About bladder problems

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Types of bladder problems

The most common bladder problems are overactive bladder (or urge incontinence) and stress urinary incontinence. See more on signs and symptoms of bladder problems. Bear in mind that everyone is unique and so it’s not surprising that bladder problems may vary from person to person. See Ron’s and Joan’s stories as examples of how bladder problems may affect people in different ways.

1. Overactive bladder

   Having an overactive bladder means the bladder muscles become more active and this leads to the feeling of needing to pass urine, even if the bladder is not full. Sometimes this urge can be unexpected and you may feel desperate to reach a toilet as soon as possible. The sudden urge to go to the loo is called urgency and, if you don’t get there in time, is known as urge incontinence. You may have only a few seconds between feeling the need to go and actually passing urine. Some people need to go very often (called frequency) or have to get up frequently during the night (nocturia).

2. Stress urinary incontinence

   Stress incontinence is leakage from your bladder that occurs when you sneeze, laugh, cough or exert yourself, for example, when exercising, or getting up from a chair. It’s particularly common among women who’ve had children and after the menopause. Usually – but not always – the amount of urine passed is small.

3. Mixed urinary incontinence

   Overactive bladder and stress urinary incontinence are separate conditions; however, some people suffer from the symptoms of both at the same time. If you do have mixed urinary incontinence, it’s important to try to work out which is the biggest problem for you so your doctor or nurse can give you the best advice on how to cope.

Why do I have bladder problems?

Bladder problems arise when something happens to disrupt the normal working of your ‘water-works’ or urinary system.

1. How the bladder works

   Each time we eat and drink, our body absorbs liquids which pass into our bloodstream. The kidneys filter out waste and extra water from the blood to make urine, which is stored in our bladder. The bladder is a stretchy muscular bag that expands like a balloon to hold a cup or two of urine. As it fills, it sends stronger and stronger signals to the brain that it's time to empty it. At the same time, the muscles at the base of the bladder – known as the sphincter muscles – contract to keep the urine in. Eventually the signals from the bladder become strong enough for you to need to go to the lavatory. This usually happens up to eight times a day.

2. Overactive bladder

   An overactive bladder doesn't wait until it's full to send an urgent signal. Instead it sends ‘false alarms’ which can cause strong sudden urges to urinate and may even lead to an accident. A strong sudden urge to urinate is also known as ‘urgency’. The reason why someone’s bladder becomes overactive is often not known. It can sometimes be caused by an infection in the bladder or it may occur in people who have an underlying medical condition such as diabetes, or following a stroke.

3. Stress incontinence

   This usually happens because the muscles in the pelvic floor or sphincter are weak or damaged. This may be worsened if you’re pregnant or overweight, as this puts additional pressure on your bladder, making it harder for you to hold in your urine. If you suffer from constipation or have had a bad cough, you may also be prone to stress incontinence.