{"id":2949,"date":"2021-04-23T08:00:00","date_gmt":"2021-04-23T01:00:00","guid":{"rendered":"https:\/\/drsoaraweeurology.com\/?p=2949"},"modified":"2026-08-30T06:21:42","modified_gmt":"2026-08-29T23:21:42","slug":"dranginkontinenz-urinabgang","status":"publish","type":"post","link":"https:\/\/drsoaraweeurology.com\/de\/2021\/04\/23\/urge-incontinence-urine-leaking\/","title":{"rendered":"Urge Incontinence: Leckage, bevor Sie die Toilette erreichen"},"content":{"rendered":"\n<div class=\"wp-block-columns coblocks-author-columns has-background is-layout-flex wp-container-core-columns-is-layout-52275889 wp-block-columns-is-layout-flex\" style=\"background-color:#8C8C971A;padding-top:2.5rem;padding-right:2.5rem;padding-bottom:2.5rem;padding-left:2.5rem\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:25%\">\n<figure class=\"wp-block-image size-full is-style-rounded\"><img data-recalc-dims=\"1\" fetchpriority=\"high\" decoding=\"async\" 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aria-label=\"View Google Scholar Profile\"\n     style=\"text-decoration: none; color: #4285F4; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M5.242 13.769L0.5 9.5 12 1l11.5 8.5-4.742 4.269C17.548 11.249 14.978 9.5 12 9.5c-2.977 0-5.548 1.748-6.758 4.269zM12 10a7 7 0 1 0 0 14 7 7 0 0 0 0-14z\"\/>\n    <\/svg>\n  <\/a>\n  \n<\/div>\n\n\n\n<p class=\"has-drop-cap wp-block-paragraph\">Urge incontinence is a sudden, overwhelming need to pass urine that is almost impossible to hold, with leakage happening before you reach the toilet. It becomes more common with age and with obesity. Unlike stress incontinence, which is overwhelmingly a female condition, <strong>urge incontinence affects men and women in similar numbers<\/strong> \u2014 and in older men it is the commonest form of incontinence there is.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The first thing worth saying to anyone living with this: <strong>it is not carelessness and it is not a matter of willpower.<\/strong> The bladder is contracting on its own, without permission and without warning. No amount of trying harder overrides a muscle that has already started to squeeze \u2014 which is why treatment works and self-blame does not.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Urology center Bangkok hospital Thailand\u00a0<a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" target=\"_blank\" rel=\"noreferrer noopener\">Booking online<\/a>\u00a0<a href=\"tel:02-310-3009\">02-310-3009<\/a>\u00a0<a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a><\/li>\n\n\n\n<li>Samitivej Sriracha hospital Chonburi&nbsp;<a href=\"tel:088-022-1445\">088-022-1445<\/a><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Who actually gets it, and why the usual summary is misleading<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Urinary incontinence as a whole is a predominantly female problem: population studies put it at roughly <strong>49% of women against 22.6% of men<\/strong>, so about two to three times more common in women. That headline figure is true, and it is also the reason a great many men never mention their symptoms to anyone.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Break it down by type and the picture changes completely:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Stress incontinence is overwhelmingly female<\/strong> \u2014 around 26% of women against 3% of men. This is the type that drives the whole female predominance.<\/li>\n\n\n\n<li><strong>Urge incontinence is close to equal between the sexes.<\/strong> In one large population study it was 5.3% of women and 5.0% of men. Among men over 60 it is the predominant form.<\/li>\n\n\n\n<li><strong>Mixed incontinence<\/strong> \u2014 both mechanisms together \u2014 is more common in women.<\/li>\n\n\n\n<li>In men, two further patterns sit outside the usual questionnaires: <strong>post-void dribbling<\/strong>, and <strong>stress incontinence after prostate surgery<\/strong>, which is a distinct problem with its own treatments.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">So the accurate statement is not that incontinence is a women\u2019s condition, nor that this particular type is a men\u2019s condition. It is that <strong>the female predominance in incontinence overall comes almost entirely from the stress type \u2014 and urge incontinence, the subject of this article, arrives at a man\u2019s door about as often as a woman\u2019s.<\/strong> Prevalence rises with age in both.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em>Note, August 2026: an earlier version of this article stated that urinary incontinence is predominantly a male problem. That was wrong, and the figures above replace it.