Functional gynecology · Bladder health
Urinary Incontinence in Women: Types, Tests and Treatment in Seoul
Urinary incontinence is the accidental leakage of urine, most often when you cough, laugh or exercise (stress incontinence) or after a sudden, strong urge to go (urge incontinence). At Hommage Clinic in Gangnam, Seoul, OB/GYN specialist Dr. Park Yuna identifies the type with simple tests, then starts with pelvic floor and bladder training before discussing procedures.
Quick answer
Urinary incontinence in women is common and treatable. At Hommage Women's Clinic in Gangnam, Seoul, female OB/GYN specialist Dr. Park Yuna first works out whether leakage is stress, urge or mixed, using a bladder diary, urine test, exam and ultrasound. Treatment starts with at least 3 months of pelvic floor training and bladder training; in trials, 56% of women with stress leakage were cured by training versus 6% without. Medication, a pessary or sling surgery follow if needed.
Key takeaways
- Stress leakage (with coughing or exercise) and urge leakage (with sudden urgency) have different causes and treatments.
- Conservative care comes first and helps many women enough that they never need a procedure.
- Bladder training for urgency may work at least as well as bladder medication in the short term, with no drug side effects.
- Mid-urethral sling surgery is highly effective for stress leakage but carries risks, including mesh exposure, that you should weigh carefully.
Infographic
Urinary incontinence in numbers
Adult women
Have some degree of urine leakage.
Cured by training
Stress leakage, pelvic floor training vs no treatment (Cochrane).
Training first
Supervised pelvic floor program before considering surgery.
Bladder training
For urgency, gradually lengthening time between toilet trips.
Bladder diary
Drinks, toilet trips and leaks recorded before your visit.
Sling surgery
Usual operating time; many women go home the same day.
Urinary incontinence at a glance
| Key fact | Details |
|---|---|
| What it is | Involuntary leakage of urine; common after childbirth and around menopause |
| Main types | Stress (with effort), urge (with sudden urgency) and mixed (both) |
| How it's diagnosed | History, bladder diary, urine test, pelvic exam, ultrasound; urodynamics before surgery |
| First-line treatment | Pelvic floor muscle training for at least 3 months, bladder training, lifestyle changes |
| Other options | Vaginal estrogen, bladder medication, pessary, mid-urethral sling surgery for stress leakage |
| Follow-up | Usually 6–12 weeks after starting treatment to review progress |
| Reviewed by | Dr. Park Yuna, OB/GYN specialist |
Book an assessment if you have
- Leakage when you cough, sneeze, laugh, jump or lift
- Sudden urges that make you rush to the toilet, or leaks before you get there
- Needing to pass urine more than about eight times a day, or waking at night to go
- A feeling of heaviness or a bulge in the vagina along with bladder symptoms
- Leakage that started after childbirth or around menopause and has not settled
Seek urgent care instead if you have
- Being unable to pass urine at all, especially with lower abdominal pain
- Fever, back or side pain and burning when you urinate, which can mean a kidney infection
- Sudden leakage with leg weakness, numbness in the saddle area or back pain
- Visible blood in your urine
What is urinary incontinence?
Urinary incontinence means leaking urine when you do not intend to. It is very common: an estimated one in four adult women has some degree of leakage, and it becomes more likely after pregnancy, vaginal birth and menopause. It is not an inevitable part of aging, and most women improve with treatment.
Continence depends on two things working together: a bladder that stays relaxed while it fills, and a urethra held closed by the pelvic floor muscles and supporting tissues. When either part changes, leakage can follow. This page explains the types, tests and treatment options; our pages on pelvic floor treatment and Kegel therapy go deeper into muscle training.
Stress vs urge vs mixed incontinence: what's the difference?
The type of incontinence decides the treatment, so it is the first thing to work out.
- Stress urinary incontinence (SUI): leakage when pressure on the bladder rises, such as coughing, sneezing, laughing, running or lifting. It happens when the pelvic floor and the tissues supporting the urethra are weakened, often by childbirth, chronic coughing, constipation, excess weight or lower estrogen after menopause.
- Urge incontinence (overactive bladder): a sudden, strong need to urinate that is hard to delay, sometimes with leakage on the way to the toilet, frequent daytime trips and waking at night. The bladder muscle contracts before it is full. Caffeine, alcohol, bladder irritation and nerve conditions can contribute.
