Urge Urinary Incontinence

What is urge urinary incontinence?

Urge urinary incontinence is frequent, urgent visits to the toilet to pass urine. Sometimes the feeling you need to pass urine comes too late and you ‘wet your pants’ before you get to the toilet. The fear of having further ‘accidents’ makes you go to the toilet when you first feel you have urine in your bladder.

Often the problem is worse during the night and can lead to bed-wetting. Frequency is when you go to the toilet 8 times or more during the day and more than twice during the night.

What causes urge urinary incontinence?

Urge urinary incontinence happens when your bladder muscles start to contract (squeeze) before you reach the toilet.

There are several causes, such as irritation in your bladder which may be due to infection or medication, diseases of the nervous system, such as Multiple Sclerosis or Parkinson’s Disease, anxiety or not drinking enough fluids. It can also happen for no obvious reason.

What is the pelvic floor muscle?

The pelvic floor is made up of layers of muscles, stretching like a hammock from your pubic bone to the bottom of your tailbone.

These muscles help to hold your bladder and bowel in position, also the uterus (womb) in women. They prevent leakage from your bladder and bowel, only relaxing when your bladder or bowel is emptying.

What can I do to help myself?

It is important that you drink plenty of fluid each day. It is recommended that you drink 1½ litres (6 to 8 large cups or glasses). However, you should not drink more than 2 litres (4 pints) of fluid each day. If you cut down on your fluids, the urine in your bladder becomes concentrated and irritates your bladder more.

Caffeine may be an irritant to your bladder and may increase your frequency of visits to the toilet. It is recommended that you gradually reduce your caffeine intake. Caffeine is found in tea, coffee, Ovaltine, high energy drinks, cola and cocoa. Substitute these drinks with water, squash or decaffeinated drinks.

Possible irritants to the bladder include:

• caffeinated drinks.
• fizzy drinks.
• grapefruit juice.
• alcohol.
• stronger brands of tea which contain more tea and tannins.
• spicy food.
• tomatoes.

Try to avoid becoming constipated by eating a healthy diet with plenty of fruit and vegetables.

What tests will I need?

Your doctor or nurse will ask you some questions about your health and urinary incontinence. A sample of your urine will be tested to find out if you have a urinary tract infection (UTI).

You will be asked to fill in a ‘frequency volume chart’ for at least 3 full days (if possible 3 days in a row), to check how often you go to the toilet and how much urine you pass.

What treatments are available?

Bladder retraining

This is a process where you retrain your bladder to hold a greater amount of urine. This should reduce the amount of times you need the toilet. Your nurse will check your chart and suggest ways to increase the time between your visits to the toilet.

You should only go to the toilet when you really need to. Regaining control of your bladder is a gradual process.

Sometimes your doctor may prescribe medication to reduce your symptoms of urgency and frequency.

Pelvic floor exercises

Your pelvic floor muscles prevent leakage from your bladder and bowel. Simple exercises carried out for 3 to 6 months can improve your muscle tone (strength) and help you to hold on longer. Your nurse or continence adviser will explain these exercises and give you a leaflet, ‘How to do pelvic floor exercises’.

Are there any other treatments?

If bladder retraining or pelvic floor exercises does not help your problem, your nurse will be happy to discuss further treatments. You may benefit from a referral to a continence adviser, physiotherapist or a doctor who specialises in urinary incontinence.

Further treatments can include medication to reduce your urgency and assist with your bladder retraining, nerve stimulation, physiotherapy or surgery.

What if I decide not to have treatment?

Your urge urinary incontinence may become worse.

Contact numbers

If you need further advice or have any questions or worries, you should talk to your nurse or continence adviser.

North Tees and Hartlepool NHS Foundation Trust

Continence Advisor

Telephone SPA patient line: 01429 522500

Opening hours: 8.30am to 4.30pm (Monday to Friday)

Further information is available from:

Bladder & Bowel Community

Forward House

17 High Street

Henley-in-Arden

B95 5AA

Email: [email protected]

Home Delivery Service: 0800 031 5406

Bladder & Bowel UK

Burrows House, 10 Priestley Road

Wardley Industrial Estate

Worsley

M28 2LY

General enquiries telephone: 0161 607 8219

Email: [email protected]

RADAR KEYS (for disabled toilet access)

11 Church Street

Exmouth

EX8 1PE

General enquiries telephone: 01395 222588

Email: [email protected]

Information used in the development of this leaflet

• Department of Health. Good practice in continence services. March 2000.

• National Institute for Health and care Excellence (NICE) 2019 Urinary Incontinence and Pelvic Organ Prolapse in Women; management. www.nice.org.uk/guidance/ng123

• Abrams P, Khoury S, Wein A. The 1st international consultation on incontinence, co-sponsored by the WHO, Monaco; Health publication 1999.

• National Institute for Health and Care Excellence (NICE), (2006) Urinary Incontinence: The management of urinary incontinence in women. www.nice.org.uk/guidance/cg40

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Patient Experience Team is here to try to resolve your concerns as quickly as possible. The office is based on the ground floor at the University Hospital of North Tees if you wish to discuss concerns in person. If you would like to contact or request a copy of our PET leaflet, please contact:

Telephone: 01642 624719

Freephone: 0800 092 0084

Opening hours: Monday to Friday, 9:30am to 4:00pm

Email: [email protected]

Out of hours

Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person.

Telephone: 01642 617617

Data protection and use of patient information

The Trust has developed Data Protection policies in accordance with Data Protection Legislation (UK General Data Protection Regulations and Data Protection Act 2018) and the Freedom of Information Act 2000. All of our staff respect these policies and confidentiality is adhered to at all times. If you require further information on how we process your information please see our Privacy Notices.

Telephone: 01642 383551

Email: [email protected]

Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team, North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, TS19 8PE or:

Email: [email protected]