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At night when I get up to urinate the flow starts as soon as I get to the toilet, sometimes before I can sit down.

Are you female or male? How old are you?

If you are a post-menopausal female this is a very common problem. You need to start by seeing your primary doctor to begin to pinpoint what the cause of the problem is, then maybe you'll be recommended to a urologist or pelvic health specialist (now they have PT for this very problem, beyond Keggels).

If you are in otherwise good health you may need to limit what you drink right before you go to bed. Disposable nighttime briefs are very absorbent and work great.
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Reply to Geaton777
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Just to start, you need to get tested for a Urinary Tract Infection (I had exactly this issue last summer; that's what it was).

If not a UTI, get a referral to a urologist and find out what's going on.
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Reply to BarbBrooklyn
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There are three major kinds of incontinence and you are suffering from urgency or stress urgency, in that the mind is sort of "letting go" of the urine before you are safely seated. To get a good idea how all this works, an exercise in thinking BACK:

Think in years past when you are, say, out shopping and are avoiding going on restroom break, you are on your way home with a pretty full bladder, and as you near the home suddenly you have to go so badly you almost cannot hold it? Now have someone stop you in the street and your attention is diverted away from being near your toilet, and turns out you CAN indeed hold it longer. In fact, you may enter your home and choose not to go until your new frock is put away.

Our urination system is amazingly complex. It operates both on the brain and on the spinal level. The bladder, when full, sends signals up the spinal cord to the brain, and the brain sends them back down to the bladder. When young all of our muscles are strong enough "to hold" thing.

The doctor, if you discuss, will tell you all about Kegels exercises to learn to have a stronger more able pelvic floor. For me and in my experience as an RN I have seen lots of squeezing going on as exercise with very little good result.

You are more in control of this than you think. For instance, if you are NOT at the toilet, but rather next door at Ima's house, your bladder won't let go. You can actually talk to your bladder as in "Nope. Not time to go". Your brain can be fooled in that way believe it or not, so play around with that idea.
Google types of incontinence, google "How Urination works" or "Micturation and how it works". Bladder 101. Good luck.

Meanwhile, know that as we age, balance goes. SO DOES BLADDER control. Wear a simple panty liner. Some even use a simple folked piece of tissue between you and your pants.

But at 82 I am just going to say, Welcome to aging. Here we are, all trying to make the best of it, and YOU ARE NOT ALONE!
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Reply to AlvaDeer
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It sounds like stress or urge incontinence. If this is happening enough that you are worried, then seek out a urogynochologist rather than a urologist to rule out gynologic or bladder problems.
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Reply to MACinCT
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