Frequently asked questions about Incontinence

Urinary leakage can happen for many reasons, though commonly urinary incontinence occurs when the muscle or the nerve that controls your bladder doesn’t work properly. Common causes included:

• Weakened pelvic floor muscles from childbirth or aging,
• Overactive bladder muscles,
• Prostate issues in men, 
• Urinary tract infections, or
• Nerve damage from conditions like diabetes or spinal injuries.^1,8,9

If you’re experiencing leaking or urgency, it’s important to speak to a healthcare professional to find the cause and get the right treatment.

Managing urinary incontinence often starts with lifestyle changes and non-surgical treatments. Common first steps include reducing caffeine and alcohol, maintaining a healthy weight, pelvic floor exercises, bladder training programs and prescription medications.⁸ If these treatments do not provide enough relief, advanced therapies such as Axonics Sacral Neuromodulation, urethral bulking agents or artificial urinary sphincters may be recommended by a specialist.⁸

In Australia and New Zealand, several healthcare professionals can help diagnose and treat urinary incontinence:

• General Practitioner (GP): your first point of contact for assessment and initial management
• Urologist: A specialist in urinary tract conditions
• Gynaecologist: specialises in female pelvic floor disorders
• Physiotherapist: provides non-surgical treatment and muscle training

Your GP can refer you to a specialist who can inform you on treatments like urethral bulking, advanced therapies like Axonics Sacral Neuromodulation or surgery such as an artificial urinary sphincter. Starting the conversation early can help you access the right care and improve your bladder health.

Faecal incontinence, also known as accidental bowel leakage, can have several underlying causes affecting the muscles and nerves that control bowel function. Common causes include weakened pelvic floor muscles, damage to the anal sphincter muscles, nerve damage and chronic constipation or diarrhoea.^{4, 13}

Yes, bowel incontinence is treatable. Treatments range from lifestyle changes and dietary modifications to pelvic floor exercises, medications and advanced therapies such as Axonics Sacral Neuromodulation.^{4, 13}

In Australia and New Zealand, several healthcare professionals can help diagnose and treat faecal incontinence:

• General Practitioner (GP): your first point of contact for assessment and referral
• Gastroenterologist: a specialist in digestive system conditions
• Colorectal Surgeon: treats structural and surgical bowel conditions
• Physiotherapist: provides non-surgical treatment and muscle training

Your GP can refer you to a specialist who can inform you on treatments like Axonics Sacral Neuromodulation or surgery, seeking help early may help improve symptom control.

Urethral bulking agents are a minimally invasive treatment option for women with stress urinary incontinence (SUI). They are injectable materials placed into the wall of the urethra to help improve closure and reduce leakage during physical activity.^{18, 19}  Urethral bulking may be suitable if you experience bladder leaks:

• When coughing, sneezing, or exercising,
• Prefer a non-surgical or minimally invasive option
• Have not had success with pelvic floor exercises or other treatments

A specialist consultation may help assess whether this treatment is appropriate for your symptoms.

A urinary bulking procedure is a quick, minimally invasive treatment usually performed as a day procedure. During the procedure:

• A small camera (cystoscope) is inserted into the urethra
• The bulking agent is injected around the urethra using a fine needle 
• The process typically takes about 10-15 minutes 

The procedure is commonly performed under light sedation, and is usually completed as a day procedure.^{17, 19}

Most patients experience little discomfort during the procedure, as local anaesthetic or light sedation is commonly used.¹⁹ Your healthcare team will provide advice on managing any discomfort and what to expect during recovery.

Recovery after urinary bulking is typically quick. Research shows that recovery is typically quick with the majority of women able to resume normal daily activities within 24 hours following treatment, depending on their doctor's advice.¹⁹

Yes. Urethral bulking agents may be considered for women who continue to experience stress urinary incontinence following previous treatment, including a midurethral sling procedure.¹⁹

Sacral Neuromodulation (SNM) is used for the treatment of bladder and bowel control problems such as:

• Overactive bladder (OAB),
• Urinary incontinence (leaking urine),
• Urinary retention (difficulty emptying bladder), and 
• Faecal incontinence (accidental bowel leakage)

SNM is typically considered for individuals who have not achieved adequate relief from conservative treatments^22,23. A specialist can assess whether SNM is an appropriate next-step treatment to help you manage your bladder or bowel condition. 

Axonics Sacral Neuromodulation (SNM) Therapy is an implantable therapy that works by delivering gentle electrical stimulation to the sacral nerves involved in bladder and bowel control.²² ²³ SNM offers a discreet, long-term²² treatment option for people with bladder or bowel control issues and may reduce symptoms such as:

• Urgency (a sudden and intense need to void)
• Frequency (increased frequency of urination or defecation)
• Leakage (involuntary loss of urine or faeces)
• Retention (difficulty emptying the bladder or bowels)

Axonics SNM Therapy provides gentle stimulation to the nerves that control bladder and bowel function, helping restore normal communication pathways between the brain, bladder and bowel.^{22, 23} These signals help modulate nerve activity involved in bladder and bowel function. A trial phase is usually performed first to assess how well the therapy works, before long-term implantation. 

No. Sacral Neuromodulation Therapy is not a cure; however, it is a clinically proven long-term therapy that may provide significant symptom relief for many patients²². Many patients experience relief, including:

• Reduction in leakage episodes
• Improved bladder and/or bowel control
• Better quality of life and confidence

Results vary between individuals; speak to your healthcare professional to understand what outcomes you can expect from SNM therapy.

Axonics SNM Therapy offers a choice between recharge-free and rechargeable systems. Depending on the device selected and therapy settings, battery longevity ranges from approximately 17 years to more than 20 years²³. Regular follow-ups with your doctor help maintain therapy effectiveness. Individual results may vary, ongoing care is important for lasting symptom control.

An artificial urinary sphincter (AUS) is an implantable device designed to treat male stress urinary incontinence, most commonly following prostate surgery.²⁴ The AUS has been available for more than 50 years as a treatment option for male stress urinary incontinence.²⁴

The AUS consists of three main components:

• Cuff: placed around the urethra to keep it closed and prevent leakage
• Pump: implanted in the scrotum, allowing you to control urination
• Reservoir: stores fluid that controls pressure in the system

These components work together to keep the urethra closed until urination is desired.²⁴

Many men experience substantial improvements in bladder control following AUS implantation, although individual outcomes vary and some leakage may still occur²⁴,²⁵. Individual results may vary and, your doctor will discuss what to expect based on your specific condition and help set realistic goals for your treatment.

The AUS is designed as a long-term treatment option, although revision or replacement procedures may be required over time.²⁴ Like any implanted device:

• It may require maintenance, revision or replacement over time due to normal wear
• Regular follow-up appointments are important to monitor performance

Your healthcare provider will guide you on long-term²² care and future procedures if needed.