Do you recognize the 7 signs of impending urinary incontinence?

Carlos Gabriel, M.D.


1. Nocturia: waking up to go to the bathroom at night.

This is one of the first signs of an overactive bladder. In fact, it is so integral to the diagnosis that many say without nocturia, you do not have overactive bladder. Once you start waking up in the middle of the night, you know that soon it is going to affect you during the day.

The reason this occurs is that at night, the fluid that accumulates around legs, flows back into the blood supply. This increase fluid goes to the kidneys turns into urine. Normally, one can handle this amount during night, but with an overactive bladder, the nerves start signaling that your bladder is fuller than it used to be able to hold.

2. Incomplete bladder emptying: Need to empty your bladder twice.

After emptying your bladder, and washing up, you feel that you need to go again. This means that your bladder wall muscles are not as strong as they use to be. Your bladder is only emptying most, and not all, of your urine. Over time, your bladder gets weaker and you notice that your second trip results in more urine coming out. You may even get to the point of sitting on the toilet until the second urge comes.

3. Keyhole Incontinence: the strong sudden urge to empty your bladder when you get to the front door and place the key in the lock.

This is a result of you training yourself to empty your bladder as soon as you get home. Over time, just the sound of the keys or the door unlocking can trigger your brain to relax. This relaxation results in your bladder getting ready to go, and you may wind up going before getting into the restroom.

4. Wearing a pad “just in case”. Face it, this means that you already have incontinence, but a very mild version of it. Some call it “light bladder leakage”. This is a sign that certain movements are resulting in small drops leaking out. This usually results from weak pelvic floor muscles, and without help there is no reason the muscles won’t continue to get even weaker.

5. Childhood bed wetting: this is defined as continued bedtime accidents past the age of 6.

Sadly, you are 8 years old, and finally get control of your bladder. Life is good for a while, until in your late teens, you notice that during gym class, you have some small drops of leaking. Over time, it gets worse. Why is this happening?!?

Unfortunately, we don’t really know. But we do know that many women who had bedtime wetting, develop urinary incontinence in their late teens. It might be that bedtime wetting was a form of urge incontinence that is now recurring. Seek treatment sooner than later.

6. Coital incontinence: leaking small drops of urine with intercourse.

It only happens occasionally. It only happens in small amounts. But it is embarrassing. And it is a sign that stress incontinence may be coming down the road. Some women respond by laying down towels, but others by decreasing their intimacy.

7. Emptying your bladder before starting a workout at the gym. You used to be able to just walk into the gym and jump on the treadmill. But lately, you have started to jump into the stall first. You haven’t had an accident, but you feel safer this way. This is an early sign of stress incontinence, and over time will occur with sneezing, coughing, and laughing.

What to do about the early warning signs of urinary incontinence?

Most women wait 8 years before talking to their physician about their urinary incontinence. But many more, had the warning signs before it even became noticeable that it was a problem. If you have any of the warning signs, speak with your physician to start an exercise program right away. Treatment is most effective when the symptoms are mild, but harder to detect because they are not a real bother.


Carlos Gabriel, M.D.  Medical Director of The Better Bladder Center, is revolutionizing Incontinence Care by treating these conditions without the use of medications or surgical procedures.

The Better Bladder Center has 2 locations in Polk County and is accepting New Patients.