incontinence MRI what to expect

Overview

An incontinence MRI is a type of scan that uses strong magnets and radio waves to take detailed pictures of your bladder, urethra, and surrounding muscles. It helps doctors see how your pelvic floor is working and find the cause of urine leakage.

Yes, incontinence is very common, especially in women after pregnancy or menopause and in older adults. An MRI is one of several tests used to understand the cause.

Incontinence MRI is typically recommended for people who have ongoing urine leakage that hasn't been explained by other tests. It can be used for both men and women, though it's more common in women.

Symptoms

Common symptoms

• Leaking urine when you cough, sneeze, laugh, or exercise
• A sudden, strong urge to urinate that's hard to control
• Frequent urination (going more than 8 times a day)
• Waking up at night to urinate
• Leaking urine without any warning

Symptoms in children

• Wetting the bed after age 5 or 6
• Daytime accidents after potty training
• Dribbling or sudden urges to pee
• Holding legs together or squatting to stop leaks

Symptoms in older adults

• Leaking urine that gets worse with age
• Difficulty reaching the toilet in time
• Frequent nighttime urination
• Leaking with physical activity (like walking or standing up)

Causes

Main causes

• Weak pelvic floor muscles (often from pregnancy, childbirth, or aging)
• Overactive bladder muscles that squeeze at the wrong time
• Nerve damage from diabetes, stroke, or spinal cord injury
• Enlarged prostate in men
• Structural problems like a prolapsed bladder or urethra

Risk factors

• Being female and having had a vaginal delivery
• Being overweight or obese
• Getting older (over 50)
• Chronic constipation that strains the pelvic floor
• Smoking (because of chronic coughing)
• Certain surgeries (like prostate surgery or hysterectomy)
• Conditions like diabetes or multiple sclerosis

When to see a doctor

See a doctor urgently if:

• If you have trouble peeing or can't pee at all
• If you see blood in your urine
• If you have severe pelvic pain along with leakage

Book a routine appointment if:

• If you leak urine often enough that it bothers your daily life
• If you avoid activities because you're afraid of leaking
• If you wake up to pee more than twice a night

Diagnosis

Your doctor will start with a conversation about your symptoms and a physical exam. They may ask you to keep a bladder diary and do a urine test. If further detail is needed, they might order an MRI – especially if they suspect a structural problem or if other tests haven't given a clear answer.

Tests that may be done

• Bladder diary (writing down when and how much you pee)
• Urine test to check for infection or blood
• Physical exam of the pelvic area
• Ultrasound of the bladder and kidneys
• Urodynamic tests (measure how your bladder works)
• Incontinence MRI – uses a strong magnet to create detailed images of your pelvic floor muscles, bladder, and urethra

What to expect at your appointment

During an incontinence MRI, you'll lie on a padded table that slides into a large tube-shaped machine. The technologist will ask you to lie still and may give you earplugs or headphones because the machine makes loud knocking noises. You might be asked to have a full bladder for part of the scan, and sometimes you'll be asked to cough or bear down (like pushing) so the doctor can see how your pelvic floor moves. The MRI is painless and usually takes about 30–60 minutes. After the scan, you can go home and resume normal activities. Results are typically reviewed by a radiologist and sent to your doctor in a few days.

Treatment

Treatment for incontinence depends on what's causing it. The MRI helps your doctor choose the right approach, which might include exercises, lifestyle changes, medicines, or surgery.

Self-care at home

• Do pelvic floor muscle exercises (Kegels) every day – like tightening the muscles you use to stop pee flow, holding for a few seconds, then relaxing.
• Train your bladder by going to the toilet on a set schedule, gradually increasing the time between visits.
• Lose extra weight if you're overweight – this can reduce pressure on your bladder.
• Avoid drinks that can irritate your bladder, like coffee, tea, alcohol, and fizzy drinks.
• Stay hydrated but don't drink too much at once – sip water throughout the day.

Medical treatments

Your doctor may suggest treatments like pelvic floor physiotherapy, where a trained therapist teaches you proper exercises and uses biofeedback. If needed, they might prescribe medicines that help calm an overactive bladder or improve muscle function. For some people, a device like a vaginal pessary (a support ring) or urethral insert may help. These treatments should be discussed with your healthcare provider – never start a new medicine without a doctor's advice.

When is surgery considered?

Surgery is usually considered only after other options haven't worked. The MRI can help your surgeon decide which procedure is best. Common surgeries include sling procedures (using a small piece of mesh to support the urethra) or bladder neck suspension. Your doctor will explain the risks and benefits.

Living with this condition

Living with incontinence can be frustrating, but many people manage it well with the right strategies. Use absorbent pads or underwear for peace of mind when you're out. Plan ahead – know where toilets are and carry a change of clothes. Don't let fear of leaks stop you from enjoying life.

Lifestyle tips

• Do pelvic floor exercises regularly – they really help strengthen the muscles.
• Practice double voiding – after you pee, wait a few seconds and try to empty your bladder again.
• Avoid heavy lifting or straining, which can weaken your pelvic floor.
• Consider using a 'pee-timer' app to remind you to go at set intervals.

Diet and exercise

Eat a high-fibre diet with plenty of fruits, vegetables, and whole grains to prevent constipation, which can worsen incontinence. Stay physically active – walking, swimming, and yoga are good – but avoid high-impact exercises like jumping on a hard surface if you have stress incontinence. Kegel exercises can be done anytime, even while sitting at your desk.

Mental health and emotional wellbeing

Incontinence can feel embarrassing and affect your confidence. It's common to feel anxious or down about it, especially if you avoid social situations. Remember that you're not alone – millions of people experience this. Talk to your doctor about how you're feeling. If you're feeling very low or hopeless, please reach out to a mental health professional or crisis support line.

Prevention

While not all incontinence can be prevented, you can reduce your risk by keeping a healthy weight, doing pelvic floor exercises regularly (especially during and after pregnancy), avoiding constipation, and not smoking. The MRI itself is a diagnostic tool, not a prevention method.

Complications

If left untreated

• Skin irritation or infections from constant moisture
• Urinary tract infections (UTIs) that keep coming back
• Falls or fractures from rushing to the toilet at night
• Social withdrawal, depression, or anxiety

Long-term outlook

Most people with incontinence can improve their symptoms with the right treatment. The MRI helps doctors find the exact cause, so you can get a plan that works for you. It may take time and some trial and error, but you don't have to accept leakage as a normal part of life. With support and ongoing management, many people regain control and feel much better.

Find support

International organisations

• International Continence Society
• World Federation of Incontinence and Pelvic Floor Disorders

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