Dr. Philippa Kaye

Bladder control often improves in the first few months after birth as tissues heal. Regular pelvic floor exercises support recovery and reduce leakage. In the early weeks, try to protect your pelvic floor by tightening the muscles before coughing, sneezing or lifting, avoiding heavy loads, and choosing gentle exercise that does not cause a feeling of pelvic strain.

What can I do about weak pelvic floor muscles? 

Making Sense of Bladder Prolapse

This may result from:
- bladder outlet obstruction, 
- reduced bladder muscle strength, 
- disrupted nerve signals between the bladder and brain. Causes include neurological conditions such as multiple sclerosis or diabetes related nerve damage, severe pelvic organ prolapse, bladder stones or tumours, 
- certain medications that interfere with bladder emptying. 


What are the causes of overflow incontinence?

ADP - Incontinence after pregnancy

 Advice & Support - AS01 - Bladder Problems

Bladder Problems

Overflow incontinence occurs as a result of not being able to empty your bladder fully, leading to chronic urinary retention.  As the bladder becomes overly full, urine can leak out involuntarily and can happen even without a strong urge to go.

What exactly is overflow incontinence?

ADP -Making Sense of Bladder Prolapse

ADP - Bladder leakage in women: symptoms, causes and treatment | Always Discreet

Bladder leakage in women: symptoms, causes and treatment

OG-Incontinence-after-pregnancy

OG-A-Users-Guide-to-Overflow-Incontinence

Postpartum urinary incontinence can often be effectively managed independently — regularity, patience, and body awareness are key. It is worth introducing daily:

- __pelvic floor muscle exercises (Kegel exercises)__ – tightening and relaxing the muscles responsible for holding urine; do this several times a day;
- __strengthening deep abdominal muscles__ – supported by breathing exercises or postpartum physiotherapy;
- __maintaining proper posture__ – avoid slouching and excessive pressure on the pelvic floor;
- __avoiding lifting heavy objects__, which increase abdominal pressure and strain bladder-supporting muscles;
- __preventing constipation__ through adequate hydration, fibre intake, and regular bowel habits, as straining places additional pressure on bladder-supporting muscles;
- __maintaining a healthy body weight__
- __limiting caffeine, alcohol, and carbonated beverages__ that irritate the bladder.


How can I manage incontinence after pregnancy?

- __[stress incontinence](/en-gb/discreet/incontinence-advice/bladder-problems/what-is-stress-incontinence-symptoms-causes-and-treatment)__– caused by weakened pelvic floor muscles that fail to properly close the urethra; leakage occurs during coughing, sneezing, laughing, or physical exertion;
- [__urge incontinence__](/en-gb/discreet/incontinence-advice/bladder-problems/frequent-urination-in-women) – associated with overactive bladder, also called detrusor instability; characterised by sudden, uncontrollable urge to urinate, often also at night;
- __overflow incontinence__ – occurs when the bladder is too full due to obstruction or weakened bladder muscles; urine leaks involuntarily even though the bladder is not fully emptied.
- [__Mixed incontinence__](/en-gb/discreet/incontinence-advice/bladder-problems/what-is-mixed-incontinence) – this is when there is more than one type of incontinence occurring at the same time.


What are the types of incontinence?

Incontinence after pregnancy

After pregnancy, symptoms of urinary incontinence may include leaking urine when coughing, sneezing, laughing, lifting or exercising. Some women also experience urgency, needing to pass urine more often, waking at night to use the toilet, or occasional leakage during sleep.

incontinence after pregnancy

If you experience constant leakage, difficulty emptying your bladder, or recurrent infections, it is important to seek medical advice. Overflow incontinence can indicate underlying bladder or nerve problems and may lead to complications if untreated. Early assessment by a GP or specialist allows appropriate treatment and can significantly improve symptoms and quality of life!

Treatment depends on the underlying cause. Options may include intermittent or long term catheterisation to empty the bladder, medication to improve bladder emptying or address contributing conditions, and surgery where a physical blockage or severe prolapse is present.

A sensitive bladder protection product can be worn to help you manage leak protection and feel more confident. There is a variety of sensitive bladder products ranging from incontinence liners and pads to underwear, so you can tailor choice to your absorbency needs. They lock in bladder leaks and odours for peace of mind. Additionally, they can be thin and flexible so you can hardly feel you’re wearing anything.  But they should be used alongside medical assessment rather than as a substitute for diagnosis and treatment.