- Mixed incontinence: both patterns together, which is common in women in midlife. Treatment usually starts with whichever symptom bothers you most.
Less often, leakage comes from a bladder that does not empty fully (overflow), which needs a different approach. A urinary tract infection can also cause temporary urgency and leakage, so it is ruled out first.
How is urinary incontinence diagnosed?
Most women need only a few simple tests. Dr. Park asks when you leak, how often and how much, and about pregnancies, bowel habits, medications and fluid intake.
- Bladder diary: a three-day record of drinks, toilet visits and leaks, which shows patterns you may not notice.
- Urine test: to rule out infection or blood in the urine.
- Pelvic exam: checks pelvic floor strength, signs of prolapse and thinning tissue after menopause. A cough test may show stress leakage directly.
- Ultrasound: measures whether the bladder empties fully and checks the uterus and ovaries with a pelvic ultrasound .
- Urodynamic study: pressure measurements of bladder filling and emptying. It is usually needed only before surgery or when symptoms are unclear. In Korea, insurance coverage for incontinence surgery may depend on these results.
Treatment options for urinary incontinence
International guidelines recommend starting with conservative treatment, which helps many women enough that they never need a procedure.
First-line care
- Pelvic floor muscle training (PFMT): the first treatment for stress and mixed incontinence. A supervised program of at least three months gives the clearest results, and checking that you are squeezing the right muscles makes a real difference.
- Bladder training: for urge incontinence, gradually lengthening the time between toilet visits over at least six weeks, with urge-suppression techniques.
- Lifestyle changes: reducing caffeine and alcohol, adjusting fluid timing, treating constipation and, if you are overweight, losing 5–10% of body weight.
Medical treatment
- Vaginal estrogen after menopause can ease urgency and frequency linked to thinning tissue. See menopause treatment .
- Bladder medication: anticholinergic drugs or beta-3 agonists (such as mirabegron) calm an overactive bladder.
- Vaginal pessary: a removable support device that can reduce stress leakage or prolapse symptoms.
Surgery for stress incontinence
The most common operation is the mid-urethral sling : a narrow strip of synthetic mesh tape placed under the middle of the urethra through a small vaginal incision, either behind the pubic bone (retropubic) or through the inner groin (transobturator). It supports the urethra when you cough or strain. The procedure usually takes under an hour, and many women go home the same day. Most studies report that around eight in ten women are cured or much improved. Alternatives include a sling made from your own tissue, colposuspension and urethral bulking injections.
Does laser treatment work for bladder leakage?
Evidence for laser treatment of stress incontinence is limited. Some small, short-term studies report modest improvement in mild leakage, but there are few high-quality trials, results tend to fade over months, and repeat sessions are usually needed. In 2018 the US FDA warned against marketing energy-based devices for urinary symptoms without proper evidence, and UK guidance recommends using vaginal laser for incontinence only within research or with special arrangements.
Vaginal laser therapy may be discussed for selected women with mild symptoms, particularly alongside dryness after menopause, but it is not a substitute for pelvic floor training and it is not a first-line incontinence treatment. Dr. Park will explain honestly what it can and cannot do for you.
Risks and possible side effects of treatment
Conservative treatments have few risks. Pelvic floor exercises can cause temporary muscle soreness, and doing them incorrectly (bearing down instead of lifting) can make symptoms worse, which is why a check is worthwhile. Bladder medication can cause dry mouth, constipation and blurred vision, and some anticholinergic drugs are avoided in older women because of possible effects on memory. Mirabegron can raise blood pressure. A pessary can cause discharge or irritation and needs regular checks.
Mid-urethral sling surgery carries risks of bleeding, infection, bladder injury during placement, difficulty emptying the bladder, new or worse urgency, groin or thigh pain, and exposure of the mesh tape through the vaginal wall, which may need further surgery. Because of mesh complications, some countries have added safeguards and registries for mesh procedures. Major urogynecology societies still support slings for stress incontinence, but you should weigh these risks before deciding.
Contact the clinic promptly if you cannot pass urine, have a fever, heavy bleeding, worsening pain or unusual discharge after any procedure.