<\/em><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">The 3 major causes of <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK563172\/\">urge incontinence<\/a><\/h2>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Detrusor overactivity<\/strong> \u2014 the bladder muscle contracts involuntarily and without warning, instead of waiting until you decide to go. This produces the sudden powerful urge and the leak that follows it, and it is the commonest mechanism.<\/li>\n\n\n\n<li><strong>Poor bladder compliance<\/strong> \u2014 a healthy bladder stretches like a resilient balloon as it fills. When it loses that give, pressure rises early, and urine is pushed out through the urethra before the bladder is anywhere near full.<\/li>\n\n\n\n<li><strong>Bladder hypersensitivity (sensory urgency)<\/strong> \u2014 the nerve endings in the bladder lining over-report. Caffeine, cold and ordinary filling all generate an exaggerated urge signal, and the bladder feels desperate at a volume it should handle comfortably.<\/li>\n<\/ol>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"2955\" data-permalink=\"https:\/\/drsoaraweeurology.com\/de\/2021\/04\/23\/urge-incontinence-urine-leaking\/isolated-image-of-unhappy-senior-man-with-thick-beard-standing-next-to-his-beautiful-wife-looking-at-camera-with-sad-facial-expressions-feeling-upset-frustrated-after-fight-people-and-relationships\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Aging.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;caption&quot;:&quot;Isolated image of unhappy senior man with thick beard standing next to his beautiful wife looking at camera with sad facial expressions, feeling upset frustrated after fight. People and relationships&quot;,&quot;title&quot;:&quot;Isolated image of unhappy senior man with thick beard standing next to his beautiful wife looking at camera with sad facial expressions, feeling upset frustrated after fight. People and relationships&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Aging is one factor involved with UI.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Aging is one factor involved with UI.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Aging.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Aging.jpg?resize=800%2C533&#038;ssl=1\" alt=\"An older adult affected by urge incontinence, which becomes more common with age\" class=\"wp-image-2955\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Aging.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Aging.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Aging.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Aging.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Aging.jpg?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Urge incontinence becomes more common with age, in both men and women.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">When urgency is not simply urgency<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Most urgency is exactly what it appears to be. A few things travelling with it change the priority, and are worth acting on rather than adding to a diary:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Blood in the urine<\/strong>, with or without pain \u2014 this needs investigation on its own terms and should not be attributed to an overactive bladder.<\/li>\n\n\n\n<li><strong>Fever, shivering, or pain in the flank or lower back<\/strong> alongside urinary symptoms \u2014 same-day assessment, not a clinic appointment. In Thailand the emergency number is 1669.<\/li>\n\n\n\n<li><strong>New numbness around the genitals or inner thighs, weakness in the legs, or loss of bowel control<\/strong> with new urinary symptoms \u2014 an emergency department the same day.<\/li>\n\n\n\n<li><strong>Sudden inability to pass urine at all, with a painful lower abdomen<\/strong> \u2014 acute retention, which needs treatment that day.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">How it is assessed<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Assessment covers a full history, physical examination, a <strong>voiding diary<\/strong> and any imaging needed to exclude other causes. The diary does more work than patients expect \u2014 it turns a vague impression into a record of when the urgency strikes, how much you passed and what you had been drinking, which is often where the pattern becomes obvious.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Where symptoms are mixed, or have not responded as expected, a <strong>urodynamic study<\/strong> measures what the bladder is actually doing as it fills \u2014 confirming involuntary contractions, and separating urge incontinence from <a href=\"https:\/\/drsoaraweeurology.com\/2021\/04\/16\/stress-incontinence-urinary\/\">stress incontinence<\/a> and from a bladder that is failing to empty. <strong>Dr. Soarawee performs urodynamic studies at Bangkok Hospital Headquarters.