Can you pee your pants and not know it? (+3 reasons)

In this article, we will discuss why you pee involuntarily without knowing it. We will also discuss some of the techniques that can help you reduce the occurrence of peeing yourself without feeling it.

Can you pee your pants and not know it?

You may pee your pants without knowing because of urinary incontinence. There are several reasons for involuntary urination, including pressure on the bladder, overfull bladder, weakness in the pelvic floor muscle, or loss of bladder control.

Physical activities, such as heavy lifting, laughing, sneezing, and sprinting may put pressure on your bladder leading to involuntary urine leakage. This is known as stress incontinence but has nothing to do with psychological stress.

If you have frequently begun to pee yourself without knowing it, immediately consult your urologist or gynaecologist. It is more common in pregnancy, menopause, patients with prostate cancer, enlarged prostate gland, or urinary tract obstruction. 

What factors contribute to bladder control issues?

There are various factors and types of urinary incontinence that may make you pee yourself suddenly and without knowing.

Stress incontinence

Sometimes physical movement and activities, including coughing, laughing, sneezing, during sex, exercise, or heavy lifting put pressure on the bladder. This causes the leakage of urine and is known as stress incontinence.

Stress incontinence most commonly occurs due to weakness of the urethral muscles. The bladder or other organs may fall and press against the urethra. Childbirth is one of the causes of weaker pelvic muscles.

Urge incontinence

Urge incontinence involves a sudden strong urge to pee, but you pee yourself involuntarily before reaching the washroom. The urge to urinate is frequent and stronger at night while resting.

Urge incontinence is more common in patients who have urinary tract infections, diabetes or some neurological disorder. The two main symptoms of diabetes insipidus involve extreme thirst and frequent urination.

Overflow incontinence

Overflow incontinence occurs when you have a strong urge to pee but can only release a limited volume or drips of urine. This could be because of a weak bladder muscle or an obstruction in the urinary tract. 

Because your bladder does not drain properly, it becomes full and overflows involuntarily even when you do not need to urinate. Overflow incontinence is more common in men because of the possibility of an enlarged prostate gland.

Other factors

Ageing tends to weaken the bladder muscles. The elderly are more prone to involuntary urination and dripping as compared to an adult. Ageing also reduces the bladder’s capacity to hold large volumes of urine (1).

Prostrate cancer and enlarged prostrate gland increase the occurrence of involuntary urination. A tumour in the urinary tract also blocks the normal flow of urine. Urine leakage is also common in patients with gallstones, urinary stones, and bladder infections.

How to reduce the episodes of involuntary urination?

As a first-line treatment, your doctor will teach you behavioural therapy such as bladder training, pelvic floor muscle training, and toileting practices. Other prevention techniques might require pharmacological intervention and lifestyle modification.

Pharmacological interventions

Antimuscuranic agents are often prescribed for urinary incontinence. These drugs include oxybutynin, solifenacin, and fesoterodine. Once the treatment has started, you should not abruptly stop taking antimuscarinic agents, especially oxybutynin, as it may worsen the symptoms of an overactive bladder.

Beta-3 adrenoreceptor agonists, including mirabegron, are used to relax detrusor muscles. They also reduce bladder afferent activity and spontaneous contractility. In some cases, anticholinergic drugs are prescribed with mirabegron for increased efficacy (2).

Women are often advised vaginal pessaries to support the bladder and vagina after giving birth or during menopause. In extreme cases, men are advised a sling surgery in which a surgical mesh is installed on the top portion of the urethra near the sphincter muscle.

Lifestyle modifications

Certain foods and drinks may stimulate your bladder involuntarily without you realizing it. If you have an overreactive bladder, you should avoid consuming chocolate, chilli peppers, large doses of vitamin C, or food that is too spicy or acidic.

You should also avoid caffeine (irritates the bladder), alcohol (diuretic), and carbonated drinks. You should avoid smoking or lifting heavy objects. If you have constipation, take high-fibre food as constipation weakens the pelvic floor muscles.

Exercise daily to reduce extra weight. Obesity may also weaken the pelvic floor muscles due to undue fatty tissue pressure on the bladder. However, avoid high-impact exercises and sit-ups as they may cause leakage and drip.

I often experience sudden involuntary urination, especially during the winter season. If you experience such issues, you must use the restroom before your bladder is full. If you pee yourself once in a blue moon then there is nothing to worry about.

However, if such episodes are frequent, immediately consult your doctor. Sometimes, this occurs due to natural phenomena like pregnancy and menopause. At times it may indicate a more serious illness like prostate cancer, and urinary tract infection.

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Shaw C, Wagg A. Urinary incontinence in older adults. Medicine. 2017 Jan 1;45(1):23-7. Shaw C, Wagg A. Urinary incontinence in older adults. Medicine. 2017 Jan 1;45(1):23-7.


Nandy S, Ranganathan S. Urge Incontinence.