Do you have a leaking bladder and constantly worry about it being untreatable? Because of the stigma surrounding these bladder conditions, you might be hesitant to get yourself checked and treated by a healthcare specialist. Instead, you might have decided to search the internet to find a solution. Luckily, you have clicked and landed on the right spot. 

This article provides detailed information about different therapies and the leaking bladder treatment your doctor or physician would recommend after assessing your condition. We have also compiled other necessary information, such as the causes, symptoms, risk factors, and more, to help you understand your bladder condition better. 

Before we proceed, it is to be noted that this article does not encourage self-diagnosing and self-treatment. If you or your loved one suffers from a leaking bladder, consult with a healthcare professional to receive early assessment and the appropriate leaking bladder treatment. 

What Is A Leaking Bladder?

Leaking bladder, also known as urinary incontinence, is a bladder condition in which the affected individual experiences involuntary leakage of urine. The process of micturition, commonly called urination, occurs involuntarily, leading the person to face unwanted embarrassing situations.

A leaking bladder or urinary incontinence is not typically considered a disease. However, it can be a concerning matter since, other than aging, it is usually an outcome of a symptom or an indication of a possible underlying disorder or injury. 

Aging or the underlying pathology or injury causes the bladder muscles or the two urethral sphincter muscles to weaken. This weakening of the muscles ultimately results in the bladder being unable to hold in the urine and the affected individual losing control over the micturition process. Hence, the patient accidentally and involuntarily leaks urine at any time. 

The condition of urinary incontinence or involuntary leakage of urine can either be symptomatic or asymptomatic. This means that an affected individual with symptomatic urine incontinence can sense when they are about to urinate or keep having the feeling to eliminate urine frequently. On the other hand, in asymptomatic urine incontinence, the patient does not realize the need to urinate and leaks urine unconsciously. 

Which Bladder Leakage Do You Have?

The condition of urinary incontinence or a leaking bladder can present in various clinical manifestations depending upon the underlying cause. Even though the types of urinary incontinence differ in their causative reason, the outcome is primarily the same, that is, the involuntary leakage of urine. Based on the leaking mechanism, bladder leakage or urinary incontinence can be classified as:

  • Stress Urinary Incontinence: A bladder leakage is diagnosed as stress urinary incontinence if it occurs due to increased intra-abdominal pressure or when pressure is applied to the bladder region. According to statistical data analysis, it occurs more commonly in young and middle-aged women than in men. 

Conditions that weaken the pelvic floor muscles, such as pregnancy, injury, or hormonal (estrogen level) changes, are some of the prime etiologies for stress urinary incontinence. The urine leakage in this incontinence presents when the individual performs daily activities like coughing, sneezing, laughing, running, jumping, lifting objects, etc. 

  • Overactive Bladder (OAB)/Urge Urinary Incontinence: This condition of a leaking bladder is characterized by frequent sudden urges to urinate followed by immediate involuntary leakage of urine. The main causative agent of an overactive bladder is the overstimulation of the micturition centers in the brain and spinal cord and the high contractility of the detrusor muscle. 

Various underlying pathologies can develop this bladder condition, such as diabetes, infections, multiple sclerosis, Alzheimer’s, Parkinson’s disease, or, rarely, bladder cancer. 

  • Overflow Urinary Incontinence: Your leaking bladder may be assessed as overflow urinary incontinence if urine constantly dribbles due to overdistention. In this condition, either the detrusor muscle’s contracting ability becomes impaired, or obstruction occurs in the urine outflow pathway. Some pathologies that can cause overflow urinary incontinence include multiple sclerosis, spinal cord injuries, diabetes, tumorous growths, pelvic organ prolapse, and more. 
  • Functional Urinary Incontinence: This type of incontinence is not typically classified as a bladder disorder since it occurs due to being unable to make it to the toilet in time. The individual’s bladder function is normal or near normal but tends to leak urine due to having an already existing movement-limiting disorder. These disorders can include arthritis, limb injuries, and even an altered mental status.
  • Reflex Urinary Incontinence: A healthcare professional may diagnose a bladder leakage problem as reflex urinary incontinence if urination occurs in large amounts without an urge or feeling a warning sign. The underlying cause of this incontinence can be pathologies like multiple sclerosis, a spinal cord injury, radiation therapy, or surgical complication. 
  • Nocturnal Enuresis/Nighttime Urinary Incontinence: Urinary incontinence is assessed as nocturnal enuresis, commonly called bed-wetting if involuntary leakage of urine occurs during nighttime when asleep. This bladder condition is usually in children aged 5 or above. Common causes underlying nocturnal enuresis include hormonal imbalances, small bladder, UTIs, diabetes, sleep apnea, constipation, etc.
  • Mixed Urinary Incontinence: If your urinary incontinence symptoms appear similar to multiple incontinences, you might be affected with mixed urinary incontinence. This type usually presents as a combination of urge and stress urinary incontinence and occurs when the bladder condition becomes chronic and persistent.
  • Total Urinary Incontinence: An individual is affected with total urinary incontinence if their bladder cannot store urine. The main underlying cause for this incontinence is typically a congenital bladder anomaly, but it can also be caused by a bladder fistula or a spinal cord injury.