Urinary incontinence care at Hommage Clinic
At Hommage Clinic, a short walk from Sinnonhyeon Station in Gangnam, bladder leakage is assessed by Dr. Park Yuna, a female OB/GYN specialist, with a pelvic exam and ultrasound in the same visit. She checks your pelvic floor contraction during the exam and starts a training plan before any procedure is discussed. If surgery is the right option, Dr. Park explains whether it can be done at the clinic or whether referral to a hospital urogynecology team suits you better. Related concerns can be planned together across our functional and cosmetic gynecology services.
For patients enrolled in Korea's National Health Insurance, many tests and medical treatments for incontinence are covered, depending on test results; cosmetic procedures are not. Visitors without coverage pay the clinic's fees directly. You receive a written estimate before any test or treatment.
Causes
Stress vs urge incontinence: what causes each type of leak
Staying dry relies on a balance between two forces. Pressure inside the bladder rises when the bladder muscle squeezes or when your tummy is pushed in by a cough, sneeze or jump. The closing pressure of the urethra , provided by the pelvic floor muscles, the urethral sphincter and the tissues that support them, holds urine in. Leakage happens whenever bladder pressure wins.
In stress incontinence , the closing side is too weak: a sudden jump in abdominal pressure overcomes a poorly supported urethra. In urge incontinence , the problem is on the bladder side: the bladder muscle contracts on its own before you are ready, creating a sudden urge. This is why pelvic floor training (which strengthens the closing side) is the first treatment for stress leakage, while bladder training and medication (which calm the bladder) are used for urgency. Mixed incontinence needs both.
Before your visit
How to keep a bladder diary
A bladder diary is the single most useful thing you can bring to an incontinence appointment. Over three days, ideally including a workday and a day off, you note what and how much you drink, each time you pass urine, each leak and what you were doing at the time. Patterns that are hard to remember, such as leaking only after coffee, or needing to go every hour in the afternoon, become obvious on paper.
The diary helps Dr. Park tell stress from urge leakage, spot whether you are drinking too little or too much, and set a starting point for bladder training. Repeating it after a few weeks of treatment shows progress you might not otherwise notice.
What to record for 3 days
- Drinks: time, type (water, coffee, tea, alcohol) and roughly how much
- Toilet trips: time of each visit, day and night
- Leaks: time, small or large, and what you were doing
- Urgency: whether you felt a sudden, strong need to go
- Pads: how many you used each day
- Optional: measure urine volume with a jug for one day
Hommage · Gangnam
Hommage Women's Clinic · Gangnam, Seoul
A simple notebook or phone note is enough for a bladder diary. Illustrative photo.
Overactive bladder
Bladder training for urge incontinence: a step-by-step schedule
Bladder training teaches an overactive bladder to hold more and to stop sending false alarms. You start from the interval your bladder diary shows, then gradually stretch the gap between toilet visits in small steps, using urge-suppression techniques to get through each urge. The program usually runs for at least six weeks, and the target interval is agreed with your doctor based on your diary.
A recent Cochrane review of 15 trials and about 2,000 adults (literature searched to November 2022) found low-certainty evidence that bladder training may cure or improve overactive bladder symptoms more often than anticholinergic medication in the early phase of treatment, without drug side effects. The evidence is not strong enough to say it always works, but it is safe, low-cost and can be combined with medication when needed.
Hommage · Gangnam
Hommage Women's Clinic · Gangnam, Seoul
Treatment moves up one step at a time, only when needed. Illustrative photo.
Step by step
The urinary incontinence treatment ladder
Incontinence treatment works like a ladder: you start on the lowest, safest step and move up only if you still have symptoms that bother you. Many women stop on the first or second step. Below is how the steps usually fit together for stress, urge and mixed leakage. For muscle training itself, see Kegel therapy and pelvic floor treatment .
Lifestyle
Steady fluids, less caffeine and alcohol, treat constipation and cough, weight loss if overweight.
Training
Pelvic floor training (3+ months) for stress leakage; bladder training (6+ weeks) for urgency.
Medical & devices
Vaginal estrogen after menopause, bladder medication for urgency, pessary for stress leakage.
Procedures
Sling surgery or alternatives for stress leakage; specialist options for urgency, usually via hospital referral.