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In men, one extra step matters before treatment starts. An enlarged prostate can produce urgency by obstructing the outlet, and a bladder that is not emptying properly can cause exactly the same symptoms as an overactive one \u2014 with the important difference that the standard overactive-bladder medications can make it worse. Measuring how well the bladder empties is therefore part of the assessment, not an optional extra.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Treatment: the AUA\u2019s three levels<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">1. Behavioural therapy \u2014 first line<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Bladder training<\/strong> \u2014 gradually stretching the interval between visits to the toilet, so the bladder relearns to hold more.<\/li>\n\n\n\n<li><strong>Cutting bladder irritants<\/strong> \u2014 caffeine above all, plus alcohol, carbonated drinks and smoking. Caffeine is worth trying first because the effect is often noticeable within days rather than weeks.<\/li>\n\n\n\n<li><strong>Weight loss<\/strong> where relevant, since obesity is one of the two established risk factors.<\/li>\n\n\n\n<li><strong>Pelvic floor training (Kegel exercises)<\/strong> \u2014 a strong pelvic floor helps suppress an urge long enough to reach the toilet. These work for men too, and are the mainstay after prostate surgery.<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"2957\" data-permalink=\"https:\/\/drsoaraweeurology.com\/de\/2021\/04\/23\/urge-incontinence-urine-leaking\/cup-of-coffee-with-foam-smile-face-on-desk-isolated\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Caffeine.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;2&quot;,&quot;camera&quot;:&quot;Canon EOS 5D Mark IV&quot;,&quot;caption&quot;:&quot;Cup of coffee with foam, smile face, on desk isolated&quot;,&quot;created_timestamp&quot;:&quot;1573139150&quot;,&quot;focal_length&quot;:&quot;35&quot;,&quot;iso&quot;:&quot;2000&quot;,&quot;shutter_speed&quot;:&quot;0.00625&quot;,&quot;title&quot;:&quot;Cup of coffee with foam, smile face, on desk isolated&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Avoid caffeine can possibly improve UI.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Avoid caffeine can possibly improve UI.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Caffeine.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Caffeine.jpg?resize=800%2C533&#038;ssl=1\" alt=\"Coffee, the single most significant bladder irritant in urge incontinence\" class=\"wp-image-2957\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Caffeine.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Caffeine.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Caffeine.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Caffeine.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Caffeine.jpg?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Cutting caffeine is among the most effective single changes a patient can make.<\/figcaption><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">2. Medication \u2014 second line<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Antimuscarinic agents<\/strong> \u2014 block the involuntary bladder contractions. Dry mouth and constipation are the usual side effects, and constipation is worth watching since it aggravates bladder symptoms in its own right. They are used with more caution in older patients, and are avoided where the bladder is already emptying poorly.<\/li>\n\n\n\n<li><strong>Beta-3 agonists<\/strong> \u2014 relax the bladder muscle to improve storage, generally with fewer anticholinergic side effects. Blood pressure is monitored during treatment.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">A partial response to the first drug is not the end of the line \u2014 the dose can be adjusted or a different agent tried, and many patients settle on the second or third attempt.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">3. Bladder botulinum toxin (Botox) \u2014 third line<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Where behaviour and medication have not been enough, botulinum toxin is injected into the bladder wall through a cystoscope, temporarily quietening the overactive muscle. It works well in the right patients, and the effect lasts roughly <strong>6 months<\/strong>, so maintenance injections are needed to sustain it. The trade-off to understand before agreeing to it is that the bladder can be quietened too far, leaving some patients temporarily unable to empty and needing to pass a catheter themselves until the effect wears off.