Quick answer. Urinary incontinence — leaking urine you can’t control — is common in women in Singapore but is NOT just an inevitable part of ageing, and it is very treatable. The two main types are stress incontinence (leaking when you cough, sneeze, laugh or exercise, often from childbirth or menopause weakening the pelvic floor) and urge incontinence (a sudden urgent need followed by leakage). Many women have both. First-line treatment is pelvic floor (Kegel) exercises and bladder training, which help a large proportion of women. If needed, a pessary, medications, or surgery such as a sling procedure can help. See a doctor — effective help is available.
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More than 4 in 10 women in some Singapore studies report some degree of urinary leakage, yet many never seek help because they think it is a normal consequence of childbirth or getting older. It is neither inevitable nor untreatable.
This guide explains the difference between stress and urge incontinence, why it happens, and the full range of treatments — from pelvic floor exercises you can start today, to pessaries, medications and sling surgery. The message throughout: this is common but treatable, so please don’t suffer in silence.
At a glance
| Feature | Stress incontinence | Urge incontinence |
|---|---|---|
| What triggers leakage | Coughing, sneezing, laughing, lifting, exercise | A sudden, strong urge to urinate |
| Underlying problem | Weak pelvic floor / urethral support | Overactive bladder muscle |
| Common causes | Childbirth, menopause, ageing, obesity, chronic cough | Often idiopathic; infection, neurological causes |
| First-line treatment | Pelvic floor (Kegel) exercises, weight management | Bladder training, reduce caffeine, pelvic floor exercises |
| Other options | Pessary, sling surgery (TVT/TOT) | Medications, bladder Botox, nerve stimulation |
Common but treatable — not just part of ageing
Urinary incontinence affects a large share of women, and the chance rises after childbirth and around menopause. But common does not mean normal or untreatable. Pelvic floor exercises alone improve quality of life in roughly 40–50% of women with stress incontinence, and many more benefit from the wider range of treatments available. The first step is simply talking to a doctor.
Stress vs urge incontinence
Stress incontinence is leakage when pressure in the abdomen rises — coughing, sneezing, laughing, lifting or exercising — because the pelvic floor and urethral support are weakened.
Urge incontinence is a sudden, hard-to-defer urge to urinate, followed by leakage before you reach the toilet, caused by an overactive bladder muscle. Mixed incontinence (both types together) is common in women and may need a combined approach.
Why it happens
Common contributors in women include:
- Childbirth — pregnancy and vaginal delivery can stretch and weaken the pelvic floor muscles and nerves.
- Menopause — falling oestrogen thins and weakens the tissues supporting the bladder and urethra.
- Ageing and pelvic floor weakness, and pelvic organ prolapse.
- Raised abdominal pressure from obesity, chronic cough or constipation.
Pelvic floor (Kegel) exercises and bladder training
Pelvic floor muscle training is first-line for stress (and helps urge) incontinence:
- Identify the right muscles (those you’d use to stop the flow of urine), then squeeze and lift, holding briefly, and relax — repeating in sets through the day.
- Correct technique matters; a women’s health physiotherapist or continence nurse can guide you, sometimes with biofeedback.
- Improvement often takes several weeks to a few months of regular practice.
- Bladder training (scheduled voiding with gradually longer intervals) helps urge incontinence, alongside cutting caffeine and managing weight.
Pessaries and medications
If exercises aren’t enough, further options include:
- Vaginal pessary: a removable support device that repositions the urethra to reduce stress leakage — a non-surgical option, useful for women who wish to avoid or delay surgery.
- Medications: for urge incontinence, anticholinergics (e.g. solifenacin, tolterodine) or mirabegron calm the bladder. For postmenopausal women, topical vaginal oestrogen may improve tissue support and symptoms.
Surgery (slings) and when to see a doctor
For stress incontinence that doesn’t respond to conservative measures, sling procedures are the most common surgery. A tape (e.g. tension-free vaginal tape, TVT, or transobturator tape, TOT) supports the urethra. At KKH the mid-urethral sling has been used since 1998 with high reported success, typically requiring only a short hospital stay. For refractory urge incontinence, bladder Botox or nerve stimulation may be offered.
These are usually performed as day surgery or short-stay procedures, and MediSave and MediShield Life can generally be applied to approved surgery, subject to limits — check with the hospital. See a doctor if leakage affects your daily life, or if you have blood in the urine, pain, recurrent infections or a noticeable vaginal bulge.
How to prepare for your appointment
Bringing a few simple records helps your doctor pinpoint the type of incontinence and the best treatment. A bladder diary kept over three days, noting when and how much you drink, how often you pass urine, any urgency, and when leaks happen, is especially useful. Also note what tends to trigger leakage, such as coughing, exercise or a sudden urge, and whether you feel a vaginal bulge or pressure. List your medications, past pregnancies and deliveries, and any previous pelvic surgery.
- Mention how leakage affects daily life, work, exercise and intimacy, as this guides how actively to treat it.
- Note your caffeine and fluid intake, since both can influence symptoms.
- Tell your doctor about any blood in the urine, pain or recurrent infections, which need separate assessment.
Special situations
Around pregnancy and after childbirth, leakage is common and often improves with pelvic floor exercises, which can usually be started gently once your doctor or physiotherapist advises. After menopause, falling oestrogen can worsen symptoms, and a doctor can discuss whether topical vaginal oestrogen may help. Older women with limited mobility may benefit from practical measures such as easier-to-manage clothing and accessible toileting, alongside treatment of the underlying cause.
Common questions
Are pelvic floor exercises worth the effort?
Yes. Done correctly and consistently over several weeks to months, they improve symptoms for a large proportion of women with stress incontinence and can help urge symptoms too. A women’s health physiotherapist can check your technique.
Is surgery the only fix for stress incontinence?
No. Many women improve with pelvic floor training, weight management and, where suitable, a pessary. Surgery such as a sling is usually considered only when conservative measures have not worked.
Related guides
- Best Urology Clinics in Singapore — our editorial shortlist
- urology clinics directory
- UTI (urinary tract infection)
- Overactive bladder & urge incontinence
- Blood in urine (haematuria)
Sources
- SingHealth – Urinary Incontinence Surgery
- SingHealth – Overactive Bladder: Conditions & Treatments
- HealthHub – Mirabegron
- SingHealth – Assessing and Managing Idiopathic Overactive Bladder: A Guide for Primary Healthcare Physicians
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