Incontinence is a loss of control of a person's bowels or bladder which can cause accidental leakage of body fluids and waste. Incontinence can be more than a physical problem. It can disrupt your quality of life if it’s not managed well.
Fear, anxiety, and anger are common feelings for people dealing with incontinence. You may avoid being intimate or having sex because you are afraid of urine, gas, or stool leakage. Fear of having an accident may keep you from being physically active, enjoying hobbies, or spending extended time outside your home.
Anyone can have incontinence during and after surgery or some other treatments for cancer. Incontinence can also occur because of other non-cancer medical conditions. Be sure to talk to your health care team if you have difficulty controlling urination or bowels. Talking about incontinence can be embarrassing, but being open and honest with your health care team can help manage it.
Having accidental loss, leaking, or dribbling of urine is called bladder or urinary incontinence.
People might describe bladder incontinence as:
People with cancer, especially those who have certain types of cancer or who are getting certain kinds of treatment, might have an increased risk for bladder incontinence because of factors such as:
Bladder incontinence is more common in women than in men. Other than the possible causes listed above, some things that may increase risk of bladder incontinence in women are:
Other than the possible causes listed above, some things that may increase risk of bladder incontinence in men are:
Not all types of bladder incontinence are the same. The most common types of incontinence are:
Stress incontinence happens when the muscle that squeezes the urethra to keep urine in the bladder is weak or damaged, if the nerves that help the muscle work have been damaged, or if there have been other changes to the muscle or the tissues around it due to surgery or treatment for cancer. (The urethra is the tube that carries urine from the bladder out of the penis or vagina) . The muscle that squeezes to close it is called the urethral sphincter.
Stress incontinence may cause you to leak urine when you cough, laugh, sneeze, lift heavy objects, or exercise. You may sleep through the night without having to get up to go to the bathroom, but leak when you get up in the morning. Making a point of going to the bathroom more often is a way to handle stress incontinence.
When the bladder has a hard time emptying like it should, and more urine is made than it can hold, it’s called overflow incontinence. Overflow incontinence is usually caused by a blockage or narrowing caused by scar tissue. It also may happen when the bladder muscle can’t squeeze well enough to get all the urine out.
Signs of overflow incontinence might be getting up often during the night to go to the bathroom, taking a long time to urinate, or having a weak, dribbling stream with little force. You might pass small amounts of urine but not feel empty. Or you may feel like you have to go to the bathroom but cannot. You might leak urine throughout the day.
Urge incontinence is also called overactive bladder. The bladder muscle contracts (squeezes) too often, usually suddenly and without warning, and you can’t control it. This can be caused by a bladder infection or irritation from radiation therapy.
In this type of incontinence, even a small amount of urine in the bladder can trigger a strong need to pass urine. Because you can’t hold a normal amount of urine, you go to the bathroom a lot and may wet yourself if you don’t get there right away. You might feel as if you have a weak bladder, or that liquids go right through you. You might even wet the bed at night.
Sometimes urinary incontinence can last a short time, depending on what's causing it. But sometimes incontinence can be long-term and uncomfortable, making some everyday activities difficult to manage.
Your health care team will ask you questions to determine the type of bladder incontinence you might have. Then, you might need tests to verify the type and learn the cause of it which will help them know the best way to manage it.
Having accidental stool or gas leakage is bowel incontinence (also known as fecal incontinence). Bowel incontinence can be caused by weak pelvic floor muscles from surgery, other trauma that causes muscle injury, nerve damage, or different medical conditions. People who have bowel incontinence might not have an urge to pass gas or stool, or might not be able to reach the toilet in time.
People might describe bowel incontinence as:
Both men and women with cancer, especially those who have certain types of cancer or who are getting certain kinds of treatment, might have an increased risk for bowel incontinence because of factors such as:
For women, a common risk factor for women is vaginal childbirth, which stretches pelvic muscles, tissues in the vagina , and the anal sphincter (this muscle controls the movement of gas and stool in the body).
Testing for bowel incontinence can be done with lab tests, endoscopy, x-ray, MRI, or ultrasound. Doctors may also use muscle strength or nerve testing (bowel function tests) or digital rectal exam. In women, a pelvic exam may be used. Your health care team may also ask about your symptoms, medical history, medication and diet (alcohol or tobacco use, or if certain foods make your incontinence worse).
You can help manage bowel incontinence by following a bowel care plan and using the toilet before you leave home. You can also make sure you carry your medications, supplies, fecal deodorants, and a change of clothes with you.
Anal discomfort, itching, and irritation can be common. Here are some ways to help manage these symptoms:
There is no single, right way to cope with bladder or bowel incontinence. The challenge is to find what is best for your situation, so you can get the help you need and return to a normal daily life. Talk with your health care team if you notice a change in bowel or bladder habits, and about the best ways to manage incontinence, if it is a problem. You might find it helpful to talk with other people who are dealing with incontinence, too. Ask a member of your cancer care team about support groups in your area.
Here are some things you can do that may help make incontinence less of a problem:
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
Bedretdinova D, Fritel X, Zins M, Ringa V. The effect of urinary incontinence on health-related quality of life: Is it similar in men and women? Urology. 2016;pii: S0090-4295(15)01186-3.
National Institute of Diabetes and Digestive and Kidney Diseases (NIH). Bladder control problems (urinary incontinence). Accessed at https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems on September 17, 2019.
U.S Department of Health and Human Services, Office on Women's Health (OWH). Urinary incontinence. Accessed at https://www.womenshealth.gov/files/documents/fact-sheet-urinary-incontinence.pdf on January 3, 2020.
Wound Ostomy and Continence Nurses Society (WOCN). Reversible causes of acute/transient urinary incontinence: A guide for patients. 2016. Available through https://www.wocn.org.
Last Revised: February 1, 2020