Surgery
Retropubic vs transobturator sling: what the evidence shows
If stress leakage still bothers you after a full course of pelvic floor training, a mid-urethral sling is the most studied operation. The largest review, a 2017 Cochrane analysis of 81 trials and more than 12,000 women, found that both main routes are "highly effective" in the short and medium term. Within a year, between 62% and 98% of women reported being cured after a transobturator sling, and between 71% and 97% after a retropubic sling, depending on the study.
The routes differ mainly in side effects. The retropubic route passes behind the pubic bone and had a higher rate of bladder perforation during surgery; the transobturator route passes through the inner groin and had more groin pain. Rates of the tape becoming exposed in the vagina were similar, around 2 in 100 women with either route. Because mesh complications can be serious and sometimes need further surgery, Dr. Park discusses them in detail and refers to an experienced hospital urogynecology team when surgery is the right next step.
Behind the pubic bone
- Short-term cure 71–97% across trials
- Bladder perforation 4.5%
- Groin pain 1.3%
- Less long-term repeat surgery in limited data
Through the inner groin
- Short-term cure 62–98% across trials
- Bladder perforation 0.6%
- Groin pain 6.4%
- Less difficulty emptying the bladder
Source: Cochrane review, Ford et al., 2017. Tape exposure about 2 in 100 with either route.
✚ Hommage Women's Clinic · Gangnam, Seoul
Hommage · Gangnam
Hommage Women's Clinic · Gangnam, Seoul
Surgery is considered only after at least 3 months of conservative care. Illustrative photo.
Timeline
Urinary incontinence treatment timeline: what to expect
How long does it take to stop leaking? For most women the answer is measured in weeks to months, not days. Bladder training needs at least six weeks, and pelvic floor training at least three months, before you can judge whether it has worked. Reviews are built in so that nobody stays on a treatment that is not helping. The timeline below shows a typical path at Hommage Women's Clinic.
Evidence
Urinary incontinence treatment: what the research says
Treatments for bladder leakage have been studied in hundreds of randomised trials. The figures below come from Cochrane systematic reviews, which pool the best available trials. They show that conservative care works for many women, and that surgery for stress leakage is effective but not risk-free. They describe groups of women in research and cannot predict an individual result.
Stress leakage cured by training
Pelvic floor muscle training vs no treatment; high-quality evidence.
Cochrane review, Dumoulin et al., 2018Bladder training vs drugs
More cure or improvement early on with bladder training than anticholinergics; low certainty.
Cochrane review, CD013571 (searched 2022)Sling cure within 1 year
Range across trials (transobturator; retropubic 71–97%); 81 trials, 12,113 women.
Cochrane review, Ford et al., 2017Tape exposure
About 21–24 per 1,000 women, similar for both sling routes.
Cochrane review, Ford et al., 2017Daily life
Bladder-friendly habits: do's and don'ts
Small daily changes support every other treatment. Many women cut back on drinking to avoid leaks, but concentrated urine irritates the bladder and can make urgency worse. Caffeine, alcohol and fizzy drinks are common triggers for an overactive bladder. Constipation and a chronic cough both put repeated strain on the pelvic floor, so treating them helps stress leakage. If you are overweight, losing 5–10% of body weight can noticeably reduce leaks.
Leakage can also affect confidence, exercise and intimacy. Many women quietly stop running, dancing or travelling. Treatment aims to give these back, and Dr. Park will ask what matters most to you.
Helpful habits
- Drink steadily through the day
- Switch to decaf or herbal drinks
- Squeeze before you cough or lift
- Eat fibre to prevent straining
- Use proper incontinence pads, not period pads
Habits that backfire
- Cut fluids sharply to avoid leaks
- Go "just in case" every half hour
- Rush to the toilet when an urge hits
- Ignore burning, blood or fever
- Assume leaking is just part of aging
Hommage · Gangnam
Hommage Women's Clinic · Gangnam, Seoul
Swapping some coffee for caffeine-free drinks can calm urgency. Illustrative photo.
Hommage · Gangnam
Hommage Women's Clinic · Gangnam, Seoul
Urine test, exam and ultrasound can usually be done in one visit. Illustrative photo.
