Breaking the silence on urinary incontinence

Urinary incontinence is a reality for one in three women - yet it’s a condition few feel comfortable talking about, often one hidden behind stigma, silence, and misinformation.

As a urologist at Mater Private Network in Cork, I see first-hand the emotional, social, and physical toll this condition can take on individuals.

It’s time we normalised the conversation and empowered people to seek the help that can significantly improve their quality of life.

What is urinary incontinence?

Urinary incontinence is the involuntary loss of bladder control. It can range from the occasional leak when you laugh or cough, to a sudden, urgent need to urinate that’s difficult to control. While this condition is common, particularly among women, it’s not something anyone should have to accept as a ‘normal’ part of ageing or motherhood.

There are two main types of urinary incontinence:

Stress incontinence, caused by weakened pelvic floor muscles or a weak urethral sphincter. Activities like coughing, sneezing, or exercising can result in urine leakage. Urge incontinence, caused by an overactive bladder, which creates a sudden, intense urge to urinate followed by involuntary loss of urine.

Many people experience a combination of both, known as mixed incontinence.

What causes it?

Urinary incontinence can result from a variety of causes. In women, pregnancy, childbirth, and menopause are common contributors. These events can stretch or weaken the pelvic floor muscles and tissues that support the bladder. Previous pelvic surgery, such as hysterectomy, also increases the risk.

In men, prostate issues — including an enlarged prostate or treatments for prostate cancer — are significant factors. Neurological conditions like multiple sclerosis, spinal injuries, or stroke can also interfere with nerve signals between the brain and bladder.

Other risk factors include ageing, obesity, chronic constipation, smoking, and a family history of bladder problems.

A common problem that’s rarely discussed

Urinary incontinence is much more common than people realise. Despite affecting one in three women at some point in their lives, research shows that, on average, women wait over six years after developing symptoms before seeking help — and only 10 to 20% pursue treatment at all.

The main reason? Stigma.

Many people are too embarrassed to talk about it, even with their GP. There’s a societal discomfort around bladder issues, and this silence only worsens the sense of isolation many feel. People often assume there are no effective treatments available — but that simply isn’t true.

Mental health impact

The stigma surrounding incontinence doesn’t just prevent people from getting treatment — it can also deeply affect mental health. Incontinence is strongly linked to reduced self-esteem, increased anxiety and depression, and can have a ripple effect on relationships, employment, and overall life stability. Many people with incontinence symptoms report feelings of powerlessness and a loss of agency over their own bodies. If you are struggling with your mental health as a result of urinary incontinence, please know that you are not alone — and support is available, both for the physical condition and the emotional toll it takes.

What can be done?

The first step is speaking to your GP, who can refer you to a specialist. Treatment is highly individualised and starts with a thorough assessment to understand the cause and type of incontinence. From there, we can develop a personalised plan.

Treatment options may include:

• Lifestyle modifications: Weight loss, fluid management, and avoiding bladder irritants such as caffeine.
• Pelvic floor physiotherapy: Strengthening exercises can make a significant difference.
• Medications: For overactive bladder or urge incontinence.
• Minimally invasive procedures or surgery, depending on the severity and underlying cause.

We work closely with patients to explain all options clearly and support them at every step.

Impact on men

Although more commonly associated with women, incontinence also affects a significant number of men — particularly as they age. Conditions like an enlarged prostate, prostate cancer treatments, and neurological issues can all lead to incontinence. Sadly, many men are reluctant to seek help due to embarrassment or the false belief that nothing can be done.

At Mater Private Cork, we routinely treat male patients with tailored interventions that restore confidence and control.

Let’s break the silence

Urinary incontinence is a medical condition — not a personal failing — and there are real, effective treatments available. For me personally, my work is not just about treating the symptoms, but the whole person. That includes recognising the emotional burden incontinence can place on a person.

If you or someone close to you is living with urinary incontinence, know that you are not alone — and more importantly, that help is available. Speaking to your GP is an empowering first step toward reclaiming your confidence, health, and quality of life. Meaningful relief and recovery can be a reality.

We just need to make room for more open conversations, better understanding, and compassionate solutions.