Incontinence is a term that describes any accident or involuntary loss of urine from the bladder or faeces from the bowel. It is not just a problem for older people and it should not be considered normal.

Incontinence is not just a problem for the elderly and should not be considered an inevitable consequence of the ageing process. It should not be considered normal and it can often be a sign of other health problems.

Sometimes incontinence can be cured and other times it can be managed with the right advice or treatment. 

Incontinence is a common condition that ranges in severity from just a small leak to complete loss of bladder or bowel control.

Bladder weakness can be the result of, or related to:

• Pregnancy
• Childbirth
• Surgery
• Menopause
• Prostate problems
• Obesity
• Constipation
• It can also be a side effect of some medications

There are a number of types of incontinence. Below is a list of the most common types and some useful information on each.

1. Stress Incontinence

Stress incontinence refers to stress upon the sphincter and pelvic muscles. A person with stress incontinence will experience small urine loss from coughing, sneezing, laughing or physical activities such as running, lifting heavy objects or getting off a chair or bed. This is the most common type of incontinence and occurs mainly in women.

2. Urge Incontinence

A person with urge incontinence experiences sudden, urgent desires to urinate and is unable to ‘hold on’ and get to the toilet in time. Their incontinent episodes may occur often, but not always, and they may have a small bladder capacity. Urge incontinence is sometimes referred to as an ‘overactive bladder’ and leakage can occur unexpectedly, such as when touching water, hearing running water, or when urination is anticipated (when you arrive home and are putting your keys in the door, for instance).

3. Retention/Overflow Incontinence

A person with retention/overflow incontinence strains to pass urine, feels that their bladder hasn’t emptied completely, constantly dribbles and may suffer from recurrent urinary tract infections. Retention/overflow incontinence is common in males who have an enlarged prostate gland.

4. Functional Incontinence

Functional incontinence is the result of physical, psychological and/or environmental problems that affect a person’s ability to reach or use the toilet. Some of these problems include poor mobility, poor dexterity, loss of memory or even poor building design.

5. Reflex Incontinence

A person suffering reflex incontinence will find that their bladder has emptied without any warning or, in some cases, without any sensation that this has occurred. Reflex incontinence can often be the result of a spinal cord injury.

6. Nocturia and Nocturnal Enuresis

A person with nocturia will wake frequently during the night to go to the toilet and find that they have insufficient time to reach the toilet once they have woken. A person with nocturnal enuresis will lose urine while they are sleeping, usually at night.

If you feel that you have any of these types of incontinence, please contact your health professional for advice on choosing an appropriate aid.

Women are twice as likely to run the risk of suffering from incontinence as men due to their anatomical characteristics, pregnancy, and menopause.

• Women who have undergone gynaecological surgery, such as a uterus ablation, are more at risk. Any surgical operation in the pelvic region runs the risk of damaging the urinary system’s muscles and nerves.
• The elderly run the risk of gradually becoming incontinent if their bladder muscles lose their tone. In addition to this, there is the fact that they are more and more exposed to neurological disorders.
• Men suffering from prostate troubles.
• People with a bladder stone or suffering from bladder descent.
• People with frequent urinary infections.
• People suffering from a neurological disorder which afflicts the nerves controlling the bladder, or which limits mobility: Parkinson’s disease, Alzheimer’s disease, multiple sclerosis, peripheral diabetic neuropathy, an injury to the spinal marrow, a cerebrovascular accident, etc.

For nine months, the pelvic floor has borne the weight of the baby, as well as the weight of the placenta and any additional kilos. The perineum may subsequently have trouble regaining its initial firmness.

Finding time is difficult but it is essential to undertake the recommended exercises both in the short and long term in order to reduce the risks of urinary incontinence.

If you feel that you have any of these types of incontinence, please contact your health professional or Continence NZ for advice.