Urinary incontinence (UI) affects approximately 1-4% of adolescents and is often associated with a diminished quality of life and significant emotional distress. Despite its prevalence, UI often goes unspoken due to feelings of shame and stigma during the critical period of identity formation and peer acceptance that is adolescence. 
The purpose of this study is to explore the psychosocial factors and daily challenges that influence the well-being of adolescents with UI in order to inform future targeted interventions.

A qualitative secondary analysis was conducted using a phenomenological approach. Data were synthesized from 25 semi-structured interviews comprising a multi-informant sample including adolescents (n = 12), healthcare professionals (n = 11), and parents (n = 2). Braun and Clarke’s six-phase deductive thematic framework was used for data analysis, and triangulation was employed to ensure a comprehensive understanding of the relationships between stigma, coping mechanisms, and mental health.

The findings suggest that UI establishes a habitual routine involving environmental barriers, such as restrictive school bathroom policies and inadequate facilities. These barriers can lead to maladaptive coping strategies, including intentional fluid restriction. Both adolescent and parent participants reported high levels of perceived and internalized stigma. 
A link was also identified between stress and UI. Periods of high stress, such as exam weeks in school, were connected to an increased number of incontinence accidents reported by adolescents. However, experiences of enacted stigma, such as bullying, were infrequent among the adolescent participants. Peer support emerged as a critical protective factor. Despite these challenges, many adolescents demonstrated resilience by engaging in cognitive reframing and integrating their condition into their self-identity.

The psychosocial effects of UI during adolescence often surpass the condition's physical symptoms, which are largely influenced by environmental factors and concerns about social judgment. Future intervention strategies should take a holistic approach that employs digital health tools to raise awareness of bladder health and promote peer support. Involving adolescents in developing these interventions and advocating for incontinence-friendly school environments can improve coping strategies and reduce the long-term impact of UI on mental health and autonomy.

The main findings suggest that the impact of UI extends well beyond clinical symptoms. UI often manifests as a persistent state of heightened alertness and perceived stigma, as described by adolescent participants.

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Continence 19S (2026) 102729
DOI: 10.1016/j.cont.2026.102729