Skip main navigation

Separating continence promotion from managing incontinence

This article separates interventions and activities that promote continence (treatment) from those which manage incontinence (containment).
© Association for Continence Advice. CC BY-NC 4.0

Professor Jo Booth has developed the model below which separates interventions and activities that promote continence (treatment) from those which manage incontinence (containment).

Separating treatment from containment

Figure 1.1: Separating treatment from containment.

Key: SNS = sacral nerve stimulation; TTNS = transcutaneous tibial nerve stimulation; IUC = indwelling urethral catheter; SPC = supra-pubic catheter

Each of the segments in the figure broadly reflect the proportion of each type of treatment or containment intervention commonly found; so for example in the continence promotion model (on the left) the majority of effort is put into supporting the person to make lifestyle changes or use behavioural interventions such as teaching them pelvic floor muscle exercises, supporting dietary changes, or bladder training.

These types of ‘first-line’ activities are offered to all people who seek help for a bladder or bowel dysfunction because they support general bladder and bowel health and there is good evidence that they are effective treatments.

Fewer people will require, or benefit from, the interventions higher up the triangle, which represent second and third line interventions.

Your task

Reflect on what types of continence interventions you spend most time doing.

Do you most commonly promote continence or manage incontinence?

When you think about your own practice, do you think the balance is right? Should you try to change your practice? Make notes about any changes you feel would benefit your patients. You can revisit these notes when you have completed the course to decide if, and how you will make changes to your practice.

Don’t forget to capture your thinking in your learning log or portfolio.

© Association for Continence Advice. CC BY-NC 4.0
This article is from the free online

Understanding Continence Promotion: Effective Management of Bladder and Bowel Dysfunction in Adults

Created by
FutureLearn - Learning For Life

Our purpose is to transform access to education.

We offer a diverse selection of courses from leading universities and cultural institutions from around the world. These are delivered one step at a time, and are accessible on mobile, tablet and desktop, so you can fit learning around your life.

We believe learning should be an enjoyable, social experience, so our courses offer the opportunity to discuss what you’re learning with others as you go, helping you make fresh discoveries and form new ideas.
You can unlock new opportunities with unlimited access to hundreds of online short courses for a year by subscribing to our Unlimited package. Build your knowledge with top universities and organisations.

Learn more about how FutureLearn is transforming access to education