Urinary Incontinence Awareness: Often Too Embarrassing To Discuss

By Jacqueline Cahill posted in Professionals & Educators

By Jacky Cahill, Executive Director The Canadian Continence Foundation

Urinary Incontinence Facts:

urinaryIncontinence is a prevalent health condition that is rarely discussed as people living with the condition are often too embarrassed to discuss it with their healthcare providers. In fact, the World Health Organization calls incontinence “one of the last medical taboos” . However, the fact is that some estimates indicate that as many as 3.3 million Canadians – nearly 10% of the population – experience some form of incontinence. Recent studies indicate that the number may be even higher, particularly among older populations: “Incontinence occurs in more than half of community-dwelling women 45 years old and older. Almost one of five women in the community reported UI that affected normal activities.” The number of individuals living with incontinence is likely to increase as the population ages, since the prevalence of the condition tends to increase with age.

What is Urinary Incontinence?

The bladder is the urine storage reservoir, the urethra is a passage through which the bladder is emptied and supportive structures and pelvic and periurethral muscles are responsible for preventing leakage. Incontinence has been defined by the International Continence Society as the “complaint of any involuntary leakage of urine.

Types of incontinence:

The following are the main types of incontinence:

  • Stress Urinary Incontinence (SUI), which is the leaking of urine with coughing, sneezing, straining, exercise or any other type of exertion. 50% of individuals with incontinence have SUI.
  • Urge Incontinence (UI) is leaking of urine associated with the sudden uncontrollable urge to empty the bladder. The urge to empty the bladder cannot be delayed and leakage occurs. UI is a key symptom of the overactive bladder syndrome.
  • Overflow incontinence (OI) is constant leaking or dribbling from a full bladder. OI implies that normal urination is impossible.
  • Mixed incontinence (MI) is a combination of stress and urge incontinence.

What triggers incontinence?

Urinary incontinence can be caused by a weakening of the pelvic muscles and urethra muscles (the tube that connects the bladder with the outside) or because of damaged ligaments. When weakened, the pelvic muscles and urethra cannot contract enough to hold urine in when stress is placed on them, such as during a strong cough or sneeze.

Urinary incontinence also occurs when a person cannot control the bladder muscle. In these circumstances, the bladder will empty when it has reached a certain degree of filling (such as it does in children before toilet training) or when something happens to make the individual feel the need to urinate.


Other Factors

The following factors are associated with incontinence:

  • Incontinence can be caused by neurological injury or disease;
  • Increasing age
  • Menopause can bring on or worsen all forms of incontinence because estrogen loss contributes to the weakness of muscles and tissues in the pelvic floor area, which supports the bladder and urinary tract;
  • Weakened pelvic muscles;
  • Previous pregnancies;
  • Certain medicines (e.g. diuretics);
  • Build-up of stool in the bowels;
  • Urinary tract (bladder) infection;
  • Medical problems such as diabetes and stroke;
  • Smoking;
  • Physical conditions affecting mobility and dexterity (e.g. MS, arthritis);
  • Obesity;
  • Caffeine and fluid intake;
  • High impact physical activities; and
  • Occupations which involve heavy lifting and straining.

What can you do?

You need to speak to your Family Physician, who can then set-up tests to determine a diagnosis. Healthcare professionals, who specialize in urinary incontinence care can be: Physiotherapists, Nurse Continence Advisors, Urologists, Urogynaecologists.

Some Urinary Incontinence treatment and management options:

  • Initial Treatment can include lifestyle changes and pelvic floor exercises
  • Surgical Options for Stress Incontinence
  • Pharmaceutical Treatments for Urge incontinence
  • Absorbant Products

The Canadian Continence Foundation (TCCF) – The only national non-profit organization serving the interest of people experiencing incontinence.

The Canadian Continence Foundation employs many strategies to raise awareness and public education about this common condition, and, ultimately, to empower people to seek treatment. Its website, includes educational materials for patients and caregivers, many downloadable fact sheets and documents and lists of health care professionals who treat UI. For detailed information on any part of this article please visit The Canadian Continence Foundation’s website: www.canadiancontinence.ca.

A new complete incontinence care handbook – The Source, is available from TCCF.

About the Author

Jacqueline graduated from McGill University with a Bachelor of Social Work degree and has for most of her career worked in the non-profit sector in Montreal. Her varied career spans several community services sectors: from psychiatric rehabilitation, women’s and refuge issues to working with the unemployed. She moved to Canada from England in 1979 and has been Executive Director of The Canadian Continence Foundation since late 2005 and currently resides in Peterborough, Ontario.