lower urinary tract symptoms (LUTS) – a range of symptoms that affect the bladder and urethra; read about the symptoms of urinary incontinence for more information