Is incontinence inevitable and normal?

Is incontinence inevitable and normal? The short answer is no.

Unfortunately, many people wrongly believe that as we age or following childbirth we should expect to develop urinary incontinence.

Older people and also their caregivers may consider urinary incontinence to be part of normal ageing — inevitable, irreversible and a sign of incompetence^[1].

This false belief leads to stigma and is one of the main reasons why so few people seek help when they experience leakage.

Other reasons include a lack of knowledge of the condition and of available treatments. Many people do not see treatment of incontinence or lower urinary tract symptoms (LUTS) as appropriate to bother their GP with^{[2, 3]}.

Should incontinence be investigated?

Incontinence is not normal and should always be investigated to find the cause.

While LUTS and incontinence are more common in older people, it is neither normal or inevitable and …

‘The notion that bladder symptoms are an irremediable consequence of ageing is nonsense. We should be treating these problems in older people with energy because the results can be truly remarkable.’ James Malone-Lee^[4].

References

_{1. Mitteness LS, Barker JC. Stigmatizing a ‘normal’ condition: urinary incontinence in late life. Med Anthropol Q. 1995 Jun;9(2):188-210. [Cited 30 July 2018] Available from: https://doi.org/10.1525/maq.1995.9.2.02a00050}

_{2. Shaw C, Tansey R, Jackson C, Hyde C, Allan R. Barriers to help seeking in people with urinary symptoms. Family Practice 2001;18:48–52. [Cited 30 July 2018] Available from: https://doi.org/10.1093/fampra/18.1.48}

_{3. Booth JM, Lawrence M, O’Neill K, Mcmillan L. Exploring older peoples’ experiences of nocturia: A poorly recognised urinary condition that limits participation. Disability and Rehabilitation. 2009;32:9;765-774. [Cited 30 July 2018] Available from: https://doi.org/10.3109/09638280903295425}

_{4. Malone-Lee J. Chap 78. Know that incontinence is not inevitable. Improving later life. Understanding the oldest old. Age UK. 2013; 78-79. ISBN 978-0-9568731-6-3. [Cited 30 July 2018] Available in PDF format from: https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/reports-and-briefings/health–wellbeing/rb_feb13_understanding_the_oldest_old_improving_later_life.pdf}

_{5. Our story, life with adult incontinence. Always UK YouTube channel. [30 Jun 2016; cited 24 August 2018] Available from: https://youtu.be/2h4e3iIQHvc}

_{Ellesworth P, Marschall‐Kehrel D, King S, Lukacz E. Bladder health across the life course. Int J Clin Pract. May 2013;67;5;397–406. [Cited 30 July 2018] Available from: https://doi.org/10.1111/ijcp.12127}