Traveling to Seoul
Bladder leakage treatment in Seoul for international patients
A bladder assessment fits easily into a short trip. The consultation, urine test, pelvic exam and ultrasound can usually be completed in one visit, and you leave with a written training plan and, if appropriate, a prescription. Expats and foreign residents can return for follow-up after six to twelve weeks. If surgery is the right option, Dr. Park explains whether referral to a hospital team in Seoul or treatment in your home country makes more sense; after sling surgery, you would need to stay long enough for the bladder-emptying check and avoid long-haul flights until your surgeon advises.
Message the clinic on KakaoTalk or WhatsApp before you travel to share your symptoms, book a time and arrange language support.
What to bring
- Passport or residence card
- A 3-day bladder diary
- List of current medicines and supplements
- Notes on births, pelvic surgery and menopause
- Previous urine tests, scans or urodynamic reports
- Arrive with a comfortably full bladder
Choosing well
How to choose a clinic for urinary incontinence in Seoul
Bladder leakage is a medical condition, not a cosmetic one. Some clinics promote laser or other device packages as a quick fix. A good clinic will first identify the type of leakage, rule out infection and incomplete emptying, offer conservative treatment, and explain the evidence and risks of any procedure honestly.
Questions to ask
- Will you tell me whether I have stress, urge or mixed leakage?
- Will you test my urine and check that my bladder empties?
- Is supervised pelvic floor or bladder training offered first?
- What is the evidence for any device or laser you suggest?
- If I need surgery, who performs it and what are the mesh risks?
What affects the cost of incontinence treatment in Seoul?
The total depends on the tests you need (urine test, ultrasound, urodynamic study), the number of follow-up visits, whether medication, vaginal estrogen or a pessary is prescribed, and whether surgery is needed and where it is performed. For patients enrolled in Korea's National Health Insurance, coverage depends on the diagnosis and test results; visitors without coverage pay directly. You receive a written estimate before any test or treatment.
Hommage · Gangnam
Hommage Women's Clinic · Gangnam, Seoul
The clinic is a short walk from Sinnonhyeon Station in Gangnam. Illustrative photo.
Your visit
What to expect at your bladder assessment
01
Before you come
If you can, keep a three-day bladder diary of drinks, toilet trips and leaks. Arrive with a comfortably full bladder for the urine test.
02
Consultation
Dr. Park asks about your symptoms, births, bowel habits and medications, and what bothers you most.
03
Exam and tests
A pelvic exam with a pelvic floor check, a urine test and an ultrasound to see whether your bladder empties fully.
04
Your plan
A training plan and lifestyle steps to start with, plus medication or referral for further tests when needed, and a review date.
Your doctor
Dr. Park Yuna
Medical Director · OB/GYN Specialist
Dr. Park first works out which type of leakage you have, because stress and urge incontinence are treated differently. She starts with pelvic floor and bladder training, checking your muscle contraction during the exam, and discusses medication or surgery only when conservative care is not enough.
OB/GYN specialist (Korea) and representative director of Hommage Clinic. Leads women's health care, labiaplasty and other cosmetic gynecology procedures.
Urinary incontinence: frequently asked questions
Is urinary incontinence normal after having a baby?
Leakage is common in the weeks after birth, especially after a vaginal delivery, and often improves within a few months with pelvic floor exercises. It is not something you have to live with. If leakage continues beyond about three months after birth, or affects daily life, an assessment and supervised pelvic floor training can help. See our Kegel therapy guide.
Can urinary incontinence be cured without surgery?
Often, yes. Supervised pelvic floor muscle training cures or clearly improves stress incontinence for many women, and bladder training helps urge incontinence. Lifestyle changes and vaginal estrogen after menopause add to the effect. Surgery is usually considered only when at least three months of conservative treatment has not helped enough.
How long does recovery take after sling surgery?
Most women go home the same day or the next day and return to light activity within a few days. You are usually advised to avoid heavy lifting, strenuous exercise and sex for about four to six weeks while the tissue heals. Your doctor will check that your bladder empties well before you leave.
Does drinking less water help with bladder leakage?
Not usually. Cutting fluids too much makes urine more concentrated, which can irritate the bladder and increase urgency and infections. Most women do well with a steady intake through the day, less caffeine, alcohol and fizzy drinks, and fewer drinks in the two hours before bed if night-time trips are a problem.
Is it a urinary tract infection or incontinence?
