A view of the past that can help us think differently about incontinence

Dr Claire L Jones

Senior Lecturer, University of Kent

Dr Kate McAllister

Research Associate, University of Kent

Researchers say it’s vital to understand how incontinence affected people in the past if we are to challenge the stigma that still surrounds the condition.

How common was urine incontinence in the past?

Dr Jones: It was more common in the 19th and 20th centuries than is recognised. In some instances, it was destroying lives. We uncovered the case of a 16-year-old in 1870 who had lost her job as a domestic servant because of her condition, and the man she wanted to be her husband wouldn’t marry her. Her parents took her to the doctor because they were worried she was going to end her life. So, although our historical research suggests that incontinence was particularly common among postpartum women and the elderly, it could affect anyone.

Dr McAllister: There were also many cases of young people aged 14–21 who were unable to work, marry or sleep because of debilitating incontinence. Records show the condition affected soldiers — men aged between 18 and 23 — in both World Wars, which often led to them being sent away from the frontlines.

How did incontinence-related stigmas arise?

Dr Jones: From the late 19th century, public conveniences became more common, and increasing numbers of houses had indoor bathrooms, so going to the toilet was more private. After the discovery of germs, incontinence was seen as unhygienic. Parenting manuals from the 1830s were explicitly shaming, describing children who wet the bed as ‘dirty’ and their mothers as a ‘disgrace’ for not toilet training them and not keeping the house urine-free.

Starting an open and frank conversation
can make people think differently
about ‘taboo’ topics.

What treatments were available?

Dr McAllister: It varied. Where the cause was functional, medicines, surgery and electrotherapy could be successful. One 19th-century electrical therapy involved passing a wire into the entrance of the urethra and then connecting it to an electrode. I read about one young woman who was treated effectively this way — but, for other patients, the method was described as ‘entirely useless.’

It’s a theme we see repeated in today’s treatments: they work for some, not all. Later, as the emphasis on the psychological causes of incontinence increased, therapy became a significant treatment. Enuresis alarms to prevent bed-wetting were introduced in the 1950s and are still used today.

Why does the history of urine incontinence matter today?

Dr Jones: There’s a view that if you can’t control your bodily functions, you’re somehow ‘deficient.’ We’re interested in uncovering how this stigma emerged so that it can be challenged. Starting an open and frank conversation can make people think differently about ‘taboo’ topics.