What Can Cause A Leaking Bladder? 

An involuntary leaking bladder or urinary incontinence is a symptomatic indication of various underlying causes. Different pathologies, injuries, physiological changes, and even dietary consumption can cause a bladder to leak urine involuntarily. Some of these underlying causes may include:

  • Aging.
  • Obesity.
  • Previous childbirths and current pregnancy.
  • Menopause.
  • Hormonal imbalance.
  • Surgical procedures like hysterectomy.
  • Neurological disorders like Parkinson’s disease, multiple sclerosis, Alzheimer’s, and stroke.
  • Spinal cord injuries.
  • Pelvic floor injuries and pelvic organ prolapse.
  • Prostate gland conditions like prostate cancer, benign prostatic hyperplasia, or prostatitis.
  • Interstitial cystitis.
  • Presence of tumor or tumor-like lesions near or along the urinary tract.
  • Severe constipation.
  • Long-standing diabetes.
  • Calculi in bladder.
  • Bladder fistula.
  • Congenital malformations of the bladder or other structures of the urinary tract.
  • Alcohol consumption.
  • High intake of carbonated and caffeinated drinks.
  • High intake of vitamin C.
  • Frequent consumption of extremely spicy, acidic, or sugary foods.
  • Use of pharmaceutical drugs like diuretics, muscle relaxants, sedatives, and antihypertensives.

Signs And Symptoms Of A Leaking Bladder

Although urinary incontinence is a symptom of an underlying cause, it can present with certain signs and symptoms that help diagnose the bladder condition. The various types of urinary incontinence usually appear with the same signs and symptoms, such as:

  • Urine leakage from normal activities like sneezing, coughing, laughing, lifting, exercising, etc.
  • Pelvic spasms create strong urges to urinate.
  • Multiple and sudden visits to the toilet per day to eliminate urine.
  • Bed-wetting and experiencing constant urine dribbling.
  • Urge to urinate when touching or hearing the sounds of running water.
  • Strong urge to urinate in between sexual intercourse, usually at the climax peak. 
  • Often pain while urinating or having blood-tinted or cloudy urine.

Leaking Bladder Treatment Your Healthcare Specialist Can Recommend

Over the years, various successful treatments for bladder leakage or urinary incontinence have been introduced owing to extensive research and advancement in medical technology. After assessing your bladder condition, taking a thorough medical history, and running several diagnostic tests, your healthcare specialist recommends a leaking bladder treatment. The treatment would either be physiotherapy and pharmacological or surgical management.

Generally, physiotherapy, along with dietary and other lifestyle changes, is recommended as the first line of treatment. But it can be combined with the pharmacological route of treatment if the bladder condition requires extensive management. On the other hand, surgical treatment is recommended only as the last resort when the bladder condition or the underlying injury or pathology becomes highly severe. 

Hence, depending upon the type of urinary incontinence you have and the severity of your bladder’s condition, your urologist, can recommend you the following leaking bladder treatment:

Physical Management

Physical therapy is usually the initial treatment for temporary and persistent urinary incontinence. It consists of a collection of different therapies that help to strengthen the pelvic floor muscles and improve voluntary control over the micturition or urination process. These therapies that collectively contribute to the bladder control training regimen include:

Kegel Exercises Or Pelvic Floor Exercises

Kegel exercises, commonly known as pelvic floor exercises, are a workout regimen performed to strengthen the muscles on the pelvic floor. By increasing the strength of these muscles, the positions of the bladder, bowel, and uterus remain stable. This stabilization prevents these organs from sagging down, which could result in pelvic organ prolapse, ultimately leading to urinary incontinence. 

The pelvic floor muscles control the urine flow, allowing you to stop it mid-stream. Hence, you can manage your involuntary bladder leakage by actively following the Kegel workout routine. Moreover, these exercises can also improve your sexual climax and bowel movements, preventing stool and gas from passing accidentally (fecal incontinence).

To accurately perform the Kegel exercises, the affected individual is instructed to:

  • Contract and lift the pelvic floor while lying, sitting, or standing, and hold the position for up to 4 to 5 seconds.
  • Relax from the position for the same duration, that is, 4 to 5 seconds.
  • Repeat the steps about 10 times to complete a single set. 
  • Perform the sets twice a day.

