Urinary Incontinence

The First International Conference for the Prevention of Incontinence, held in England in 1997, made a number of recommendations, including providing information to the public on healthy bladder habits, on when and how to seek help on supportive toilet training practices and attitudes by parents (and their effect on successful attainment of continence), as well as simply providing information that incontinence can be treated. Relatives of people with existing incontinence are likely a receptive group to target with information on treatment. For example, by age seven, 10 to 16 percent of boys and 5 to 15 percent of girls have bedtime incontinence (nocturnal enuresis). By age twelve, this prevalence is 5 percent in boys and 2 percent in girls. This benign delay in maturation will usually respond to appropriate advice on eating, drinking, regular daytime voiding, and reducing fluid intake later in the day.

For prenatal women, regular pelvic muscle exercises can improve the strength and function of the pelvic floor and may reduce the likelihood of postpartum stress urinary incontinence. Regulation of bowel function with diet, avoidance of constipation or straining during voiding also reduces the likelihood of stress incontinence or the falling down (prolapse) of the bladder or rectum into the vagina. Factors that contribute to maternal birth injury, such as childbearing in adolescent females (when pelvic growth is incomplete) and a lack of obstetrical services that can provide prompt Cesarean section, are potentially preventable.

In summary, urinary incontinence is a complex symptom that results from a variety of causes, requiring careful assessment of the type of incontinence and of contributing factors. Urinary incontinence will respond to a variety of measures. Generally, lifestyle and behavioral interventions, which are noninvasive, should be tried first. A positive message for those with incontinence who have never received assessment or treatment is that incontinence may be resolved, improved, or better contained in all sufferers.