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Bladder botulinum toxin injection is not performed at Bangkok Hospital Headquarters<\/strong> \u2014 if your case reaches that point, a referral to a centre that offers it can be arranged. Everything before it, including the urodynamic study and both earlier treatment levels, is available here, and the great majority of patients are managed successfully without ever needing the third line.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"536\" data-attachment-id=\"2956\" data-permalink=\"https:\/\/drsoaraweeurology.com\/de\/2021\/04\/23\/urge-incontinence-urine-leaking\/glass-medicine-vial-jar-botox-with-medical-syringe-pattern-on-white-background-with-blue-liquid-the-concept-of-medicine-hyaluronic-acid-beautician-drugs-virus-flu-pain-reliever-copy-space\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Botox.jpg?fit=1200%2C804&amp;ssl=1\" data-orig-size=\"1200,804\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;4.5&quot;,&quot;camera&quot;:&quot;Canon EOS 77D&quot;,&quot;caption&quot;:&quot;Glass Medicine Vial jar botox with medical Syringe pattern on white background with blue liquid. The concept of medicine, hyaluronic acid, beautician, drugs, virus, flu, pain reliever. Copy space&quot;,&quot;created_timestamp&quot;:&quot;1576796012&quot;,&quot;focal_length&quot;:&quot;50&quot;,&quot;iso&quot;:&quot;100&quot;,&quot;shutter_speed&quot;:&quot;0.0125&quot;,&quot;title&quot;:&quot;Glass Medicine Vial jar botox with medical Syringe pattern on white background with blue liquid. The concept of medicine, hyaluronic acid, beautician, drugs, virus, flu, pain reliever. Copy space.&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Endoscopic botox injection has a role in UI treatment.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Endoscopic botox injection has a role in UI treatment.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Botox.jpg?fit=800%2C536&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Botox.jpg?resize=800%2C536&#038;ssl=1\" alt=\"Bladder botulinum toxin injection, the third-line treatment for refractory urge incontinence\" class=\"wp-image-2956\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Botox.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Botox.jpg?resize=300%2C201&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Botox.jpg?resize=1024%2C686&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Botox.jpg?resize=768%2C515&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Botox.jpg?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Bladder Botox via cystoscopy is the third-line option for urge incontinence that has not responded.<\/figcaption><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Outcomes vary a great deal between patients, so the goal is worth agreeing at the start. Some are aiming for complete dryness; for others, being able to sit through a meal or a meeting without anxiety is the win that matters. Both are legitimate targets, and naming yours makes the treatment plan a good deal easier to judge.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"673\" data-attachment-id=\"2959\" data-permalink=\"https:\/\/drsoaraweeurology.com\/de\/2021\/04\/23\/urge-incontinence-urine-leaking\/doctor-holding-a-card-with-urology-medical-concept\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Urology.jpg?fit=1200%2C1009&amp;ssl=1\" data-orig-size=\"1200,1009\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;8&quot;,&quot;camera&quot;:&quot;Canon EOS 1100D&quot;,&quot;caption&quot;:&quot;Doctor holding a card with Urology, Medical concept&quot;,&quot;created_timestamp&quot;:&quot;1467458392&quot;,&quot;focal_length&quot;:&quot;29&quot;,&quot;iso&quot;:&quot;400&quot;,&quot;shutter_speed&quot;:&quot;0.025&quot;,&quot;title&quot;:&quot;Doctor holding a card with Urology, Medical concept&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Urologist is a specialist who take care of UI.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Urologist is a specialist who take care of UI.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Urology.jpg?fit=800%2C673&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Urology.jpg?resize=800%2C673&#038;ssl=1\" alt=\"A urologist discussing individualised treatment goals for urge incontinence\" class=\"wp-image-2959\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Urology.