Private urinary incontinence clinic in London, same-day urology.

Which type

• Stress incontinence — leaking on coughing, sneezing, laughing, lifting or exercise. Caused by a weakened pelvic floor or sphincter. Commonest after childbirth and after prostate surgery.
• Urge incontinence — a sudden desperate need to go, with leakage before reaching the toilet, often with frequency and getting up at night. Caused by an overactive bladder muscle.
• Mixed — both, which is very common.
• Overflow — dribbling from a bladder that does not empty, most often in men with prostate enlargement.
• Knowing which you have matters, because the treatments are different and doing the wrong one does not help.

Pelvic floor training done properly

1. Find the muscles. Sitting or lying, squeeze as though stopping wind and stopping urine at the same time, and lift inwards and upwards.
2. Do long holds — hold for as long as you can up to 10 seconds, rest for the same, repeat up to 10 times.
3. Do short squeezes — quick, strong contractions, up to 10 times.
4. Three sets a day, every day, for at least three months before judging it. Improvement usually starts at six to eight weeks.
5. Add the knack — squeeze before you cough, sneeze or lift. This alone reduces leaking considerably.

A supervised programme with a pelvic health physiotherapist is substantially more effective than doing them alone, and is recommended as first-line treatment for at least three months before anything else is considered.

Bladder retraining for urgency

• Do not rush to the toilet when urgency strikes. Stop still, sit down if you can, and contract the pelvic floor quickly several times — this suppresses the bladder contraction. Wait for the urge to pass, then walk calmly.
• Gradually extend the interval between visits, by 15 minutes at a time over weeks.
• Stop going 'just in case' — it trains the bladder to hold less.
• Keep a three-day bladder diary; it is the single most useful thing to bring to an appointment.

Other measures and treatments