### This is generalised advice and isn't personalised nor to replace the advice of your doctor and other health care professionals.

How can I treat overflow incontinence?

ADP - Overflow incontinence: symptoms, causes and treatment options

Healthcare professionals usually describe bladder prolapse (cystocele) as mild, moderate or severe, a way of understanding the stages is based on how far the bladder has descended into or beyond the vagina:

- Stage 1 (mild): The bladder has dropped slightly, but sits well inside the vagina.
- Stage 2 (moderate): The bladder has descended to the opening of the vagina.
- Stage 3 (severe): Part of the bladder bulges outside the vaginal opening.
- Stage 4 (very severe/complete prolapse): The bladder is completely outside the vagina.


How is bladder prolapse classified?

In order to understand prolapse you need to learn about the pelvic floor.
The pelvic floor is a group of muscles and connective tissues that act like a supportive hammock at the base of a woman’s pelvis. These muscles help hold the bladder, uterus and bowel in place, and they play a key role in bladder control, bowel function and sexual wellbeing. When the pelvic floor is strong, everything stays supported and works smoothly; when it weakens, for example due to childbirth, menopause, ageing or strain, you may notice issues like leaks, pressure or discomfort.

A prolapse happens when the pelvic floor muscles and supporting tissues become weakened and can no longer hold the pelvic organs, such as the bladder, uterus, or bowel, in their usual position. As a result, one or more of these organs can drop down and press into the vaginal wall, leading to symptoms.

Let’s explain some medical terms:

-	Uterine prolapse – this is when the uterus slips down into the vagina
-	Rectocele – where the rectum bulges into the vagina and leads to symptoms like the sensation of not fully opening your bowels, or difficulties passing stool.
-	Cystocele – bladder prolapse, where the bladder bulges into the vagina.

Symptoms of bladder prolapse

What is the pelvic floor and prolapse?

Dr. Philippa Kaye Image

Dr Philippa Kaye is a practising GP with specialist interests in women’s health, children’s health and sexual health, working across NHS and private practice. She trained at Downing College, Cambridge, and completed her clinical training at Guy’s, King’s and St Thomas’ medical schools. Dr Kaye is a bestselling health author, with books including The M Word, Doctors Get Cancer Too, Breasts: An Owner’s Guide and The Science of Menopause. She is a regular contributor to national television, radio and print media, where she is known for providing clear, evidence-based medical advice. Through her clinical work, writing and media appearances, Dr Kaye is committed to improving understanding of health and wellbeing, particularly for women everywhere, after all, information is power.

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9 top tips to help you through the menopause

Advice from our Experts

Overflow incontinence: symptoms, causes and treatment options

Articles reviewed

ADP - 7 Natural Remedies for an Overactive Bladder

7 Natural Remedies for an Overactive Bladder

Urinary incontinence is the involuntary leakage of urine, which may be mild or more significant. Although many people suffer in silence it extremely common affecting approximately half to a third of women, particularly during pregnancy, after childbirth and around menopause.  It occurs when the coordination between the bladder, urethra and pelvic floor muscles is disrupted.

What is urinary incontinence?

 Advice & Support - AS05 - Pregnancy & Postpartum

Pregnancy & Postpartum

ADP - Overactive Bladder Treatments

Overactive Bladder Treatments

__Do you sometimes put on a fresh pair of pants, only to find them soaked through within a matter of minutes? This can even happen at night, leaving you sleepless and uncomfortable. If so, you may have overflow incontinence. Overflow incontinence is a less common type of urinary incontinence that occurs when the bladder does not empty properly. It can lead to frequent or constant leakage and should always be assessed by a healthcare professional.__

Dr Philippa Kaye is a practising GP with specialist interests in women’s health, children’s health and sexual health

Philippa Kaye - Practicing GP-NHS

The symptoms of overflow incontinence include:
- constant or frequent leakage;
- difficulty starting urination;
- a weak or intermittent urine stream;
- feeling unable to fully empty the bladder;
- frequent urinary tract infections;
- in some cases bedwetting.

What are the symptoms of overflow incontinence?

ADP - Talking to a doctor about weak bladder

Talking to a doctor about weak bladder

In addition to all the excitement, so many new experiences and challenges come with a new baby!. One challenge many mums face but rarely talk about is incontinence after pregnancy. Taking time for self-care and focusing on strengthening your pelvic floor can make a real difference. Find out why incontinence after childbirth happens and how you can manage it so you can focus on what matters most to you.

