incontinence complications awareness

Overview

Incontinence means losing control of your bladder or bowel, so urine or stool leaks unexpectedly. When this isn't managed well, it can lead to health complications such as skin problems, urinary tract infections, and kidney damage. This article explains these risks and what you can do to stay healthy.

Yes, it is very common. Millions of people of all ages experience incontinence at some point in their lives. It affects both men and women, although it becomes more frequent with age.

Incontinence can affect anyone, but it is more common in older adults. Women may be affected more often because of pregnancy, childbirth, and menopause. Men with prostate problems, people with diabetes, and people with conditions that affect the nerves (such as stroke or spinal cord injuries) are also at higher risk.

Symptoms

Common symptoms

• Skin irritation, redness, or a rash where urine or stool leaks
• Burning or stinging when you urinate
• Frequent urinary tract infections
• Cloudy, smelly, or visibly blood-stained urine
• Persistent feeling of pressure or fullness in the bladder
• Worsening of bladder control

Symptoms in children

• Bedwetting after the age when it is usually expected
• Signs of pain or discomfort when urinating
• Sores or persistent nappy rash that does not heal
• Reluctance to use the toilet or socialise due to wetting accidents

Symptoms in older adults

• Sudden confusion or increase in confusion (which can be a sign of a urinary infection)
• Rashes, skin breakdown, or pressure sores from sitting in wet clothing
• More falls, especially at night when rushing to the toilet
• Loss of independence or withdrawal from social activities

Causes

Main causes

• Moisture from leaked urine or stool staying on the skin for long periods, causing irritation and infection
• Stagnant urine in the bladder that allows bacteria to grow
• Difficulty cleaning properly after an episode, especially with limited mobility
• Using absorbent products that are not changed often enough
• Underlying problems that caused the incontinence, such as a weak bladder, overactive bladder, or constipation

Risk factors

• Getting older
• Being female, especially after childbirth or menopause
• Being male with an enlarged prostate
• Having diabetes or high blood sugar
• Having had surgery or radiotherapy in the pelvic area
• Being constipated regularly
• Being immobile or bedbound
• Smoking or drinking heavy amounts of caffeine and alcohol

When to see a doctor

See a doctor urgently if:

• Any signs of a kidney infection (fever, chills, vomiting, back or side pain)
• Being unable to pass urine
• Sudden loss of bladder control with fever and feeling unwell

Book a routine appointment if:

• Any incontinence that is affecting your daily life
• Skin that is becoming sore, red, or broken down
• Recurrent urinary tract infections
• If you would like advice on products, bladder training, or exercises

Diagnosis

A doctor will ask about your symptoms and medical history, examine you, and look for signs of existing complications. They may ask you to keep a diary of your fluid intake and your urinary habits. They may also refer you to a specialist if needed.

Tests that may be done

• Urine test (urinalysis) to check for infection, blood, or sugar
• Urine culture to see what type of bacteria is causing an infection
• Blood tests to check kidney function
• Ultrasound of the kidneys and bladder to look at their structure
• Post-void residual scan to measure how much urine remains in the bladder after you go

What to expect at your appointment

Your doctor will talk you through each test as it is done. Most tests are simple and pain-free. You might need to give a urine sample or have a small ultrasound probe placed over your lower belly. After the tests, your doctor will explain what the results mean and help you make a plan.

Treatment

Treatment depends on the type of incontinence you have and the complications that have developed. The key goals are to manage the cause, protect your skin, treat any infections, and support you in daily life. A combination of lifestyle changes, bladder training, and professional therapies often works well.

Self-care at home

• Change wet pads, pads, or clothing promptly, and clean and dry your skin gently
• Use a barrier cream to protect the skin from moisture (ask your pharmacist which type is suitable for you)
• Drink enough water throughout the day to keep urine diluted (aim for about 6–8 glasses, unless your doctor advises otherwise)
• Avoid constipation by eating plenty of fibre and staying active
• Practise pelvic floor muscle exercises to strengthen the muscles that control urine flow
• Go to the toilet at regular intervals, even if you do not feel the urge

Medical treatments

Your healthcare team may offer behavioural therapies, such as bladder training, pelvic floor muscle training, and scheduling your toilet visits. If a urinary tract infection is present, they will give you appropriate medicines for the infection. They may also recommend other medicines to relax the bladder or reduce the urge to go. These are given based on the exact cause and your overall health. A physical therapist or continence nurse may give you personalised advice.

When is surgery considered?

Surgery is not the first option. It is only considered when other treatments have not worked or when there is a clear structural problem. Examples include procedures to lift the bladder, support the urethra, or insert a small device that helps the bladder neck stay closed. A specialist will explain the benefits and risks before you decide.

Living with this condition

You can still have an active, full life. Plan ahead by carrying extra supplies, knowing where toilets are, and using waterproof mattress protectors at home. Try to empty your bladder regularly and take your time. If you have carers, make sure they know how you like to be assisted.

Lifestyle tips

• Maintain a healthy weight to reduce pressure on your bladder
• Quit smoking, as smoking can make coughing worse and irritate the bladder
• Limit caffeine and alcohol, which can make you urinate more
• Keep moving with gentle activities like walking, as long as your doctor agrees
• Manage conditions like diabetes or prostate problems carefully

Diet and exercise

A balanced diet with plenty of fruits, vegetables, and whole grains helps prevent constipation, which can put pressure on the bladder. Aim for 6–8 glasses of fluid a day, but avoid drinking large amounts all at once. Regular pelvic floor exercises can make a real difference if you do them consistently.

Mental health and emotional wellbeing

Living with incontinence can be distressing. It may lead to embarrassment, worry about smells or accidents, and avoiding social situations. Over time, this can affect your mood and self-esteem. It is important to know that these feelings are normal and that you are not alone. Talk to your doctor, a trusted friend, or a counsellor if you are feeling down. If you are ever having thoughts of self-harm or in crisis, please reach out to your local crisis service or call your local emergency number immediately.

Prevention

It may not always be possible to prevent incontinence itself, but you can definitely reduce the risk of complications. Effective management, good hygiene, and treating infections early are the most important steps. Staying active, having a healthy diet, and maintaining a healthy weight also help.

Complications

If left untreated

• Recurrent urinary tract infections
• Damage to the kidneys from repeated infections or backflow of urine
• Skin infections and chronic sores or pressure ulcers
• Falls and fractures from rushing to the toilet
• Social isolation and depression
• Rarely, life-threatening sepsis

Long-term outlook

With the right support and care, most complications of incontinence can be treated and many can be fully avoided. Many people see great improvement in their symptoms. The most important thing is to talk openly with your healthcare provider and follow a plan that works for you. You are not alone, and there is always a path forward.

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