What is incontinence?

Getting rid of your bodies waste products is a complex process. When our control mechanisms don't work properly we experience incontinence - the accidental or involuntary leakage of urine or bowel movements. This can have an impact on confidence and well-being as well as on personal hygiene and health.

What causes incontinence?

Ageing cannot cause incontinence. Although bowel and bladder weakness becomes more common as we get older, incontinence is not an inevitable part of ageing. Because incontinence is not a distinct disease, it is often difficult to determine a definite cause.

Urinary incontinence can be divided into four groups:

• Stress incontinence – means leaking urine when you cough, sneeze or exercise. It is caused by weakness in the muscles that control the opening of the bladder as well as the pelvic floor muscles. This type of incontinence is most usual in women because of the impact of pregnancy, but men may develop stress incontinence after a prostate operation.
• Urge incontinence – means having a sudden urgent need to pass urine, but not being able to reach the toilet in time. An overactive or 'unstable' bladder often causes this.
• Overflow incontinence – this happens when the bladder does not empty completely. Urine can build up and end up literally overflowing.
• Functional incontinence – this is where practical issues such as having difficulty walking or not being able to undo clothing quickly enough can lead to incontinence.

Approximately 40 per cent of all urinary incontinence cases fall into more than one of the categories described above.

Faecal incontinence

Losing control of one's bowels - faecal incontinence - is both distressing and embarrassing. Sometimes the cause is malfunction of the nerves at the base of the spine that control the lower bowel. Damage to the sphincter muscles in the anus or to the nerves controlling these muscles, or constipation can also cause bowel leakage.

Pelvic floor weakness is another leading cause and this can also contribute to urinary incontinence. Help the Aged produces an advice leaflet on Bladder and Bowel Weakness (PDF) – with advice on the treatment and management of incontinence.