Female incontinence

Urinary incontinence, when urine leaks out from the bladder when you don’t want it to, can affect women of all ages.

For some women, urine leakage occurs with coughing, laughing or with exercise. Other women may have a sudden urge to use the bathroom, and leak before they can get to the toilet. Women with urine leakage may stop activities they enjoy. You might feel embarrassed. You may worry about not being able to quickly find a bathroom.

Number of women by age 40 affected by urinary incontinence

Symptoms and diagnosis

Making a diagnosis

We will ask you about your symptoms and your medical history, including childbirth history and any past surgeries.

A gentle physical examination will be done and you may be asked to complete a bladder diary where you will keep track of urine leakage, fluid intake and any discomfort for a day or two. The diary helps find behavior changes to improve your symptoms.

Tests to find the cause and type of your condition

In some cases, your doctor may recommend tests to find the cause of your incontinence. Your doctor will discuss these tests with you and explain how they are performed. These tests could include:

Measures how much urine your bladder can hold.

Checks for urine leakage when you cough.

Looks inside your urethra and bladder using a thin tube with a camera

Measures how much urine is left in your bladder after you urinate. This could be done with a catheter or with a bladder scan.

Tests your urine for infection, urinary stones or other problems.

Measures your bladder pressure and urine flow.

Causes of incontinence

Urine leakage can happen at any age and becomes more common as you get older. Being pregnant, giving birth and the changes of menopause weaken pelvic floor muscles which puts pressure on the bladder. Nerve damage from conditions like multiple sclerosis, obesity or diabetes also can cause urine to leak

Types of incontinence

There are different types of female incontinence:

This is due to a weak urethra tube. Urine leaks when you cough, laugh, lift something heavy or sneeze. Some women experience only an occasional problem. Others have severe or frequent leakage.

This is due to an irritated bladder. You might urinate frequently (day or night), or feel a strong urge to urinate all of a sudden. You might leak a little or completely lose all of your urine.

This is due to a weak bladder, or a tight urethra tube. Your bladder doesn't empty properly, so this leads to leakage.

You have symptoms of stress incontinence and overactive bladder.

Treatments and research

Your treatment options

Treatment for bladder leakage depends on the type of incontinence, as they each have different causes.  We will talk with you about the range of treatment options for your type of bladder leakage.

Nonsurgical treatments

You change how much and when you drink and use the bathroom at scheduled times. This retrains your bladder.

A physical therapist works with you on behavior modification, education and exercises to strengthen your pelvic floor muscles.

Kegel exercises strengthen your pelvic floor and bladder muscles.

You use devices to measure your muscle strength while performing pelvic floor muscle exercises.

A ring-shaped device called a pessary is placed in your vagina. The pessary supports your bladder or uterus. This takes pressure off your bladder.

There are medicines that control urge incontinence. They work best when taken for long-term use.

Surgical treatments

A treatment for when the urethra is weak, a bulking agent like collagen is injected near the opening of your bladder. This narrows the opening and reduces leakage.

If the bladder muscle is too tense or the bladder spasms, Botox can be injected into the bladder wall using a cystoscope (a thin camera placed through the urethra tube).  This causes the bladder muscle to relax and reduces leaking.

A device like a pacemaker is implanted into the low back to stimulate the bladder nerves. If your urge incontinence doesn't respond to behavioral changes or medicine, this may be a good option for you.

Surgery repairs weakened tissue to support the urethra. A mesh material called a sling is placed to support the urethra. Another option uses a tissue graft from your own body to create a sling.

Meet our team

Seamless, patient-centered care

At UW Health, you see a team of urogynecologists who completed extra training to treat these health issues. Your care might include combined treatment from specialists in pelvic floor physical therapy, urology and urogynecology.


Comprehensive care all in one place

At the UW Health Women’s Pelvic Wellness Clinic in Madison, Wis., you get care from a variety of specialists. All of them are experts in treating pelvic floor disorders — including incontinence.

Patient and support services

Get answers to your questions about incontinence care

Dr. Christine Heisler explains urinary incontinence, a common issue many woman experience.
Dr. Heidi Brown explains UW Health's Women's Pelvic Wellness Program