What is continence?

Symptoms:

Urine leaks during activities like laughing, sneezing, jumping, lifting, shouting and coughing. It happens when physical exertion increases abdominal pressure which also puts pressure on the bladder. It is often only a small leak but in more severe cases, the pressure can cause a greater loss of urine.

Common causes:

• The urethral sphincter, the pelvic floor muscles, or both, are weak or damaged and cannot hold the urine in.

• Pregnancy, childbirth, menopause, surgical trauma and lung conditions causing frequent coughing, like cystic fibrosis or emphysema.

• Women who have given birth vaginally are most likely to develop stress incontinence because childbirth stretches, and sometimes damages, the pelvic floor muscles and nerves.

• Age is also a factor. Pelvic floor muscles and the urethra weaken causing leaks. Women can experience symptoms after menopause.

• Men can experience symptoms after a pelvic fracture or prostate surgery.

Urge incontinence is also known as an overactive bladder.

Symptoms:

A sudden need to urinate. A strong urge or feeling that you need to urinate when the bladder is not full. The body cannot stop involuntary bladder contractions. It can happen straight after you have just urinated. Often very little or no urine actually comes out.

Common causes:

• Pregnancy, childbirth, pelvic floor trauma, menopause, diseases like Multiple Sclerosis and Parkinson’s disease.

• Can also happen when there is an infection of the bladder, urinary tract or prostate.

• It is more likely to develop as people get older.

• Postmenopausal women are more likely to develop this condition because of changes to the bladder and muscles. 

• Studies suggest 40-60% of people have incontinence after a stroke and for around 15% of people, it does not go away.

Symptoms: 

Both stress and urge continence. Most women experiencing incontinence have both symptoms.

Common causes:

• Pregnancy, childbirth, pelvic floor weakness or trauma, menopause, surgical trauma, diseases like Multiple Sclerosis and Parkinson’s disease.

• Men are more likely to experience mixed following prostate removal or enlarged prostate surgery.

• It can also occur in much older, frail men or women.

Symptoms: 

Urine leaks not linked to pathology or urinary system problems.

Common causes:

• If everything is working fine, it could be due to an illness or disability.

• For example, physical or cognitive impairment like lack of mobility, head injuries, dementia, mental illness, medications.

• Sometimes it is about not getting to a toilet and undressed ready to urinate. This could be due to arthritis or the location of, and ease of, access to facilities.

Symptoms: 

Urine frequently dribbles because the bladder is not emptying properly. You might not feel the need to go. The symptoms are similar to stress incontinence.

Common causes:

• Examples of causes are diabetes, neurological damage, spinal cord injury, Parkinson’s disease, Multiple Sclerosis, shingles, enlarged prostate.

• Men are more likely to be diagnosed because it can happen when something blocks the urine from flowing normally, like an enlarged prostate. It can also happen for women if there is a severe prolapse of the bladder or uterus.

• Both men and women may experience this if their bladder muscle becomes under-active.

• Some medications used to prevent bladder muscle contraction or that remove the need to urinate can cause overflow incontinence.

Symptoms: 

The bladder attempts to empty due to a involuntary reflex reaction. It is usually large amounts without any warning. The brain does not receive a message that the bladder needs emptying because the nerves are damaged.

Common causes:

• Usually relates to people with serious neurological impairment from a spinal cord injury, Multiple Sclerosis, damage during surgery or other injuries.

Symptoms: Inability to stop the urge to poo. It happens so quickly that it is not possible to make it to the toilet in time. It includes soiling yourself without realising you needed to go and leaking poo when you pass wind.

Not being aware that you need to go is sometimes referred to as passive incontinence. This is where your body may not be able to tell that your rectum is full and you need to go.

Common causes:

• Diarrhoea, constipation, wind, bloating, hemorrhoids, loss of storage capacity in the rectum, surgery, damage to the back passage, poor diet.

• Rectal prolapse where the rectum drops down into the anus.

• Women can experience rectocele where the rectum protrudes through the vagina.

• It can be a complication linked to child birth.

• It is more likely in women taking menopausal hormone replacements.

• It is more common in adults over 65.

• Often happens during the late stage of Alzheimer’s and dementia.

• Can be linked to Irritable Bowel Syndrome, Coeliac disease or Crohn’s disease.

• Physical disabilities can make it difficult for people to get to facilities in time.