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Urology.jpg?resize=300%2C252&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Urology.jpg?resize=1024%2C861&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Urology.jpg?resize=768%2C646&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Urology.jpg?resize=14%2C12&amp;ssl=1 14w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Agreeing a realistic goal together is what makes the treatment plan work.<\/figcaption><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">If you are experiencing urge incontinence and would like specialist evaluation, Dr. Soarawee Weerasopone offers specialist consultations at Bangkok Hospital Headquarters. <a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\">Book a Consultation<\/a>. Appointments at Samitivej Sriracha Hospital can be arranged by calling the Urology department on <a href=\"tel:0880221445\">088-022-1445<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bangkok Hospital Telemedicine is available for patients who cannot attend in person, including international patients \u2014 arrange it in advance by email to the Urology department at <a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a>. A video consultation suits reviewing a completed voiding diary and current medications and deciding what testing is worthwhile; examination and urodynamic study are done in person. Samitivej Sriracha is in-person only. For the cost of any consultation, test or procedure, please contact the Urology department at <a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a> rather than asking here.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Frequently Asked Questions About Urge Incontinence<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">What is the difference between urge incontinence and stress incontinence?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Urge incontinence is urine leakage triggered by a sudden, uncontrollable urge to void \u2014 the bladder contracts involuntarily before the patient can reach the toilet. Stress incontinence, by contrast, is leakage caused by physical exertion that increases abdominal pressure (coughing, sneezing, lifting, laughing), without an urge sensation. The two differ sharply in who gets them: stress incontinence is overwhelmingly female, at roughly 26% of women against 3% of men, while urge incontinence is close to equal between the sexes. Both can coexist as mixed incontinence, and a urodynamic study can establish which mechanism is dominant.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Is urinary incontinence more common in men or women?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Incontinence overall is about two to three times more common in women, with population studies reporting roughly 49% of women against 22.6% of men. That gap comes almost entirely from stress incontinence, which is overwhelmingly female. Urge incontinence, the type described in this article, is close to equal between the sexes \u2014 around 5.3% of women and 5.0% of men in one large population study \u2014 and among men over 60 it is the commonest form of incontinence. Prevalence rises with age in both sexes. Men also experience two patterns that general surveys tend to miss: post-void dribbling, and stress incontinence following prostate surgery.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">What lifestyle changes can improve urge incontinence?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Per AUA guidelines, first-line management is behavioural therapy. This includes bladder training (gradually increasing the time between bathroom visits), reducing or eliminating bladder irritants such as caffeine and alcohol, maintaining a healthy body weight, and pelvic floor muscle training (Kegel exercises, which work for men as well as women). These interventions can significantly reduce urge episodes and leakage frequency without medication. Keeping a voiding diary to track fluid intake, voiding times and leakage episodes helps both patient and urologist identify patterns and monitor progress.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">When is Botox injection recommended for urge incontinence?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Intravesical botulinum toxin (Botox) injection is recommended as a third-line treatment when behavioural therapy and oral medications have not provided adequate symptom control. The procedure is performed via cystoscopy, and Botox temporarily quietens the overactive bladder muscle, reducing involuntary contractions and urgency episodes. Effects typically last about 6 months, after which repeat injection is required to maintain benefit. The main trade-off is that the bladder can be quietened too far, so some patients temporarily cannot empty and need to pass a catheter themselves until the effect wears off. This procedure is not performed at Bangkok Hospital Headquarters; assessment, urodynamic study and the first two treatment levels are provided there, with referral arranged if third-line treatment is needed.