Urgency urinary incontinence, also called urinary urgency or overactive bladder, is characterised by sudden, uncontrollable, irresistible urges to urinate. Unlike stress incontinence, it comes on suddenly, sometimes before the bladder is completely full, leading to involuntary urine loss before you can reach the toilet. This condition can have a major impact on your quality of life, but there are medical solutions and targeted exercises to help you regain full bladder control.
- Urgency incontinence is caused by involuntary contractions of the bladder detrusor muscle.
- Treatment is based on pelvic floor training, healthy lifestyle habits and behavioural techniques.
- The connected Emy Trainer pelvic floor trainer lets you train your pelvic floor at home with effective biofeedback to reduce urge leaks: discover our solutions for female urinary incontinence.
Understanding urgency urinary incontinence: definition and mechanisms
Urgency urinary incontinence is one of the symptoms of overactive bladder syndrome. It is marked by urgency (a sudden, intense urge) associated with involuntary urine leakage. According to the French Association of Urology (AFU), this condition affects around 15% of women over 40, and its prevalence rises significantly with age.
From a physiological point of view, urination is regulated by the detrusor muscle, which forms the bladder wall. Under normal circumstances, this muscle relaxes during the filling phase and contracts only when you consciously decide to urinate. In the case of urinary urgency, the detrusor undergoes premature involuntary contractions, sending the brain a false signal that the bladder is full.
The pelvic floor plays an essential mechanical locking role. If the pelvic floor muscles are weakened, they can no longer counter the pressure created by abnormal bladder contractions, which leads to urine leakage.
What causes urgency incontinence in women?
The cause of frequency (urinating more often) combined with urgent urges can be multifactorial:
- Bladder irritation: A urinary tract infection (cystitis), bladder stones or local inflammation can irritate the lining of the bladder and trigger involuntary detrusor contractions.
- Neurological changes: Multiple sclerosis, Parkinson’s disease, stroke or spinal cord injury can disrupt nerve signals between the brain and the bladder.
- Hormonal changes: At menopause, the drop in oestrogen levels causes atrophy of the urinary tract and pelvic floor tissues, which contributes to reduced tone and bladder instability.
- Lifestyle habits and irritant substances: Excess caffeine, tea, alcohol, fizzy drinks, sweeteners or smoking directly irritate the bladder wall.
- Psychological factors and stress: Anxiety can increase the sensitivity of the central nervous system and worsen the urge to urinate.
Symptoms: how do you recognise urinary urgency?
The clinical signs of urgency incontinence are very distinctive and clearly differ from stress incontinence:
- A sudden, urgent need to urinate: The urge comes on abruptly, is hard to put off, and is often accompanied by panic at the idea of not finding a toilet right away.
- Heavy leakage: Unlike stress incontinence, where leakage appears as drops when you cough or jump, urgency incontinence can lead to partial or complete emptying of the bladder.
- Nocturia: The need to get up several times during the night to urinate, seriously disrupting sleep.
- Environmental triggers: Hearing running water, touching cold water or simply putting the key in the lock when you get home (the key-in-the-door syndrome) can instantly trigger the urge to urinate.
Treatments and solutions for managing overactive bladder
Treatment is based on a step-by-step approach, combining diet and lifestyle measures, training and, if needed, medical follow-up.
1. Behavioural training and the bladder diary
Behavioural training consists of retraining your bladder to store urine. Keeping a bladder diary for three days makes it possible to record urination times, voided volumes and leakage episodes. The clinician can then suggest a scheduled voiding programme, gradually increasing the time between two bathroom trips (for example, waiting an extra 15 minutes when the urge appears).
2. Pelvic floor training
Strengthening the pelvic floor muscles is a key part of treatment. A strong pelvic floor lets you use the bladder inhibition technique: when an urgent need arises, voluntarily contracting the pelvic floor sends a neurological inhibitory reflex to the detrusor muscle, easing bladder pressure and giving you time to reach the toilet calmly.
3. Medical and surgical treatments
If training is not enough, a specialist doctor or urologist may prescribe medication, including anticholinergics or beta-3 agonists, which help the bladder muscle relax. Other advanced options are also available, such as intravesical botulinum toxin injections or sacral neuromodulation.
The benefits of using Emy Trainer in care
To successfully train your pelvic floor at home and manage urinary urgency, using the connected biofeedback pelvic floor trainer Emy Trainer offers major benefits:
- Immediate visual biofeedback: Thanks to patented 360° pressure sensors, Emy turns your pelvic floor contractions into real-time feedback in the mobile app through playful games. You learn how to contract the right muscles precisely and effectively.
- Detrusor inhibition effect: By mastering fast, powerful pelvic floor contractions through training programmes, you can stop the bladder’s involuntary contraction reflex when urgency strikes.
- Clinically validated medical device: Designed in collaboration with healthcare professionals (midwives, physiotherapists), the Emy trainer provides safe, personalised training.
Frequently Asked Questions (FAQ)
What is the difference between stress incontinence and urgency incontinence?
Stress incontinence happens when abdominal pressure increases (coughing, laughing, sneezing, lifting, sport) without any prior urge to urinate. Urgency incontinence is caused by involuntary bladder contractions and is accompanied by an immediate, uncontrollable need to urinate.
Can urgency urinary incontinence be completely cured?
Yes, in many cases, appropriate care combining pelvic floor training, bladder retraining and lifestyle adjustments can completely resolve or greatly reduce urgency symptoms.
How long does it take to see results with pelvic floor training?
Early improvements are generally felt after 3 to 4 weeks of regular practice (3 sessions a week). Consistency is essential to achieve lasting results in pelvic floor tone.
Conclusion
- Urgency incontinence results from uncontrolled contractions of the bladder detrusor muscle and requires an accurate diagnosis.
- Combining bladder retraining and pelvic floor training is the most effective first-line strategy.
- The connected Emy Trainer pelvic floor trainer supports you every day at home with targeted biofeedback exercises to help you regain control of your bladder: learn more about Emy Trainer.
Sources
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Pelvic floor muscle training for urinary incontinence in women, E. J. Hay-Smith, L. C. ladder training for urinary incontinence in adults, S. A. Wallace, B. Roe, K. Williams, M. Palmer, January 2004, Cochrane Database of Systematic Reviews 2004(1):CD001308 - link
- Oral anticholinergic drugs versus placebo or no treatment for managing overactive bladder syndrome in adults, A. Stoniute, P. Madhuvrata, M. Still, E. Barron-Millar, G. Nabi, M. I. Omar, May 2023, Cochrane Database of Systematic Reviews 2023(5):CD003781 - link
