Bladder or bowel leakage is also known as ‘incontinence’. It is very common affecting an estimated 1 in 5 women and 1 in 10 men. It can affect anyone regardless of age, sex or health although some people are more likely to experience bladder leakage than others. It is a physical problem that individuals cannot control.

Additional problems include an inability to empty the bladder effectively (urinary retention) and problems using the toilet – both of which can contribute to leakage.

Incontinence is not a disease but a symptom with one or more underlying causes. If the underlying causes can be identified, then there is the possibility that the leakage can be cured or substantially reduced.

Causes include:

• A failure of the bladder or bowel to work correctly (physiological dysfunction) e.g. overactive bladder muscle (detrusor), enlarged prostate gland, vaginal prolapse, or neurological conditions such as multiple sclerosis or spinal cord injury
• Other factors e.g. urinary tract infection, constipation, certain types of drug, diabetes
• Difficulty with using the toilet - this could be temporary after surgery or longer term e.g. arthritis, problems with use of your hands, dementia
• Causes related to lifestyle – alcohol intake, diet and obesity.

You are strongly recommended to seek help. Assessment by an appropriate health care professional who will start to reveal the causes of your problems and enable discussion of suitable treatments and strategies for managing your symptoms.

Talking about incontinence

Bladder and bowel leakage is a subject that many people find very difficult to talk about. In fact, there are thought to be millions of people worldwide who live with incontinence but keep the condition hidden and who have never sought medical help.

Although many people find it difficult to discuss this problem with others, when they do, they often feel a sense of relief. It is also important to remember that if you do decide to talk to a healthcare professional about your problem, they are used to discussing incontinence and will help you through.

Finding the right person to help you

Take the first step to getting help by contacting a health professional…..

• Talk to your family doctor or community nurse – they may be able to advise about some simple measures that help you with your bladder and/or bowel leakage (incontinence).
• If this doesn’t help you may need a specialist continence nurse who can do an in-depth assessment and advise you on further options.
• You may also need specialist medical help from the following:
  • Uro-gynaecologist – specializes in helping women with urinary incontinence
  • Urologist – for men or women
  • Colorectal surgeon – specialist for bowel incontinence
• Some consumer organisations or companies have helplines – talking to a helpline nurse can give you tips to resolving your leakage (incontinence), help you think through who you might need to see or how best to explain your current difficulties.

See continence organisations in your country for local help.

If you would like to learn about bladder and bowel problems in more depth join this free online course from the Association for Continence Advice. The course is for healthcare professionals and members of the public.