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For further information and advice on COPD, please contact your healthcare professional.

COPD and incontinence

Urinary incontinence is the unintentional passing of urine. It's a common problem thought to affect millions of people.1

There are several types of urinary incontinence, including:1

Stress incontinence

When urine leaks out at times when your bladder is under pressure; for example, when you cough or laugh

Urge (urgency) incontinence

When urine leaks as you feel a sudden, intense urge to pee, or soon afterwards

Overflow incontinence (chronic urinary retention)

When you're unable to fully empty your bladder, which causes frequent leaking

Total incontinence

When your bladder cannot store any urine at all, which causes you to pass urine constantly or have frequent leaking

What causes urinary incontinence?

Stress incontinence happens when the muscles that normally keep urine in become weakened or damaged. Urge incontinence is caused by the bladder’s detrusor muscle becoming overactive, creating a sudden, strong need to urinate.

Overflow incontinence occurs when something blocks or obstructs the bladder, stopping it from emptying fully. Total incontinence is less common and can be due to conditions present from birth, spinal injuries, or a small tunnel-like opening (fistula) that forms between the bladder and a nearby area, allowing urine to leak continuously.1

What can you do about urinary incontinence with COPD?

If you experience any type of urinary incontinence, it’s important to speak with your GP. Urinary incontinence is a common problem, and your GP is there to help. Reaching out is often the first step toward finding ways to help manage your symptoms.1

In most cases, urinary incontinence can be diagnosed during a GP consultation. They will ask about your symptoms and may carry out an examination.1

Treating urinary incontinence

The type of treatment you receive will depend on the type of urinary incontinence you have and the severity of your symptoms.
 


If it is caused by an underlying condition, you may receive treatment for this alongside incontinence treatment. Conservative treatments, which do not involve medicines or surgery, are tried first and can include lifestyle changes, pelvic floor muscle training (Kegel exercises), and bladder training.2

Pelvic floor exercises for urinary incontinence

Your pelvic floor muscles surround the bladder and urethra (the tube that carries urine from your bladder out of your body) and control the flow of urine as you pee. Weak or damaged pelvic floor muscles can cause urinary incontinence (e.g. when you cough), so exercising these muscles is often recommended.2,3
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How to find your pelvic floor muscles

  • Pelvic floor exercises can be effective at reducing leaks. It's important to do them properly and include short squeezes and long squeezes.4
  • You can feel your pelvic floor muscles if you try to imagine stopping yourself peeing.4

How to exercise your pelvic floor muscles5

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Sit comfortablySit, stand, or lie down, whichever you find most comfortable, and relax your thighs and buttocks

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Tighten musclesImagine you are urinating and tighten your muscles as if you’re trying to stop mid-flow. Hold for 10 seconds, then relax. Try not to hold your breath and keep breathing normally

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RepeatRepeat the exercise up to 10 times

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Try fast holdsYou can also try repeating the same actions as with the slow exercises, but this time try tightening the muscles as quickly as possible

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Make it routineYou may want to try mixing slow and fast exercises a few times each day. Incorporating them into your routine may also help but remember to not overdo it — your pelvic floor is like other muscles and can get tired.

You might find that you can’t hold for 10 seconds to start with. Hold it for as long as you can and try to build up to 10 seconds. It’s more important to do the exercises properly than to rush to get to 10 seconds.

Tips to help avoid incontinence4

Smoking can worsen incontinence because frequent coughing strains the pelvic floor muscles

Stop smoking

Smoking can worsen incontinence because frequent coughing strains the pelvic floor muscles
Avoid high-impact exercise and sit-ups, which put pressure on the pelvic floor. If you are able to exercise, choose strengthening that support core strength

Do the right exercises

Avoid high-impact exercise and sit-ups, which put pressure on the pelvic floor. If you are able to exercise, choose strengthening that support core strength
Lifting (e.g. lifting children or shopping bags) increases strain on the pelvic floor. When lifting is unavoidable, tighten your pelvic floor muscles before and during the lift

Avoid lifting

Lifting (e.g. lifting children or shopping bags) increases strain on the pelvic floor. When lifting is unavoidable, tighten your pelvic floor muscles before and during the lift
Being overweight can weaken your pelvic floor muscles and cause incontinence because of the pressure of fatty tissue on your bladder. Losing weight may help lessen symptoms

Lose excess weight

Being overweight can weaken your pelvic floor muscles and cause incontinence because of the pressure of fatty tissue on your bladder. Losing weight may help lessen symptoms
Straining to poo weakens pelvic floor muscles. Increase fibre, stay active, and don’t ignore the urge to go

Treat constipation promptly

Straining to poo weakens pelvic floor muscles. Increase fibre, stay active, and don’t ignore the urge to go
Caffeine irritates the bladder and may make incontinence worse. Coffee has the biggest effect, so you could consider stopping drinking it. Fizzy drinks, tea, and hot chocolate can also contain caffeine. You could consider replacing them with water or herbal/fruit teas

Cut down on caffeine

Caffeine irritates the bladder and may make incontinence worse. Coffee has the biggest effect, so you could consider stopping drinking it. Fizzy drinks, tea, and hot chocolate can also contain caffeine. You could consider replacing them with water or herbal/fruit teas
Alcohol acts as a diuretic and increases urination. Reducing intake may help symptoms

Cut down on alcohol

Alcohol acts as a diuretic and increases urination. Reducing intake may help symptoms
You should drink 6–8 glasses a day unless advised otherwise. Avoiding fluids may worsen incontinence (because it reduces your bladder's capacity) and also cause constipation

Drink plenty of water

You should drink 6–8 glasses a day unless advised otherwise. Avoiding fluids may worsen incontinence (because it reduces your bladder's capacity) and also cause constipation
Avoid spicy or acidic foods (like curries and citrus fruits) as they can irritate the bladder and worsen leaks

Eat the right foods

Avoid spicy or acidic foods (like curries and citrus fruits) as they can irritate the bladder and worsen leaks
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For information on living well with COPD, see our ‘Living with COPD’ pages.

Learn more about Living with COPD

Healthcare team could include a GP, nurse, pharmacist, physiotherapist, dietitian, occupational therapist, counsellor and stop smoking advisor.

Healthcare team could include a GP, nurse, pharmacist, physiotherapist, dietitian, occupational therapist, counsellor and stop smoking advisor.

Abbreviations:

COPD, chronic obstructive pulmonary disease; GP, general practitioner.

References:

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