Incontinence

Summary

Incontinence, that is the uncontrolled voiding of urine or faeces (or both), is a common problem which, contrary to many assumptions, is not restricted to the extremes of the lifespan. Amongst children it is more common in boys (see ‘Enuresis’), but at all other ages it is more prevalent in women. Widely quoted UK figures put the prevalence of urinary incontinence at about 1.6% of men and 8.5% of women in the age range 15–64 while the corresponding figures for those aged over 65 are 6.9% and 11% respectively (Thomas et al., 1980). Figures from a postal survey into faecal or double (i.e. faecal and urinary) incontinence carried out by the same team (Thomas et al., 1984) suggest prevalences of 4.2% and 1.7% for men and women respectively in the age range 15–64 and 10.9% and 13.3% for men and women older than 64. However, precise figures are very difficult to obtain and many cases go unreported because of shame and embarrassment (incontinence has been dubbed ‘the last taboo’) or because many believe that some degree of incontinence is part of the normal ageing process or the inevitable consequence of childbirth. All too many cases only come to light during the course of investigation of some other condition that requires attention. Predictably the incidence of both urinary and faecal incontinence is very much higher amongst elderly institutionalized individuals. This is hardly surprising as incontinence is one of the major factors that leads to institutionalization in this section of the population.