Incontinence

Continence is the ability to control the bladder and/or bowel. The loss of control is called “incontinence” and can include the losing control of the bladder, bowel or both. Incontinence can range in severity from a small leak, to complete loss of control. This can be an embarrassing problem, with significant impact on a person’s quality of life and self-confidence. 

Importance for people 50+

Incontinence affects approximately 5 million Australians, including one in three women, and one in ten men. It is also commonly reported in trans men and women, particularly in relation to gender-affirming surgery or hormone therapy.  The risk of incontinence increases as people age, but it is not a normal component of the aging process. Little is known about incontinence in people living with HIV, but it will likely become more common as people living with HIV age, just like the general population.   

Incontinence can be caused by pelvic floor weakness, nerve problems, infections and other medical problems. Incontinence may also follow surgery for conditions like prostate or anal cancer. Other risk factors include infections, chronic diarrhoea, obesity, previous pregnancies, medical conditions like diabetes and dementia, and some medications. 

People with bladder and bowel incontinence may experience a number of symptoms. These might include leaking urine, gas or faeces with coughing, sneezing, lifting, or exercise, leaking or loss of control on the way to the toilet, or because a person can’t get to the toilet at all, leaking after a sudden urge to empty the bladder or bowel, a sensation of incomplete emptying followed by leakage, or a lack of sensation of needing to empty either the bladder or bowel.  

Management strategies

If you are experiencing incontinence, please speak with your healthcare provider about possible management strategies. It may be helpful to maintain a diary of your bladder or bowel incontinence, including when it occurs, how often, whether it is getting worse, what brings it on, toileting habits, as well as a food and drink diary. Your healthcare provider may need to conduct a physical examination, conduct additional tests, or refer you to a specialist. Management of incontinence may involve practical solutions, continence products, pelvic floor exercises (for men, and women) and sometimes medications.