Once the patient gets accustomed to the routine and becomes comfortable enough to perform the exercises, the physician will recommend increasing the exercise duration and the number of sets performed per day. 

Biofeedback And Electrical Stimulation

Biofeedback and electrical stimulation are two pelvic floor physiotherapies recommended for individuals who can not perform Kegel exercises properly. Biofeedback training aims to determine whether the correct pelvic floor muscles are contracted while performing a kegel exercise. The healthcare specialist inserts a probe into the affected individual’s vagina, and a monitor displays the squeezing of the muscles.

On the other hand, electrical stimulation involves applying a tiny painless electrical current to the pelvic floor muscles to stimulate them. This procedure causes the muscles to contract, giving the sensation similar to when a Kegel exercise is performed. 

Timed Voiding

The timed voiding or timed toileting therapy incorporates setting a schedule for voiding or urinating to improve the affected individual’s voluntary control over their process of micturition. This therapy also aims to prevent the overfilling of the bladder. It encourages the patient to go to the bathroom to eliminate urine only at a certain time instead of going every time they feel the urge to urinate. Your healthcare provider will instruct you to:

  • Urinate early in the morning, right after you wake up.
  • During the initial stages, set 1 hour between each voiding session.
  • With time, gradually increase this interval to up to 3 hours max. 
  • Always go to the bathroom before going to sleep. 

Double Voiding

Double voiding physical therapy is recommended to promote complete voiding in individuals with urinary incontinence. This physiotherapy involves sitting on the toilet for extra seconds after eliminating urine to ensure the entire bladder is emptied. Eliminating the full volume of stored urine prevents the risk of bladder infections and possible leakage. To perform double voiding, your physician would instruct you to:

  • Relax when urinating and avoid stopping the flow mid-stream.
  • Sit on the toilet for an extra 15 to 45 seconds after urinating. Try to lean forward, sit straight, and move slightly to eliminate any remaining fluid.
  • Push by expanding the belly with slight pressure at the very end to get rid of the last urine droplets. 

Urgency Suppression

A healthcare professional recommends urgency suppression therapy if the individual is affected by urge urinary incontinence. This physical therapy improves the patient’s control over their micturition process and reduces their frequency of sudden urges. To achieve urgency suppression, the healthcare specialist would advise the affected individual to:

  • Stop their current activity if they feel a sudden urge and stay still to enable bladder control instead of rushing to the bathroom. 
  • Quickly perform Kegel exercises to maintain a contracted pelvic floor and relaxed bladder.
  • Practice mental distractions like visualization of a relaxing scenario and taking slow, deep breaths when a sudden urge is felt. 
  • Go to the toilet only after the urge has subsided and not before that. 

Pharmacological Management

The pharmacological route for treating urinary incontinence is prescribed when a physical therapy-only treatment becomes ineffective due to the severing of the underlying cause. As mentioned earlier, this management is done in combination with physiotherapies to improve bladder function. Various pharmaceutical drugs are available, and your health care specialist would prescribe one according to your bladder condition, underlying pathology, and medical history. The common drugs prescribed for urinary incontinence include: 


Anticholinergic drugs are medications that act on the parasympathetic nerve receptors in the smooth muscles to block and inhibit the action of the neurotransmitter called acetylcholine. Acetylcholine, or Ach, is the main neurotransmitter that causes urination by relaxing the urethral sphincters. By blocking its action, the sphincters remain contracted, and involuntary bladder leakage can be prevented. Your healthcare specialist may recommend an anticholinergic medication like tolterodine, fesoterodine, darifenacin, solifenacin, trospium, and oxybutynin.

Beta-3 Adrenoceptor Agonists

The beta-3 adrenoceptor agonists or beta-3 adrenergic receptor agonists are pharmacological agents that relax the smooth muscles of the lower urinary tract. These smooth muscles are the detrusor muscle of the bladder and the internal urethral sphincter muscle. By relaxing these muscles, the bladder capacity increases, allowing it to store more urine without voiding it instantly. A common beta-3 adrenoceptor agonist that doctors usually prescribe for treating urge urinary incontinence is Mirabegron. 

Alpha Blockers

Alpha-blockers or α-adrenoreceptor antagonists are medications generally used to treat high blood pressure. But when given as a leaking bladder treatment, they act on the bladder, urethral, and prostate smooth muscles to relax them, increasing the bladder’s urine storage capacity and promoting complete voiding. Alpha-blockers also aid in creating a urine outflow path in men with benign prostatic hyperplasia. Healthcare specialists usually prescribe a few alpha-blockers for urinary incontinence: silodosin, tamsulosin, doxazosin, alfuzosin, and terazosin. 