During pregnancy and childbirth, the pelvic floor muscles, connective tissues and nerves are stretched to allow the baby to pass through the birth canal. This can weaken pelvic floor support and affect bladder control after birth. Pregnancy itself can also place strain on these muscles, meaning symptoms may occur even before delivery.

Factors that can increase the likelihood of postnatal urinary incontinence include delivering a larger baby, a prolonged or difficult vaginal birth, and assisted deliveries. Although caesarean birth may reduce the risk compared with vaginal delivery, carrying a baby during pregnancy can still weaken pelvic floor muscles, so incontinence can occur regardless of birth method.

What causes incontinence after pregnancy?

Dr. Philippa Kaye - Discreet

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Well the good news is that there are lots of measures that can help!

- __Pelvic floor exercises.__ 
Strengthening the pelvic floor is one of the most effective first-line treatments. These muscles support the bladder, uterus and bowel, and regular exercises can ease symptoms and prevent prolapse from worsening. A pelvic health physiotherapist can teach you how to do the exercises correctly. Most people need to practise daily for at least 3 months to see improvement. Pelvic floor exercise programmes are available online, including apps like the Squeezey app and many women find it helpful to build them into everyday activities like sitting at a desk or waiting for the kettle to boil.

- __Lifestyle changes__ 
Certain habits can reduce pressure on the pelvic floor. You may be advised to:

- avoid heavy lifting where possible
- treat constipation with diet changes (such as more fibre and fluids) or laxatives if recommended
- maintain a healthy weight
- manage a chronic cough (for example, due to smoking, asthma or reflux)

These steps help prevent further strain on the pelvic floor and may improve symptoms.

- __Vaginal oestrogen__ 
For women after menopause, low-dose vaginal oestrogen can strengthen and improve the elasticity of the vaginal tissues, which may help reduce prolapse symptoms and make pessaries more comfortable to use. This type of oestrogen acts locally and is considered safe for most women, though it should be discussed with a doctor if you have a history of certain cancers or conditions.

- __Women’s health physiotherapy and biofeedback__ 
Specialist pelvic health physiotherapists can offer tailored pelvic floor rehabilitation, including techniques such as biofeedback, which uses sensors or visual cues to help you learn how to correctly contract and relax the pelvic floor muscles. Biofeedback can be helpful for some women with bladder prolapse, particularly in mild to moderate cases, as it supports more effective strengthening and improves awareness of pelvic floor function. Your GP can refer you to a physiotherapist with pelvic health training if this treatment is appropriate for you.

- __Pessary__ 
A pessary is a silicone device placed inside the vagina to support the bladder and vaginal walls. It can be a very effective option for many women, including those wishing to avoid surgery. A healthcare professional will fit the right type and size for you. Some pessaries can be removed and cleaned at home; others require regular checks and cleaning in clinic. They are generally safe but can occasionally cause discharge, irritation or slipping out, so follow-up appointments are important.

- __Surgery__ 
Surgery is considered when symptoms are significant or when other treatments haven’t helped. The most common operation for bladder prolapse is an anterior vaginal wall repair (anterior colporrhaphy), which tightens the tissues supporting the bladder.
Vaginal mesh is no longer routinely used for prolapse surgery in the UK.
Surgery can be done under general, spinal or local anaesthetic. Recovery times vary, and you will be advised to avoid heavy lifting and constipation afterwards.

- __Managing leaks while seeking treatment__ 
Some women experience urinary leaks as part of their symptoms. Absorbent pads or liners can help you stay comfortable while treatment is ongoing. Choose unscented products designed for bladder leakage rather than menstrual pads, as they absorb differently.

Bladder leaks are common, but that doesn’t mean that they are normal or that you need to put up with symptoms. If you think you may have bladder prolapse, it’s important to see your GP or a pelvic health specialist. They can confirm the diagnosis, explain your options, and help you choose the treatment that best suits your symptoms, health and lifestyle.

While you’re going through these treatments, it can be helpful to wear protection against little urine leaks resulting from your condition, so you can feel as comfortable as possible. Incontinence products come in a variety of different sizes and absorbencies to match urinary needs.

*If you are going through menopause or experiencing bladder leaks, always make sure to consult your doctor or a health specialist for these medical conditions.

