incontinence follow up care

Overview

Incontinence is the loss of bladder or bowel control. Follow-up care means having regular check-ins with your healthcare team to monitor your symptoms, adjust treatments, and help you feel confident in your daily life. It is not just about check-ups – it is an ongoing partnership to make sure you stay as healthy and comfortable as possible.

Yes. Incontinence affects millions of people around the world. Many people do not mention it to their doctor because they feel embarrassed, but it is very common and treatable.

Incontinence can affect people of all ages. It is more common in women, especially after pregnancy or menopause, and in older adults. It can also occur in children and in people with certain medical conditions.

Symptoms

Common symptoms

• Leaking urine when you cough, laugh, sneeze, lift something heavy, or exercise
• A sudden, strong urge to urinate that is hard to control
• Frequent urination, including waking up more than once at night
• Leaking urine without any warning or during sleep
• Leaking stool or gas
• Discomfort or pressure in the lower abdomen

Symptoms in children

• Bedwetting past the usual age
• Daytime accidents after being toilet trained
• A frequent urgent need to go to the bathroom
• Constipation that may be linked to bowel leakage

Symptoms in older adults

• Weak urine stream or dribbling after urination
• Feeling that the bladder is not completely empty
• Urgency and accidental leakage before reaching the toilet
• Increased risk of urinary tract infections
• Bowel leakage or difficulty controlling gas

Causes

Main causes

• Weakened pelvic floor muscles from childbirth, surgery, or aging
• Overactive bladder muscles that push urine out too early
• Enlarged prostate or prostate surgery in men
• Nerve damage from conditions such as diabetes, stroke, or spinal injury
• Constipation that puts pressure on the bladder
• Urinary tract infections that cause temporary urgency

Risk factors

• Obesity or being overweight
• Smoking, which can cause chronic coughing and weaken tissues
• Heavy lifting or high-impact exercise
• Certain medicines that increase urine production or relax the bladder
• Family history of incontinence
• Advanced age

When to see a doctor

See a doctor urgently if:

• If you have pain when urinating
• If you see blood in your urine
• If you have fever, chills, or pain in your back or side
• If you suddenly cannot urinate at all

Book a routine appointment if:

• If you have any type of urine or bowel leakage that bothers you
• If you are ready to talk openly about your symptoms
• If you are being treated for incontinence and need to review how things are going
• If you notice no improvement after a few weeks of self-care strategies

Diagnosis

Your doctor will ask about your symptoms, how often they happen, and how they affect your life. You may be asked to keep a bladder diary, which is a simple log of when you drink, when you urinate, and when you leak. A physical exam may also be done to check the strength of your pelvic floor muscles.

Tests that may be done

• Urine test to check for infection or blood
• Bladder ultrasound or scan to see how much urine stays in the bladder after urinating
• Urodynamic testing, which checks how well your bladder stores and releases urine
• A pad test to measure how much leakage occurs
• If bowel incontinence is involved, your doctor may recommend a rectal exam or other bowel tests

What to expect at your appointment

Most tests for incontinence are simple and do not hurt. You may be asked to drink water so your bladder is full for an ultrasound. Some tests ask you to urinate into a special machine while sitting in private. Your doctor will explain each step and give you time to ask questions.

Treatment

Treatment for incontinence varies depending on the type and cause. Your plan may start with simple self-care strategies and pelvic floor exercises. If those do not help enough, your doctor can talk about medical treatments, devices, or procedures. Follow-up appointments help you track progress and adjust the plan.

Self-care at home

• Do pelvic floor muscle exercises (often called Kegel exercises) every day
• Practice bladder training – gradually increasing the time between trips to the bathroom
• Plan regular toilet visits, such as every 2 to 3 hours
• Reduce drinks that irritate the bladder, like caffeine, acidic drinks, and alcohol
• Drink enough water but spread it out through the day
• Maintain a healthy weight through diet and activity

Medical treatments

If lifestyle changes and exercises are not enough, your doctor may suggest medication to relax the bladder or tighten the pelvic floor muscles. There are also devices that can be inserted into the urethra or vagina to support the bladder. For some people, nerve stimulation therapy, which sends gentle electrical pulses to the nerves that control the bladder, can help. Your doctor will recommend options based on your specific situation and evidence from current guidelines.

When is surgery considered?

Surgery is usually only considered after other treatments have not helped enough. Procedures can support the bladder or urethra, treat an enlarged prostate, or address an overactive bladder. Your doctor will explain the benefits, risks, and recovery time of any surgery they recommend.

Living with this condition

Living with incontinence is easier when you have a plan. Carry a small bag with pads, wipes, and a change of underwear. Locate restrooms before you go somewhere new, and give yourself permission to use them whenever you need. Keep your skin clean and dry to reduce irritation.

Lifestyle tips

• Keep to a regular toilet routine
• Wear absorbent pads or protective underwear if they help you feel comfortable
• Exercise regularly, but avoid high-impact activities if they cause leaking – try walking, swimming, or cycling
• Quit smoking if you smoke, since coughing can make leaking worse
• Consider caffeine-free drinks if caffeine triggers urgency

Diet and exercise

A balanced diet with plenty of fiber helps prevent constipation, which can put pressure on the bladder. Drink enough water throughout the day, but try not to drink large amounts in a short time. Exercise strengthens your body and can help you maintain a healthy weight, which reduces pressure on the pelvic floor.

Mental health and emotional wellbeing

Incontinence can feel embarrassing and may cause anxiety, stress, or withdrawal from social activities. These feelings are normal and understandable. Talking about it with someone you trust can help. Remember that you are not failing – this is a medical condition, and getting the right follow-up care is the first step to feeling better.

Prevention

Not all types of incontinence can be prevented, but you can reduce your risk by keeping a healthy weight, exercising your pelvic floor muscles, avoiding smoking, and managing chronic cough or constipation. If you notice early signs, asking for help quickly can stop it from getting worse.

Complications

If left untreated

• Skin irritation and rashes from constant moisture
• Urinary tract infections that keep coming back
• Sleep disruption and tiredness
• Social isolation or low mood
• A fall or injury if you rush to the bathroom and slip

Long-term outlook

The outlook for incontinence is positive. Most people can significantly reduce their symptoms, and many become fully continent again with the right treatment plan. Follow-up care makes a real difference, so attend your appointments and share your progress honestly. You deserve to live with dignity and confidence.

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