Topical Estrogen

Topical formulations of low-dose estrogen are prescribed to women with urinary incontinence due to low levels of this hormone, as seen in those who have reached menopause. These formulations can be in patches, rings, or vaginal creams and are applied directly to the vaginal wall or urethral tissue. The absorption of estrogen after application strengthens the urethra and the vagina, which in turn aids in preventing involuntary bladder leakage. 

Tricyclic Antidepressant

Tricyclic antidepressants such as Imipramine are commonly prescribed for treating depression. However, it also works on the bladder muscles, relaxing them, and on the urethral sphincter muscles to contract them. Healthcare specialists prescribe Imipramine for nighttime urinary incontinence or nocturnal enuresis to improve the bladder’s urine holding capacity. 

Surgical Management

The surgical route is recommended as a last resort for treating urinary incontinence if pharmacological management fails or there is a significant defect or obstruction in the urinary tract. A few commonly used surgical treatments include:

Sling Procedures

Different sling procedures exist for the male and female urinary tracts and are mostly performed to treat stress incontinence. A sling created from human tissue or mesh is surgically inserted under the urethra. It lifts the urethral passage along with the bladder neck and supports them to prevent the involuntary leakage of urine. 

Burch Colposuspension

The Burch colposuspension is another surgical leaking bladder treatment that lifts and supports the bladder neck and urethra. It can be performed as an open surgery or through laparoscopy. The prolapse bladder neck and proximal urethra are lifted and suspended behind the pubic symphysis in this procedure. This relieves the increased abdominal pressure effect on the bladder, preventing accidental leakage of urine. 

Artificial Urinary Sphincter

An artificial urinary sphincter or valve is surgically implanted under the belly muscles and around the urethra if the urethral sphincters fail to function completely. The affected person can manually control their urine flow by pumping and relaxing the valve. 

Other Management 

Besides the three management mentioned above for treating urinary incontinence, a few other options include:

  • Implants like urethral inserts, pessary rings, sacral nerve stimulators, and botox.
  • Radiofrequency therapy on the tissues of the lower urinary tract.
  • Absorbent pads to keep the skin dry and prevent irritation.
  • Urinary catheters as the last resort if no treatment or therapy works.

How Does A Leaking Bladder Affect A Person’s Life?

Having to put up with a leaky bladder can be both embarrassing and tiresome. Generally, individuals with urinary incontinence are uncomfortable going out in public places and staying away from toilet access because of the fear of leaking in front of people around. This fear of embarrassment gradually causes them to lessen their social interactions and withdraw from actively participating in everyday activities and hobbies. With time, these behavioral changes can even adversely affect their mental health. 

Other than becoming socially distant, the affected person shies away from consulting a healthcare specialist and getting a proper medical assessment on time. It is one of the reasons why cases of urinary incontinence are underreported worldwide. This hesitancy, in turn, causes their bladder control condition to worsen, delaying the initial treatment and making alternative therapies ineffective. 

In addition to impacting social life, a leaking bladder can negatively affect a person’s hygiene and make them susceptible to various infections. Frequent leakage of urine and the moisture’s constant contact with the skin develop body odor and cause the skin barrier to become sensitive. As a result, the sensitive contact skin becomes prone to rashes, sores, and in severe cases, the growth of fungal infections. 

Extensive skin infections on the urine-damped skin also slow down the healing of wounds. Moreover, the risk of frequently becoming infected with urinary tract infections or UTIs increases in individuals with urinary incontinence. 

Who Is More Susceptible To Developing A Leaking Bladder? 

Various factors can put an individual at a higher risk of developing a leaking bladder. Such risk factors include:

  • Being a female.
  • Old age.
  • Being overweight or obese.
  • Having a family history of urinary incontinence.
  • Having a pre-existing disease like multiple sclerosis, Parkinson’s disease, Alzheimer’s, diabetes, and renal and vascular diseases.
  • A pre-existing spinal cord or pelvic floor injury.
  • A history of smoking or consuming alcohol.

Bottom Line

If you have a leaking bladder or urinary incontinence, then without getting a proper checkup, you might see your condition as untreatable. However, various physical, pharmacological, surgical, and alternative treatments exist that cater to all types and severity of urinary incontinence. Hence, by getting an early assessment by a healthcare specialist, you can receive an accurate diagnosis and the appropriate leaking bladder treatment that can reverse your bladder control issue to normal. Although thinking about getting a consultation might feel embarrassing, taking the right step at the right time will help you live your life to the fullest.