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">When should urinary urgency be seen urgently rather than in clinic?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Go to an emergency department the same day, or call 1669 in Thailand, for fever or shivering with pain in the flank or lower back alongside urinary symptoms; new numbness around the genitals or inner thighs, leg weakness or loss of bowel control together with new urinary symptoms; or sudden inability to pass urine at all with a painful lower abdomen. Blood in the urine, with or without pain, needs investigation in its own right and should not be assumed to be an overactive bladder.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Disclaimer:<\/strong> This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters. It is intended for educational purposes only and does not constitute medical advice. Prevalence figures vary considerably with the definition of incontinence used and the population studied. No medical advice, diagnosis or prescription is provided through personal messaging channels or social media. Always consult a qualified healthcare professional before starting any medical treatment.<\/p>\n\n\n\n<script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\",\n  \"@graph\": [\n    {\n      \"@type\": \"MedicalWebPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/04\/23\/urge-incontinence-urine-leaking\/#webpage\",\n      \"url\": \"https:\/\/drsoaraweeurology.com\/2021\/04\/23\/urge-incontinence-urine-leaking\/\",\n      \"name\": \"Urge Incontinence: Leaking Before You Reach the Toilet\",\n      \"headline\": \"Urge Incontinence: Leaking Before You Reach the Toilet\",\n      \"description\": \"The three causes of urge incontinence, who actually gets it in men and in women, how a voiding diary and urodynamic study establish the diagnosis, and the AUA stepwise treatment from bladder training through medication to bladder Botox.\",\n      \"datePublished\": \"2021-04-23\",\n      \"dateModified\": \"2026-08-30\",\n      \"lastReviewed\": \"2026-08-30\",\n      \"inLanguage\": \"en\",\n      \"specialty\": \"https:\/\/schema.org\/Urologic\",\n      \"medicalAudience\": { \"@type\": \"MedicalAudience\", \"audienceType\": \"Patient\" },\n      \"isPartOf\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#website\" },\n      \"author\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"reviewedBy\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"publisher\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"about\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/04\/23\/urge-incontinence-urine-leaking\/#condition\" },\n      \"disambiguatingDescription\": \"Bladder botulinum toxin injection and sacral neuromodulation are not performed at Bangkok Hospital Headquarters; referral is arranged. 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Prevalence rises with age in both sexes. Estimates vary considerably with the definition used and the population studied.\",\n      \"riskFactor\": [\n        { \"@type\": \"MedicalRiskFactor\", \"name\": \"Increasing age\" },\n        { \"@type\": \"MedicalRiskFactor\", \"name\": \"Obesity\" }\n      ],\n      \"possibleTreatment\": [\n        { \"@type\": \"MedicalTherapy\", \"name\": \"Behavioural therapy: bladder training, reduction of caffeine and alcohol, weight loss, pelvic floor muscle training\" },\n        { \"@type\": \"MedicalTherapy\", \"name\": \"Antimuscarinic medication\", \"adverseOutcome\": { \"@type\": \"MedicalEntity\", \"name\": \"Dry mouth and constipation; used with caution in older patients and avoided where bladder emptying is already impaired\" } },\n        { \"@type\": \"MedicalTherapy\", \"name\": \"Beta-3 agonist medication\", \"adverseOutcome\": { \"@type\": \"MedicalEntity\", \"name\": \"Blood pressure elevation, monitored during treatment\" } },\n        { \"@type\": \"MedicalTherapy\", \"name\": \"Intravesical botulinum toxin injection (third line, not performed at Bangkok Hospital Headquarters; referral arranged)\", \"adverseOutcome\": { \"@type\": \"MedicalEntity\", \"name\": \"Temporary inability to empty the bladder, requiring self-catheterisation until the effect wears off\" } }\n      ],\n      \"typicalTest\": [\n        { \"@type\": \"MedicalTest\", \"name\": \"Voiding diary\" },\n        { \"@type\": \"MedicalTest\", \"name\": \"Urodynamic study\" },\n        { \"@type\": \"MedicalTest\", \"name\": \"Measurement of post-void residual urine\" }\n      ]\n    },\n    {\n      \"@type\": \"FAQPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/04\/23\/urge-incontinence-urine-leaking\/#faq\",\n      \"isPartOf\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/04\/23\/urge-incontinence-urine-leaking\/#webpage\" },\n      \"mainEntity\": [\n        {\n          \"@type\": \"Question\",\n          \"name\": \"What is the difference between urge incontinence and stress incontinence?