### This is generalised advice and isn't personalised nor to replace the advice of your doctor and other health care professionals.

I have bladder prolapse, now what?

- Difficulty urinating
- Feeling like you still have to ‘go’ even immediately after urination
- A dragging sensation in the vagina, or the sensation that there is extra tissue or a lump in the vagina
- Tissue protruding from the vagina
- Heaviness or pressure in the vaginal area
- Frequent urinary tract infections
- Stress [incontinence](/en-gb/discreet/incontinence-advice/bladder-problems/what-is-stress-incontinence-symptoms-causes-and-treatment): leaking urine when sneezing, coughing, exercising or lifting heavy objects
- Painful intercourse

Symptoms of bladder prolapse

Meta Description	You may feel extra tissue in your vagina that feels a little bit like a ball - this may be a sign that you have a prolapsed bladder. Find out what you can do about it!

The pelvic floor muscles work together with the front wall of the vagina to support the bladder, a hollow organ that fills up with urine, signalling when it’s time to go. When the pelvic floor muscles surrounding the bladder weaken or loosen, the bladder is no longer supported, causing it to slouch against the vagina and creating an obstruction or bulge in the vaginal cavity.
One of the risk factors for developing bladder prolapse is menopause as the lower levels of oestrogen associated can lead to weakness in the pelvic floor and vagina. If they deteriorate enough, the bladder is no longer supported and can fall into the vagina.

Other risk factors for bladder prolapse are:

- Pregnancy and in particular vaginal delivery

- Surgery, such as a hysterectomy

- Excessive strain on the pelvic floor for example from long-term constipation, lifting heavy objects, a chronic cough or weight gain

In women, the pelvic floor muscles and the connective tissues of the vagina help support the bladder and keep it in its usual position. If these muscles or tissues become weakened or stretched, the bladder can drop down (prolapse) and press into the front wall of the vagina. This can lead to a feeling of pressure, bulging, or changes in bladder control.

Menopause is one risk factor. After menopause, lower oestrogen levels can reduce the strength and elasticity of the vaginal tissues, making prolapse more likely. However, prolapse can happen at any age and usually results from a combination of factors that weaken the pelvic floor over time.

Known risk factors include:

- Pregnancy and vaginal birth – especially if labour was long, the baby was large, or instruments (forceps/ventouse) were used
- Pelvic surgery, including hysterectomy
- Long-term strain on the pelvic floor, such as ongoing constipation, frequent heavy lifting, or a chronic cough
- Being overweight, which increases pressure on the pelvic floor
- Ageing, which naturally reduces muscle strength over time

Why does bladder prolapse happen?

Overflow incontinence can have a significant impact on your emotional wellbeing and quality of life. Worry about leakage or odour may lead some women to withdraw socially and feel really distressed. Please talk to your doctor as support and effective treatment can really help, improve confidence and daily functioning.

Overflow incontinence is mainly caused by chronic urinary retention, which means that the bladder can’t be fully emptied.

Find out why incontinence happens in and after pregnancy and how you can manage it for maximum comfort and confidence.

# Dr. Philippa Kaye
Practising GP, NHS Trained at Downing College, Cambridge & Guy's, King's & St Thomas' Medical School

If you are experiencing bladder leaks, speak to your GP or midwife. Assessment usually starts with a discussion of symptoms, urine testing and sometimes a bladder diary. Treatment may include specialist pelvic floor physiotherapy, lifestyle adjustments, and in some cases medication or referral to a specialist. Surgery is only considered when conservative treatments have not been effective.

If you need protection to help you manage leaks, try wearing products designed for bladder leaks They lock in bladder leaks and odours within seconds, to help you stay comfortable and confident as your body recovers and you seek professional advice. They can also be thin and discreet on your clothes so you barely feel you’re wearing them. They come in different sizes and absorbencies to meet a wide range of protection needs.

### This is generalised advice and isn't personalised nor to replace the advice of your doctor and other health care professionals.

How can I treat incontinence after pregnancy?

We’re diving into bladder prolapse, because sometimes your bladder decides to “drop in” a little too literally. Don’t worry, we’ll make sense of it together.

ADP - How to do pelvic floor exercises

How to do pelvic floor exercises

Overflow incontinence occurs as a result of not being able to empty your bladder fully.  Click to learn what it is, what its causes are and how to treat it.

Dr. Philippa Kaye BIO

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