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Incontinence Information

Incontinence and Your DoctorIt’s important to realize that incontinence is a very common condition and can affect even the healthiest people. Nearly 3.3 million Canadians live with either urinary incontinence or bowel incontinence every day.

There are many potential reasons for incontinence, including prostate issues, stroke, cognitive impairment/dementia, or simply aging.

Depending upon the causes, incontinence may be permanent or temporary. An example of permanent incontinence could be a traumatic injury to the spinal cord, where it is no longer possible for the brain to send signals to the excretory organs. Temporary incontinence may be caused by medications such as diuretics. When the diuretic is no longer taken, the incontinence may disappear.

Since there are many causes and treatments for the loss of bladder and/or bowel control, we recommend seeking professional health care advice from your Doctor or a Continence Nurse to discuss the treatments and options.

 

Types of Incontinence

Stress Incontinence

Stress urinary incontinence is a slight leakage of urine, frequently occurring during coughing, sneezing, laughing or doing any form of physical activity, and is caused by weakened pelvic or sphincter muscles.

Symptoms include:

  • Bladder leakage with coughs, sneezes, or physical activity
  • Bladder leakage in small amounts without the sensation of urine loss  (drops, spurts)
  • No incontinence at night

 

Urge Incontinence

Urge incontinence is a sudden, involuntary emptying of the bladder, caused by the bladder contracting when it should not, often with little to no warning. This can be caused by urinary tract infection or by brain damage typical of a stroke.

Symptoms include:

  • Strong, uncontrolled urgency prior to incontinence
  • More frequency of urination
  • Incontinence at night more than 2 times
  • Urine loss on the way to the bathroom
  • Moderate to large amount of urine leakage (gush)

 

Overflow Incontinence

Overflow incontinence is a continual leakage of urine occurring when the bladder fails to contract when it should or the bladder becomes overfull because it cannot release urine due to obstruction of the urethra. This can occur as a side effect of certain medications or can be caused by constipation or an enlarged prostate gland.

Symptoms include:

  • Difficulty starting urine streams
  • Weak or intermittent stream (dribbles)
  • Post-void bladder dribbling
  • Prolonged bladder voiding
  • Feeling of fullness after bladder voiding
  • Voiding small bladder amounts often 

 

Functional Incontinence

Functional incontinence is any form of incontinence which prevents a person from reaching a toilet in time, and is usually associated with strong emotional states, psychiatric problems, poor mobility or physical barriers in the environment. There is no physical disorder, however psychiatric/ emotional problems or the physical inability to get to a toilet prevent normal continence.

Symptoms include:

  • Mobility/manual dexterity impairments (arthritis, tendonitis in hands)
  • Lack of toilet access
  • Medication usage (sedative, hypnotic, CNS diuretic, anticholinergic, alpha-adrenergic antagonist)
  • Pain with movements
 

Mixed Incontinence

Mixed incontinence is a combination of stress incontinence and urge incontinence.

 

Total Incontinence

Total incontinence is a constant loss of urine, resulting from a lack of sensation that a person needs to urinate. It’s most commonly caused by neurological disorders, spinal cord injuries, birth defects, severe trauma or senility.

 

Bowel Incontinence

Bowel incontinence is the inability to control bowel (fecal) movements, caused by an inability of the rectum to hold stool in the anus. Bowel incontinence is often caused by delayed damage from childbirth, complications from prior anus surgery, or constipation. Symptoms of bowel incontinence include:

  • Leakage of stool when passing gas
  • Watery or partial bowel discharge 
  • Complete bowel discharge 
  • Pain with bowel movements

 

Night-Time Incontinence 

Night-time incontinence, or enuresis in youth, may adversely affect one’s quality of sleep due to frequent episodes of waking for the individual. 

The use of inadequately absorbent or improperly fitted products that leak and do not wick fluid away from the skin to keep it dry can contribute to awakenings, discomfort, and may poorly affect the skin health of the wearer. The adverse effects of fragmented sleep include:

  • Behavioural changes
  • Decline in physical endurance
  • Listlessness
  • Anxiety
  • Depression
  • Knowledge deficits
  • Impaired mobility
  • Decreased physical, emotional, or cognitive abilities

If night-time incontinence or enuresis is a concern, consider specialized night-time products which are intended for extended wear or overnight use to reduce sleep disturbance.

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