For some people, getting home after a long day doesn’t just bring relief — it brings an overwhelming urge to urinate.
Simply seeing the front door, putting the key in the lock, or hearing running water can be enough to trigger a leak.
This phenomenon, known as “latchkey incontinence,” has now been studied by researchers at the University of Pittsburgh, who have found that mindfulness exercises and a type of non-invasive brain stimulation may help reduce these sudden urges and leaks.
The results, published in Continence, mark the first study to test brain-based therapies for urinary incontinence.
Latchkey incontinence — also called situational urgency urinary incontinence — happens when certain sights, sounds, or places trigger the bladder. Common triggers include front doors, garage doors, restrooms, running water, or even getting into a car.
According to lead researcher Cynthia Conklin, Ph.D., this is a form of Pavlovian conditioning — the same type of learned response seen in Pavlov’s dogs, which salivated when they heard a bell linked to mealtime.
Over years of rushing to the bathroom upon arriving home, the brain begins to associate the door with urination, causing the bladder to react automatically.
In an earlier study, the research team used MRI brain scans while showing women pictures of their personal triggers (such as their own front door) alongside neutral images.
They found higher activity in a brain area called the dorsolateral prefrontal cortex when participants viewed the trigger images. This part of the brain helps with cognitive control — in this case, deciding whether to act on the urge to urinate.
The new study tested whether stimulating this brain region while exposing participants to their triggers could help them regain control.
Researchers used two methods: a 20-minute guided mindfulness exercise and transcranial direct current stimulation (tDCS), a safe, painless technique that delivers mild electrical currents to the scalp to influence brain activity.
The mindfulness exercise, developed by coauthor Carol Greco, Ph.D., was similar to a standard “body scan” meditation, where participants bring attention to different parts of the body. But this version included a special focus on noticing bladder sensations without reacting to them.
Sixty-one women over the age of 40 who regularly experienced trigger-related leaks took part. They were randomly assigned to one of three groups: mindfulness only, tDCS only, or a combination of both. Each participant attended four sessions over five to six days, during which they viewed photos of their personal triggers while receiving the assigned therapy.
All three groups reported improvements. Participants experienced fewer urgency episodes, fewer leaks, and reduced feelings of urgency when looking at their trigger cues. The researchers noted that the level of improvement was similar to results seen with standard treatments like medications or pelvic floor therapy — but without the side effects of drugs.
The study did not include a “no-treatment” control group, so further research is needed. Still, the response from participants was overwhelmingly positive. More than 90% completed all sessions, and many said they kept using the mindfulness technique in their daily lives. Some even sent thank-you cards — a rare event in clinical research.
Senior author Becky Clarkson, Ph.D., emphasized that bladder problems can deeply affect quality of life, leading to embarrassment, social isolation, and even depression. She hopes that non-drug options like mindfulness and brain stimulation will give people more tools to manage their symptoms.
Next, the team plans to test the mindfulness program in independent living communities for older adults and explore creating an app so people can access the training at home. The researchers believe this could make treatment more widely available — and help people realize they don’t have to suffer in silence.
This study is important because it tackles a specific, often overlooked type of urinary incontinence that can have a major impact on daily life. By targeting brain activity and mindfulness, the researchers address not just the bladder, but the learned brain-bladder connection.
While the results are promising, the lack of a control group means more rigorous trials are needed before firm conclusions can be made. Still, the strong participant engagement and similarity of results to traditional treatments suggest that these brain-based and behavioral methods could become valuable, low-risk options for people reluctant to take medications.
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The study is published in Continence.
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