Total Incontinence: the loss of control

Incontinence can vary in its severity depending on the condition or cause, from short term to a life changing long term problem.

Total incontinence is described as the continuous and total loss of urinary control. This type of incontinence is regarded as the most severe, with symptoms being constant and uncontrollable. Many of those living with total incontinence will need to urinate constantly, throughout the day and night.

There are a few causes and conditions which can lead to total incontinence:

  • A bladder defect from birth: abnormalities in the bladder can cause some people to be incontinent from birth. Bladder exstrophy, a condition which occurs when the skin over the lower abdominal wall (bottom part of the tummy) does not form properly, this results in the bladder forming open and exposed outside of the abdomen. Due to this abnormality the bladder cannot perform to full capacity, and in turn causes the person to be incontinent. Other birth defects include Hypospadias (a birth defect of the urethra in the male where the urinary opening is not at the usual location on the head of the penis) and obstructive defects of the renal pelvis (the area at the centre of the kidney where urine collects).

  • Damage to spinal cord: either through injury or a degenerative disease, such as Muscular Sclerosis (MS), or damage to the spinal cord can lead to symptoms of total incontinence.

    • MS is a condition which can affect the brain and/or spinal cord. This lifelong condition can bring with it a wide array of potential symptoms, such as visual impairment, difficulty moving limbs and incontinence.

      There are two bladder problems which can occur because of having MS: the problem of storing urine or the problem of emptying the bladder. Some people will experience the need to urinate frequently, due to the nerve pathways in the spine being interrupted. Even the smallest amount of urine can cause the bladder to contract, which can result in overflow incontinence. Urinary tract infections are a widespread problem found in those with MS.

    • Spinal Cord Injuries (SCI) can be caused by any accident or incident where the spinal cord is damaged to such an extent that it can no longer function to its full capacity. These injuries can be temporary or permanent depending on the level of damage that has been done. Those with permanent damage to their spinal cord will find themselves incontinent for life.

  • A bladder fistula: also known as Vesicovaginal Fistual, is a condition which only affects women, a bladder fistula is a small hole which appears between the bladder and the vagina. As a result, women with this condition can experience constant urinal leakage.

  • Neurogenic: those whose symptoms are less severe will find that incontinence pads and/or pants can be sufficient treatment to avoid urinal leakage. For those that cannot rely solely on incontinence pants or pads, catheterisation is one of the most common treatments. You can read more about catheters and their uses here.

Although there is no cure for total incontinence, pads, pants and catheters can help you manage your symptoms and as such allow you to live life more comfortably.

If you are living with a condition which is causing you to experience symptoms of total incontinence and you have questions you need answering, please visit our talkbladder forum where our growing community can help.

Sources used in writing this article are available on request

Information contained in this Articles page has been written by talkhealth based on available medical evidence. Our evidence-based articles are certified by the Information Standard and our sources are available on request. The content is not, though, written by medical professionals and should never be considered a substitute for medical advice. You should always seek medical advice before changing your treatment routine. talkhealth does not endorse any specific products, brands, or treatments.

Information written by the talkhealth team

Last revised: 18 March 2018

Next review: 18 March 2021