Almost half (45%) of all people with incontinence wait at least five years before they get help, according to Karen Logan, a consultant continence nurse at Gwent Healthcare NHS Trust.
"There's a huge stigma around incontinence, despite it being so common," she says. "I would urge anyone with symptoms to come forward, as it's more than likely that we can sort out the problem and really improve their quality of life."
You should get help if you've had incontinence problems for more than a few weeks to rule out conditions such as diabetes.
Incontinence help from your GP
Your GP can assess whether you have incontinence and decide which type of incontinence you have.
They can also:
If lifestyle changes and treatments don't solve the problem, your GP can refer you to a continence adviser or specialist.
Continence clinics
Continence clinics can be based in a hospital or in the community, often attached to a health centre. They have specialist teams providing support and medical advice for people with bladder or bowel incontinence.
You don't need to be referred by your GP and can phone them directly to make an appointment.
"If you prefer not to see your GP, these are an excellent alternative first stop for diagnosis and treatment," says Logan. "We can significantly improve life for 75-80% of the people who come to us with incontinence problems."
On your first visit, a continence adviser, usually a nurse who specialises in bowel and bladder problems, will assess you and explain your incontinence treatment options.
Continence advisers, and the incontinence physiotherapists who work alongside them, are particularly good at teaching pelvic floor exercises to women with sudden leaks (stress incontinence).
For women with regular urges to use the toilet (urge incontinence), they can provide bladder training.
They can also supply pelvic floor-strengthening devices – such as vaginal cones, and continence pads and products – and explain how to use them.
Call your local hospital for details of your nearest NHS continence clinic.
The hospital incontinence specialist
If the help offered by your GP or local continence clinic doesn't work, you can be referred to a hospital urologist or urogynaecologist for tests and possible incontinence surgery.
If you have bowel incontinence, you may be referred to a colorectal surgeon or gastroenterologist.
According to Karen Logan, only 10-15% of patients who attend continence clinics have to be referred for surgery.
If you decide to have surgery, it's important that your surgeon has the necessary skills and training.
Check that they're trained in surgery for incontinence and have done these operations often enough to keep their skills up-to-date.
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