Here is one of society’s “taboo” topics that we really do not like to talk about. So we will keep this article mercifully brief.

Urinary incontinence – the involuntary passing of urine – is common. It is thought to affect a third of adults over 60. Women are affected twice as often as men and the problem is more common (but not inevitable) as we age. Women who have had vaginal births are most at risk. Obesity and sedentary living and alcohol-abuse are all clear risk factors.

There are various types of incontinence, and many patients have mixed-cause incontinence. A full assessment that includes abdominal, rectal, and vaginal examination as well as some tests like ultrasound-imaging, will be needed to assess the situation. Treatment options include lifestyle changes, pelvic muscle exercises, medications, assistive devices (e.g. pessaries inserted vaginally) and surgery. Various absorbent pads (adult diapers) are often used. A family doctor is the best person to see initially, but referral to specialist urologists, gynaecologists, and others, is likely.

Treatment results are mixed, and a lot depends on the underlying cause as well as the patient’s general health. A combination of exercises, lifestyle changes, and surgery is often quite helpful.

The message here is simple: urinary incontinence is a distressing, important, and common condition. It causes much suffering and is among the main reasons for admission to institutional care in the elderly. It is something we should try to be less hesitant to discuss since it is very likely to affect us or those we care for, now or in the future.