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Common myths about incontinence

There are many myths circulating in the broader community about incontinence. Incontinence is a condition that it is not widely discussed in the community, amongst family, friends, colleagues, or professionals. It is also a topic, that individuals with this condition, struggle to even discuss with their general practitioner (GP). This lack of “broader” conversation around this condition, has led to many misconceptions being circulated and perpetuated. Here we address the myths. 

1. It only happens when one gets old

This is untrue. Incontinence can occur in children, adolescents, and adults of all ages (for various reasons). It is not a “normal” part of ageing. Certain aspects of our physiology can “predispose” many of us to a higher risk of incontinence, as we age. So, it does not “automatically” apply that one will become incontinent with ageing. Research that TENA have done over the years suggests that those affected are evenly spread with around 1/3 being between 10 and 30 another third over 30-60 and a third over 60. 

2. It is not related to an illness

This is untrue also. There are many illnesses that can cause incontinence at the onset of the illness or as the illness progresses. Common conditions are dementia, multiple sclerosis, stroke, spina bifida, downs syndrome, acquired brain injury, diabetes, and Parkinson’s disease. The degree of incontinence will vary with each condition and with the severity of impairment to the central nervous system, thus affecting bladder and/or bowel function.

See our Education and Knowledge section for more information on various causes on incontinence. 

3. It only happens to men with prostate problems or women who have had children

An enlarged prostate is not the only cause of incontinence. Certainly, many elderly men as they age, experience urinary urgency, nocturia or difficulty starting flow and cessation of their urine flow, as their prostate enlarges each decade. But many women also experience urinary incontinence, and some children and some adolescents (for a variety of behavioral or physiological reasons)

Many women can experience “stress” urinary incontinence due to changes that occur during pregnancy or post childbirth. Women have a shorter urethra and there is a lot of pressure on this structure during childbirth. Pelvic floor muscles can be weakened or damaged during childbirth and this can affect sphincter control also, and hence some incontinence. (Weakened pelvic floor muscles can also affect elderly men and contribute to stress incontinence)

“Overflow” urinary incontinence can occur when the bladder cannot empty completely and the gradually gets filled with residual urine. This happens mostly with an enlarged prostate that causes bladder outlet obstruction.

A “weak and overextended” bladder muscle that is unable to contract is another common cause of incontinence. This can in turn be caused by factors such as diabetic sensory neuropathy, herniated discs or spinal stenosis.

During menopause, the urethras supporting structures, muscles and connective tissue, can weaken due to hormonal changes. Constipation, obesity or a chronic cough can also contribute to stress incontinence in both sexes.

Incontinence can be a side effect of certain medications also. Some medications have a diuretic effect (eg frusemide) causing increased urination or can cause diarrhoea (eg metformin). If this becomes significant, it could lead to incontinence.

Also see our education and knowledge section here for more information on Dementia, diabetes, obestity, prostate cancer and incontinence. 

4. It can’t be fixed

Incontinence that is related to certain degenerative neurological diseases where the condition worsens over time (such as MS, dementia or Parkinson’s) will not be “cured” ( the incontinence will slowly worsen). Some individuals who experience a stroke may have incontinence at the onset, but it may improve or resolve with time. The severity of the incontinence is determined by the severity of the stroke and the location in the brain affected. With some neurological conditions, incontinence may/will not improve, such as spina bifida or an acquired brain injury.

Prostate surgery can improve incontinence in some men. Women that experience incontinence post childbirth or during menopause can improve the condition with pelvic floor exercises. The success will depend on the severity of damage/weakness to the pelvic floor. Surgery for women with a prolapse or men with a bladder outlet obstruction, can cure their incontinence or lessen it. Urinary symptoms can improve for women post menopause. In summary incontinence can be resolved in some conditions and not in others. 

5. Once you have it you just have to put up with it

This is a huge mis-conception in the broader community, which is why so many people do not seek help. A large number of women post childbirth, can experience stress incontinence for years or decades, before finally raising the issue with a health care professional or their GP. And many men can struggle with prostate issues and urinary symptoms for long periods before seeking help.

