Continence: The Practical To-Do List
Continence: what is worth doing, what is worth avoiding, and when to stop and see a doctor.
Bladder and bowel control, and the treatable conditions that affect it. It is extremely common, rarely mentioned, and treatable — and the usual response of drinking less makes it worse.
Key takeaways
- First-line for stress incontinence: supervised pelvic floor muscle training
- Minimum trial: at least 3 months
- Most useful single change: Ask for referral to a specialist continence service or physiotherapist.
- Commonest mistake: Drinking less to manage symptoms.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
Do
- Ask for referral to a specialist continence service or physiotherapist
- Do pelvic floor exercises daily for at least three months
- Treat constipation, which puts sustained pressure on the bladder
- Reduce caffeine and alcohol rather than total fluid
Do not
- Drinking less to manage symptoms
- Assuming incontinence is a normal part of ageing
- Relying on pads without seeking assessment
The numbers behind the list
Those two lists follow from the published figures here.
| Measure | Figure |
|---|---|
| First-line for stress incontinence | supervised pelvic floor muscle training |
| Minimum trial | at least 3 months |
| Bladder training | first-line for urgency |
| Reducing fluid | concentrates urine and worsens urgency |
| Caffeine and alcohol | common bladder irritants |
If you change one thing
Ask for referral to a specialist continence service or physiotherapist. If you only change one thing, make it that.
Where to go next
- Continence at a Glance
- Continence: Sorting the Evidence From the Noise
- Continence — the reference entry
- Staying Independent: What the Evidence Actually Says
- Nutrition in Later Life: Sorting the Evidence From the Noise
When to speak to a doctor
See a GP for any new incontinence, blood in the urine, pain on passing urine, or a feeling of something coming down in the vagina. Seek emergency care for sudden inability to pass urine, or for new incontinence with back pain, leg weakness or numbness around the groin — this can indicate nerve compression.
Where this comes from
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.
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