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Urgency incontinence

Published July 22, 2020
• Reviewed by a UI Health Care Provider
on July 31, 2023

What is urgency incontinence?

Urgency incontinence is the uncontrolled loss of urine that happens when a person feels a sudden strong need to go to the bathroom. It is thought to be due to an over-excited nervous system making your bladder spasm.

This can happen:

  • At the sight, feel or sound of running water
  • When you put a key in your door at home
  • When you enter a bathroom
  • When you think about going to the bathroom

How do I treat it?

  1. Urgency incontinence can be caused or made worse by a bladder infection. Your doctor can test you for this.
  2. Your provider may test your bladder to be sure it empties fully.
  3. Make lifestyle changes:
    • Do not eat or drink bladder irritants, such as caffeine, artificial sweeteners, carbonated drinks, tobacco, alcohol, and spicy foods. This can cause more frequency and urgency.
    • Have normal fluid intake. Drink 48 to 64 ounces of total fluids each day.
  4. Take medicines to lessen the strength of bladder contractions.
  5. Do Kegel exercises. Contract the muscles of your pelvic floor. This gives you time to get to the bathroom.
  6. Do bladder retraining (timed voids and urge suppression). This improves brain-bladder connections for better control.
  7. Squeeze the muscles before you stand. Talk to your bladder, tell it to wait before going to the bathroom.
  8. When you have a strong urge, freeze and squeeze your pelvic floor muscles. Try to calm the urge before you walk to the toilet.
  9. Do not get constipated.
  10. Use vaginal estrogen. This may help urgency after menopause for some women.
  11. Sometimes correcting pelvic prolapse will make urgency leakage better. Talk with your doctor about this.
  12. Talk with your doctor if these options do not help. You may be able to try Botox injections or nerve stimulation.

How do I treat using 'freeze and squeeze'?

Freeze and squeeze is a technique using your pelvic muscles. It will help when you feel the urge.

Freeze

Stop and be very still. Sit down if you can or stand quietly. Do not move. Stay very still to keep control. Rushing to the bathroom makes the nervous system more excited. This makes you more likely to leak.

Squeeze

Quickly squeeze and let go of your pelvic floor muscles (quick flicks) for 1 to 2 seconds or 5 to 6 times. Use as much effort as you can. This sends a message to your brain to relax and hold urine. Try to distract yourself by thinking of something other than going to the bathroom.

Breathe

Relax. Take a deep belly or diaphragmatic breath. Let it out slowly. Try to make the urge go away by staying distracted and positive.

Repeat

Do the steps above if the urge comes back. When you feel the urge go away, walk to the bathroom. Do not rush. Keep doing your quick flicks to relax bladder spasms. Urinate when the urge goes away.