There are many options now available to those with urinary or feacal incontinence to either reduce symptoms or cure them. There is a wide range of therapeutic options on offer these days, and a proliferation of new drug treatments. Options could include pelvic floor exercises (assisted with devices or electrical stimulation) bladder retraining, revision of diet and fluid intake, scheduled toileting based on bladder patterns, urethral bulking agents, artificial urethral sphincters, various surgical treatments for a prolapsed bladder/uterus/rectum or an enlarged prostate, Botox (Botulinum toxin type A) injected into the bladder muscle for an overactive bladder, pessaries (a stiff ring that can be inserted into the vagina to prevent temporary leakage) or sacral nerve stimulation to activate the sacral nerves to control urge incontinence. There are also medications that can treat/minimise incontinence. So, in summary, for some types of incontinence it does not mean “you have to put up with it for life!” 

6. One can’t prevent it happening

This is untrue for less severe and “non- permanent” types of incontinence. In many cases it can be prevented by dietary and lifestyle habits. Read more here “Healthy Bladder Tips”. 

7. People seek help quickly for the condition

This is untrue. Market research conducted by TENA has found that it takes around seven years for a person with incontinence to seek help from a health care professional. This is due in part to the amount embarrassment associated with the condition and secondary, due to the lack of understanding about the condition, and that it can, in many cases, be treated and symptoms reduced or eliminated. Please see our advise on discussing incontinence with clients who may not want to bring up the topic. 

8. Pelvic floor exercises won’t help

This is untrue for the majority of persons with mild or moderate pelvic floor weakness due to hormonal changes, childbirth, trauma, or effects of ageing. These days there is a plethora of help available to learn about pelvic floor exercises. Persons with stress incontinence can be reviewed by a physiotherapist that has specialized in pelvic floor education and treatment. Certainly, education by an experienced physiotherapist or continence nurse specialist would be strongly advised. There are many phone App’s now available to make learning these exercises and doing them regularly, as easy as possible. See here for more information on pelvic floor exercises and treatment.

Pelvic Floor Exercises

To find a pelvic floor physio in Australia

To find a pelvic floor physio in NZ

Information about pelvic floor exercises and treatments- Victorian Continence Resource Centre 

9. Wearing a menstrual pad for incontinence is fine

This is a large misunderstanding by the broader public and this view is held by many. This is due to a lack of understanding about how continence and menstrual pads are designed. Menstrual products are designed to absorb the thick, slow flow of blood. They are made predominantly of fluff pulp, which means they are not designed to absorb urine.

Incontinence products are purpose-made to capture the thin, fast flow of urine. They contain Super Absorbent Polymer or SAP which expand to hold up to 50 times their own weight to lock the urine inside the pad. Incontinence products contain odour neutralising elements to remove odours, as well as a protective layer which helps to ensure the liquid is drawn down into the pad, leaving the wearer feeling dry and comfortable.

For more information on continence causes and kits to give to clients please join our TENA assist program via tenaassist.com for access to free samples, Dementia, diabetes and prostate kits and much more.

TENAassist.jpg

Dementia free kit

For more information

The Continence Foundation of Australia (CFA)
www.continence.org.au
National Continence Helpline 1800 33 00 66

The Continence Foundation of New Zealand
www.continence.org.nz
National Continence Helpline 0800 650 659

The Prostate Cancer Foundation Australia
https://www.prostate.org.au/

The Australian Government website - HealthDirect
https://www.healthdirect.gov.au/questions-to-ask-before-surgery

The Department of Health Australia
https://www.bladderandbowel.org

The Department of Health New Zealand
https://www.health.govt.nz/your-health

Treatment options for feacal incontinence
https://pubmed.ncbi.nlm.nih.gov/28267690/

Medications for incontinence
https://pubmed.ncbi.nlm.nih.gov/15686302/

Common medical treatment options
https://www.mayoclinic.org/diseases-conditions/urinary-incontinence/diagnosis-treatment/drc-20352814