SEXUAL HEALTH CONCERN

Incontinence

Also called: incontinence, leaking urine, bladder leaks, stress incontinence, weak bladder, cant hold wee, pee leaking, leaking pee, wee leaking, leaking wee

Incontinence is the involuntary loss of bladder or bowel control. It can range from occasional leakage to frequent symptoms that interfere with everyday activities, sleep or confidence.

TYPICALLY OCCURS

Pelvic floor weakness, bladder changes, nerve problems and medical conditions

TREATED BY

Continence surgery, medication, pelvic floor therapy and lifestyle management

ALSO LINKED TO

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Why it happens?

Urinary incontinence occurs when the normal systems responsible for storing and releasing urine do not work effectively together. The bladder, urinary sphincters, pelvic floor muscles and nervous system all contribute to bladder control. Weakness of the pelvic floor or urinary sphincter can allow urine to leak when pressure inside the abdomen increases, such as during coughing, sneezing, laughing or exercise. This is known as stress urinary incontinence. Pregnancy and childbirth, pelvic surgery, ageing and changes associated with menopause can contribute to pelvic floor weakness, although urinary incontinence can affect people of any sex.

Another common form is urge incontinence, where a sudden and intense need to urinate is followed by involuntary leakage. This can occur when the bladder muscle contracts when it should remain relaxed and is often associated with overactive bladder. Urinary tract infections, bladder irritation, certain medications, neurological conditions and conditions affecting the prostate can also contribute to urinary symptoms. Some people experience mixed incontinence, where both stress and urgency-related leakage occur. Less commonly, overflow incontinence can develop when the bladder does not empty properly and becomes overly full.

Bowel or faecal incontinence involves difficulty controlling bowel movements or the unintended passage of stool. It can result from damage or weakness affecting the anal sphincter muscles, pelvic floor or nerves, as well as conditions causing persistent diarrhoea or severe constipation. Childbirth injuries, previous surgery, neurological disorders and certain bowel conditions may contribute. Because incontinence has many possible causes, identifying the type and underlying reason is important. Symptoms can often be improved or managed, and assessment can also help identify medical conditions that may otherwise remain untreated.

How far along is it?

Early

Small amounts of leakage occur occasionally, perhaps during coughing, sneezing, exercise or when there is a sudden urge to use the toilet. Everyday activities are generally unaffected.

Moderate

Leakage becomes more frequent or predictable. Urgency, night-time symptoms or difficulty reaching the toilet may occur, and continence products or changes to daily routines may become necessary.

Advanced

Loss of bladder or bowel control occurs regularly and substantially affects everyday activities, sleep, work or social life. There may also be difficulty emptying the bladder or controlling bowel movements.

What addresses it?

Treatments that address this

Incontinence sling surgery→

It is worth seeking professional advice when bladder or bowel leakage becomes recurring, is getting worse or begins affecting sleep, exercise, work, relationships or everyday activities. Assessment is also advisable when symptoms appear suddenly or are accompanied by difficulty urinating, recurrent urinary infections, changes in bowel habits or a feeling that the bladder does not empty properly.

Incontinence can sometimes be a symptom of an underlying medical, neurological, urinary or bowel condition, so persistent leakage should not automatically be attributed to age.

Seek urgent medical assessment if new loss of bladder or bowel control occurs alongside severe back pain, numbness around the genitals or buttocks, or new leg weakness, as this can indicate serious nerve compression. Blood in the urine or stool, inability to pass urine, or significant unexplained bowel changes should also be medically assessed.

Quick Questions:

What are the main types of urinary incontinence?

The main types include stress incontinence, where urine leaks during activities such as coughing or exercise; urge incontinence, associated with a sudden strong need to urinate; mixed incontinence, involving both; and overflow incontinence, where the bladder does not empty effectively.

What causes bladder leakage?

Possible causes include pelvic floor weakness, pregnancy and childbirth, ageing, menopause, prostate problems, bladder conditions, urinary infections, neurological disorders, medications and previous pelvic surgery.

Is incontinence a normal part of ageing?

No. Incontinence becomes more common with age, but it should not be considered an inevitable or untreatable consequence of getting older. Persistent symptoms are worth discussing with a healthcare professional.

Can incontinence be treated?

In many cases, symptoms can be significantly improved or managed. The appropriate approach depends on the type and cause and may include pelvic floor rehabilitation, bladder training, lifestyle changes, medication, continence procedures or surgery.