A urinary tract infection usually causes burning, frequent urination, urgency and sometimes cloudy or bloody urine, starting over a day or two. Incontinence tends to build up gradually without burning. Infection can cause temporary leakage, so a urine test is part of every assessment. Read about UTI treatment.
Can foreigners get incontinence treatment in Seoul?
Yes. International patients and foreign residents can book an appointment at Hommage Clinic in Gangnam. Bring your passport or residence card, a list of your medications and, if possible, a bladder diary. Walk-ins are welcome during opening hours; please contact us before your visit to arrange language support.
What is the difference between stress and urge incontinence?
Stress incontinence is leakage when pressure rises, such as coughing, sneezing, laughing or exercise, because the urethra is poorly supported. Urge incontinence is leakage after a sudden, strong need to go, because the bladder muscle contracts too early. They are treated differently, so identifying the type is the first step.
How long does bladder training take?
Bladder training usually runs for at least six weeks. You gradually lengthen the time between toilet visits, starting from the interval in your bladder diary. A Cochrane review found low-certainty evidence that it may help overactive bladder symptoms as much as or more than anticholinergic medication early on.
How successful is sling surgery for stress incontinence?
In a Cochrane review of 81 trials, short-term cure rates ranged from about 62% to 98% across studies, with both main routes highly effective in the short and medium term. Long-term results vary more. Risks include bladder injury, groin pain, difficulty emptying and tape exposure, which occurred in about 2 in 100 women.
Are bladder medications safe?
They are widely used but can cause side effects. Anticholinergic drugs may cause dry mouth, constipation and blurred vision, and some are avoided in older women because of possible effects on memory. Mirabegron can raise blood pressure. Dr. Park reviews your health and other medicines before prescribing and checks how you respond.
Does menopause cause bladder leakage?
Lower estrogen after menopause thins the tissues of the vagina and urethra, which can add to urgency, frequency and leakage. Vaginal estrogen can ease these symptoms and is often combined with pelvic floor training. See our menopause treatment page.
What should I bring to my bladder appointment?
A three-day bladder diary of drinks, toilet trips and leaks is the most helpful thing to bring, along with a list of medicines, notes on births or pelvic surgery and any previous test results. Arrive with a comfortably full bladder so a urine sample can be tested.
Can urinary incontinence come back after treatment?
It can. Pelvic floor strength fades if training stops completely, and later events such as another birth, menopause, weight gain or a chronic cough can bring symptoms back. A short maintenance routine helps. After sling surgery, long-term cure rates are lower than short-term ones, and some women need further treatment.
References
Sources used for this page, reviewed by Dr. Park Yuna, OB/GYN specialist. Read our editorial and medical review policy.
- Dumoulin C, Cacciari LP, Hay-Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2018;10:CD005654. Cochrane
- Ford AA, Rogerson L, Cody JD, Aluko P, Ogah JA. Mid-urethral sling operations for stress urinary incontinence in women. Cochrane Database Syst Rev. 2017;7:CD006375. Cochrane
- Bladder training for treating overactive bladder in adults. Cochrane Database Syst Rev. CD013571. Cochrane Library
- National Institute for Health and Care Excellence. Pelvic floor dysfunction: prevention and non-surgical management. NICE guideline NG210. 2021. NICE
This page is general information and does not replace a personal consultation. Illustrations are original works of Hommage Women's Clinic, Gangnam, Seoul; photos marked illustrative are not of patients.
Related women's health services
Pelvic Floor Treatment
Assessment and care for weak or tight pelvic floor muscles and early prolapse.
Kegel Therapy
How to do pelvic floor exercises correctly, and how long they take to work.
Vaginal Laser Therapy
Medical laser uses for dryness after menopause and mild bladder symptoms.
UTI Treatment
Testing and treatment for bladder infections, including repeat infections.
Menopause Treatment
Care for hot flashes, dryness, bladder changes and long-term health.
Pelvic Ultrasound
An imaging test of the uterus, ovaries and bladder, often done in the same visit.
Stop planning your day around your bladder
Book an assessment with Dr. Park Yuna in Gangnam. An exam, urine test and ultrasound can usually be done in one visit.
Hommage Clinic · 4F, Building A, 509 Gangnam-daero, Seoul (near Sinnonhyeon Station) · Mon & Fri 10:00–20:00 · Tue–Thu 10:00–19:00 · Sat 10:00–15:00