We’re talking about something most people are loath to discuss, even with their doctors: urinary incontinence.
As many as 30 per cent of people over 65 have one or more of the three forms of urinary incontinence. Although women are far more likely than men to experience incontinence, by the age of 80, the gender disparity disappears. Urinary incontinence is not just embarrassing; it can affect your entire quality of life, leading you to cut out activities and friends you love and even changing the way you feel about yourself.
But here’s the thing: leaking urine and sudden strong urges to urinate aren’t conditions you have to live with simply because you’re getting older. There are excellent medical and lifestyle treatments for incontinence. The first step, however, is admitting you have a problem and contacting your doctor or nurse.
Together, the two of you need to work out what type of incontinence you have. There are three main types – urge, stress and overflow – although you can have more than one at a time, in which case it’s called mixed incontinence.
With stress incontinence, you involuntarily leak urine when you laugh, run, sneeze, cough or otherwise exert yourself. This is by far the most common form and occurs especially in women, often because of childbirth. If the pelvic floor muscles (which hold everything in your reproductive area in place) become weak, stretched or otherwise damaged during pregnancy or labour, stress incontinence often occurs. But men aren’t off the hook. Stress incontinence is often their cross to bear after prostate surgery.
This is the second most common form in men. It occurs when something blocks the urethra, the tube leading from the bladder to the outside of the body. In men, the blockage is most often caused by an enlarged prostate, medically known as benign prostatic hyperplasia (BPH). With BPH, your prostate pinches the urethra closed like a clamp would pinch a garden hose. Pressure builds up until urine finally leaks out without your voluntary assistance. Don’t be embarrassed about BPH: it’s the most common health problem in men aged 60 and above.
In this form of incontinence, the urge to go strikes as suddenly as a summer storm – and often with similar flooding. Urge incontinence can occur if you have a central nervous system condition such as Alzheimer’s or Parkinson’s disease or have had a stroke. It may also be related to increased sensitivity of your bladder muscles to a brain chemical called acetylcholine, which stimulates the bladder into action.