Incontinence Guide

Incontinence is generally defined as the unintentional or unavoidable emptying of the bladder, generally at inappropriate times. Sometimes this manifests itself in urine leaking out, particularly when coughing, sneezing, laughing or exercising, while in other people it can mean feeling suddenly ‘caught short’ and being unable to get to the toilet in time, or simply feeling as if your bladder is never fully empty. It can be a distressing and debilitating problem, which is thought to affect 1 in 5 women over the age of 40 and 1 in 33 men of working age. Incontinence affects about 6 million people in the UK, and affects both men and women, although women are more likely than men to be affected. It also becomes more common as people age.

Causes & Types of Incontinence

Incontinence can be caused by a number of different factors, both physical and mental – from weak or damaged pelvic floor muscles to the brain failing to recognise the urge to urinate. It can be the result of an illness – such as a stroke or Alzheimer’s disease – or can simply be a consequence of aging. Incontinence can be a temporary consequence of pregnancy and childbirth or a urinary tract infection, or it can be caused by a tumour or enlarged prostate.

The most common types of incontinence are stress incontinence and urge incontinence. Stress incontinence is when urine leaks out at inconvenient moments, such as when sneezing or laughing. Urge incontinence is when you are suddenly overcome by the urge to urinate, and is also known as an overactive bladder. Stress incontinence and urge incontinence are collectively responsible for 90% of all cases of incontinence.

Women who are pregnant or have given birth are particularly vulnerable to suffering from incontinence, as the pelvic muscles are stretched during pregnancy and delivery. Women who have undergone a long labour, or who have had more than one child, are more likely to suffer from post-pregnancy incontinence. Most women should be taught pelvic floor exercises during their pregnancy to minimise the risk of incontinence – and any incontinence following pregnancy is usually only temporary.

Living with Incontinence

Urinary incontinence can be very traumatic to live with – many sufferers withdraw from many social activities for fear of embarrassment, and feel stigmatised and unable to confide in close friends and family. This can lead to isolation, anxiety and depression . Many people often dismiss incontinence as something which happens only to women, or older people – but while these groups are more likely to be affected, men and younger people may also suffer from incontinence. In such cases, people often delay seeking help through embarrassment, when their problem could easily be resolved.

Treatments for Incontinence

Incontinence is a fairly common problem, and there are various ways incontinence, and the problems created by it, can be addressed, from bladder control training such as pelvic floor exercises to bladder Botox injections, although the effectiveness and suitability of each method varies from case to case.

Pelvic floor exercises, sometimes referred to as Kegel exercises, act to strengthen the muscles of the bladder, which means they are less likely to let urine leak out. It is recommended that you do these three times daily – and even if you do not currently suffer from incontinence, they can help you to prevent this occurring. A doctor, nurse or midwife can show you how to correctly perform these exercises.

Other treatments for incontinence include having Botox injected into the bladder to paralyse muscles so they cannot move uncontrollably; having an artificial sphincter fitted to control the flow of urine; and having surgery to lift the neck of the bladder or remove any objects which are obstructing the flow of urine.

Managing Incontinence

It is also possible to manage incontinence, so that it is easier to continue your daily life. Many companies produce incontinence products such as absorbent pads or underwear, and sometimes these are available on prescription from your health service. Many companies offer incontinence products designed especially for men, and there are a variety of incontinence support groups online, which offer forums to ask questions and discuss stories with other sufferers, as well as tips on how to alter clothes in order to make it easier to go to the toilet, or how to plan a holiday when you suffer from incontinence.

There are a few simple changes you can make to your diet to help prevent incontinence: avoid spicy or tomato-based foods, and make sure to drink plenty of liquids throughout the day – doctors recommend drinking around 6-8 cups each day. It is also important to drink the right kind of liquids: try to avoid excess consumption of caffeine, alcohol or fruit juice. If you are prone to needing the toilet during the night, try not to drink too much liquid in the couple of hours before you go to bed.

Associated Problems

There are other problems associated with incontinence – the skin around the genitals can become very irritated due to frequent exposure to dampness, and people who suffer from incontinence are more likely to develop a urinary tract infection. In addition to these problems, people who have to make frequent trips to the toilet during the night (a condition known as nocturia) may suffer from fatigue and find their ability to concentrate greatly decreased. Many people who suffer from incontinence also become depressed, so it is important to seek help as soon as possible.