\",\n          \"acceptedAnswer\": {\n            \"@type\": \"Answer\",\n            \"text\": \"Urge incontinence is an involuntary bladder contraction causing leakage before reaching the toilet. Stress incontinence is leakage from physical exertion such as coughing or sneezing that raises abdominal pressure, without an urge. They differ sharply in who gets them: stress incontinence is overwhelmingly female, roughly 26% of women against 3% of men, while urge incontinence is close to equal between the sexes. Both can coexist as mixed incontinence, and a urodynamic study establishes which mechanism dominates.\"\n          }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"Is urinary incontinence more common in men or women?\",\n          \"acceptedAnswer\": {\n            \"@type\": \"Answer\",\n            \"text\": \"Incontinence overall is about two to three times more common in women, with population studies reporting roughly 49% of women against 22.6% of men. That gap comes almost entirely from stress incontinence. Urge incontinence is close to equal between the sexes, around 5.3% of women and 5.0% of men, and among men over 60 it is the commonest form of incontinence. Prevalence rises with age in both sexes. Men also experience post-void dribbling and stress incontinence after prostate surgery, which general surveys tend to miss.\"\n          }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"What lifestyle changes can improve urge incontinence?\",\n          \"acceptedAnswer\": {\n            \"@type\": \"Answer\",\n            \"text\": \"AUA first-line management is behavioural: bladder training to extend the interval between voids, reducing caffeine and alcohol, maintaining a healthy weight, and pelvic floor exercises, which work for men as well as women. A voiding diary tracking fluid intake, voiding times and leakage episodes helps identify patterns and monitor progress.\"\n          }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"When is Botox injection recommended for urge incontinence?\",\n          \"acceptedAnswer\": {\n            \"@type\": \"Answer\",\n            \"text\": \"As third-line treatment, when behavioural therapy and oral medication have not controlled symptoms. Botulinum toxin is injected into the bladder wall via cystoscopy and temporarily quietens the overactive muscle, with effects lasting about 6 months before repeat injection. The main trade-off is that the bladder can be quietened too far, so some patients temporarily cannot empty and need to pass a catheter themselves until the effect wears off. It is not performed at Bangkok Hospital Headquarters; assessment, urodynamic study and the first two treatment levels are provided there, with referral arranged if third-line treatment is needed.\"\n          }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"When should urinary urgency be seen urgently rather than in clinic?\",\n          \"acceptedAnswer\": {\n            \"@type\": \"Answer\",\n            \"text\": \"Go to an emergency department the same day, or call 1669 in Thailand, for fever or shivering with pain in the flank or lower back alongside urinary symptoms; new numbness around the genitals or inner thighs, leg weakness or loss of bowel control together with new urinary symptoms; or sudden inability to pass urine at all with a painful lower abdomen. Blood in the urine, with or without pain, needs investigation in its own right and should not be assumed to be an overactive bladder.\"\n          }\n        }\n      ]\n    }\n  ]\n}\n<\/script>\n","protected":false},"excerpt":{"rendered":"<p>Nicht rechtzeitig zur Toilette zu gelangen ist keine Fahrl\u00e4ssigkeit \u2013 es handelt sich um eine unwillk\u00fcrliche Blasenkontraktion, die einer Behandlung unterliegt. Dr. Soarawee Weerasopone erkl\u00e4rt die drei Ursachen, wer sie bei M\u00e4nnern und Frauen tats\u00e4chlich bekommt, und die schrittweise Behandlung.<\/p>","protected":false},"author":185281453,"featured_media":10115,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"advanced_seo_description":"Urge incontinence: the three causes of leaking before reaching the toilet, how it differs from stress incontinence, and the AUA stepwise treatment from bladder training through medication to bladder Botox. 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