incontinence that comes and goes

Overview

Incontinence that comes and goes means you have times when you leak urine without meaning to, but it doesn't happen all the time. You may leak for a few days and then be dry for weeks or months. This type of incontinence can be unpredictable. It is often related to stress or urge incontinence, but the symptoms are not constant.

Yes, many people experience incontinence that comes and goes, especially as they get older or after childbirth. It is more common than you might think.

It affects people of all ages, but is more common in women, older adults, and those with certain health conditions like diabetes or nerve problems.

Symptoms

Common symptoms

• Leaking urine when you cough, sneeze, laugh, or exercise (stress incontinence)
• Sudden, strong urge to urinate followed by leakage (urge incontinence)
• Feeling like you need to go often, even when your bladder isn't full
• Waking up at night to urinate

Symptoms in children

• Bedwetting (nocturnal enuresis)
• Leaking during daytime activities like running or playing
• Sudden urges that cause accidents

Symptoms in older adults

• Leakage when moving from sitting to standing
• Inability to reach the toilet in time
• Increased frequency of urination, especially at night

Causes

Main causes

• Weak pelvic floor muscles (often after childbirth or with age)
• Overactive bladder muscles
• Urinary tract infections (UTIs)
• Nerve damage from conditions like diabetes, multiple sclerosis, or stroke
• Medications that affect bladder control
• Constipation (the bowel pressing on the bladder)

Risk factors

• Being female
• Pregnancy and childbirth
• Obesity
• Smoking
• Diabetes
• Aging
• Certain surgeries (like prostate surgery in men)

When to see a doctor

See a doctor urgently if:

• If incontinence comes on suddenly with pain, fever, or inability to urinate
• If you see blood in your urine

Book a routine appointment if:

• If incontinence affects your daily life, even if it comes and goes
• If you have to wear pads or avoid activities because of leakage
• If you have other symptoms like frequent UTIs

Diagnosis

Your doctor will ask about your symptoms, how often they happen, and what triggers them. They may ask you to keep a bladder diary for a few days.

Tests that may be done

• Urine test to check for infection or blood
• Bladder ultrasound to see how much urine is left after you go
• Cystoscopy (a thin tube with a camera to look inside your bladder)
• Urodynamic tests to measure bladder pressure and function

What to expect at your appointment

You may be asked to cough or bear down during an exam. Tests are usually not painful, though some may be uncomfortable. Your doctor will explain each step.

Treatment

Treatment depends on the cause and type of incontinence. Often, simple changes can make a big difference. Your doctor may suggest a combination of lifestyle changes, exercises, and medications.

Self-care at home

• Kegel exercises to strengthen pelvic floor muscles (tighten and hold for 5-10 seconds, relax, repeat)
• Bladder training – schedule bathroom visits every 2-3 hours and gradually increase the time
• Avoid caffeine, alcohol, and acidic foods that can irritate the bladder
• Maintain a healthy weight
• Drink enough water but not too much at once

Medical treatments

Medications can relax an overactive bladder or help tighten the muscles that control urine flow. Your doctor will prescribe a type suitable for you. Other options include nerve stimulation therapy, Botox injections into the bladder, or using a pessary (a device placed in the vagina to support the bladder).

When is surgery considered?

Surgery is rarely the first option, but it may be considered if other treatments haven't worked. Procedures can lift the bladder or support the urethra. Discuss risks and benefits with a specialist.

Living with this condition

Many people manage incontinence that comes and goes with pads or protective underwear on days when symptoms are worse. Planning ahead – knowing where restrooms are – can help reduce anxiety. You don't have to let it stop you from being active.

Lifestyle tips

• Practice pelvic floor exercises daily
• Avoid lifting heavy things if your pelvic floor is weak
• Use the toilet regularly, even if you don't feel the urge
• Keep a spare change of clothes with you for peace of mind

Diet and exercise

Eat a high-fiber diet to prevent constipation (which can worsen incontinence). Drink 6-8 glasses of water a day, but avoid large amounts before bed. Gentle exercise like walking is good, but avoid high-impact activities if they trigger leakage.

Mental health and emotional wellbeing

It's common to feel embarrassed, anxious, or frustrated. Incontinence can affect your confidence, relationships, and social life. Remember you are not alone, and help is available. If you feel down, talk to your doctor or consider seeing a counsellor. If you are in crisis, contact your local emergency services or a mental health helpline.

Prevention

Not always, but you can reduce your risk by doing pelvic floor exercises, maintaining a healthy weight, not smoking, and treating constipation quickly.

Complications

If left untreated

• Repeated urinary tract infections
• Skin rashes or sores from constant moisture
• Falls from rushing to the toilet
• Social isolation and depression

Long-term outlook

Most people with incontinence that comes and goes can improve their symptoms with the right approach. Many achieve dryness or better control. Even if complete dryness isn't possible, managing symptoms can greatly improve your quality of life.

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