Do I have incontinence?

Have you ever had the urge to go to the bathroom but didn’t quite make it on time? Do you find that bladder leakage prevents you from playing with your children or grandchildren, socialising or doing other things you love? If you’ve ever wondered whether those little dribbles are normal or something to be concerned about, you probably want to read on.

Around 4.8 million Australians over the age of 15 live with incontinence and, with the right advice and products, can get on with everyday life without letting it interfere. Some health conditions and life events can put you at an increased risk of developing either urinary or faecal incontinence, from pregnancy and childbirth to menopause and diabetes. While it may cause distress and embarrassment, it’s crucial to realise that there are many ways to manage incontinence and, in some cases, cure it.

How can I determine whether I have incontinence or if it’s something else, you ask. Before we get into the whys of the condition, it’s important to establish exactly what it is. Any accidental loss of urine from the bladder or involuntary bowel movement is considered incontinence. In the case of urine incontinence, it can range from just a dribble to the complete loss of bladder control. No matter how light the bladder leakage may be, it’s important to realise that it’s not normal and it should be addressed.

Do I have incontinence if I’ve only experienced bladder leakage once? Even if you’ve only had one episode of leakage while laughing, coughing or exercising, strictly speaking, you have been incontinent. If it happens once, you should be aware of it; if it happens again, you need to address the issue.

One way of addressing incontinence is to start looking at the circumstances around the involuntary loss of bladder control. Sonya Meyer, National Clinical Educator at MoliCare, suggests thinking about the lead-up to the episode and start keeping a diary. The idea is to take note of how many times it happens to see if it has turned into a recurring problem.

Remember to register in the diary:

• When it happened
• What you were doing beforehand
• Where you noticed it
• How much it was

Taking a closer look at the lead-up can help you determine what your triggers may be. Common scenarios could include picking up your three-year-old child or grandchild and noticing later in the bathroom that there’s been some leakage. If you experience bladder loss when picking things up, you could have stress incontinence (more about the different types later). If you had a sudden urge to go to the bathroom and didn’t have time to get there, this could also be a sign of incontinence. You may not necessarily have any accidents but you find that you have started planning your activities around going to the bathroom. Whilst this is not classed as incontinence if no accidents happen, it can be a lead up.

If you know you have an hour-long meeting scheduled and you pop into the bathroom just before to avoid any trouble, this could also be a case of urgency. In this scenario, you would still have an incontinence problem but you’d be managing it by going to the bathroom more frequently to empty your bladder. Some women may notice that they experience incontinence just before their periods, on account of the pelvic floor muscles relaxing during that time.

The Continence Foundation of Australia came up with this questionnaire to help you determine whether you have incontinence:

• Do you sometimes feel you have not completely emptied your bladder?
• Do you have to rush to use the toilet?
• Are you frequently nervous because you think you might lose control of your bladder or bowel?
• Do you wake up twice or more during the night to go to the toilet?
• Do you sometimes leak before you get to the toilet?
• Do you sometimes leak when you lift something heavy, sneeze, cough or laugh?
• Do you sometimes leak when you exercise or play sports?
• Do you sometimes leak when you change from a seated or lying position to a standing position?
• Do you strain to empty your bowel?
• Do you sometimes soil your underwear?
• Do you plan your daily routine around where the nearest toilet is?

Did you answer ‘yes’ to any of the questions? You may have incontinence.

Stress incontinence: Childbirth and pregnancy can weaken the pelvic floor muscles supporting the urethra, causing leakage during activities that put pressure on the bladder. During menopause, oestrogen is produced in lower quantities, this can affect the muscles allowing urine to pass through the urethra.

Urge incontinence: If you have a sudden and strong need to urinate, your bladder may be feeling fuller than it actually is. You may also hear this referred to as unstable or overactive bladder. The cause is not fully understood but it seems to become more common as we age. Stress, caffeine and alcohol seem to worsen the symptoms.

Chronic retention: If your bladder is unable to empty properly, it may result in frequent leakage of small amounts of urine.

Functional incontinence: When a person does not recognise the need to go to the toilet or does not recognise where the toilet is, they may not get to the toilet in time or pass urine in inappropriate places.

Faecal incontinence: This may mean you pass faeces at the wrong time. It could also be that you pass wind when you don't mean to or accidentally stain your underwear.

Even though incontinence can be quite common, it’s important to understand that it’s not normal and there's help available. No matter the cause, you can be treated, better managed and in some cases cured.

If you think you could have incontinence, the first thing to remember is that you're not alone. Talk to your doctor or a continence advisor about your symptoms, as they will not go away on their own and may worsen over time. A professional will be able to offer you a solution. The right products will help you gain back your confidence and manage the problem so you can carry on with everyday life as usual.