Frequently Asked Questions On Incontinence
Incontinence can either be temporary and chronic. Temporary incontinence is commonly caused by:
- Limited mobility
- Childbirth
- Urinary tract infection
- Medication side-effects
Chronic incontinence is commonly caused by:
- Bladder muscle weakness
- Birth defects
- Brain or spinal cord injury
- Blocked urethra
- Pelvic floor muscle weakness
- Nerve disorders
- Stress Incontinence - This is loss of urine when you exert pressure or stress on your bladder by coughing, sneezing, laughing, exercising or performing any act that increases intra-abdominal pressure and in turn puts pressure on the bladder.
- Urge Incontinence - This is a sudden, intense urge to urinate, followed by an involuntary loss of urine. The causes of this type are a urinary tract infection or anything that irritates the bladder.
- Overflow incontinence - This is an inability to empty your bladder, so it overflows uncontrollably and you leak urine.
- Mixed Incontinence - A combination of both stress and urge incontinence.
- Functional Incontinence - This type of incontinence is linked to physical disability or other factors. For example, a person with Alzheimer''s disease may not be able to make it to the toilet on time because of his disorganized mental state. Then again, a person confined to a wheelchair may find it difficult to get to a toilet in time.
- Overactive Bladder - Symptoms of these include urinary frequency, urgency and awakening at night to urinate.
- Transient - Temporary leakage due to external factors like medication, infection or a cough.
Women are said to sufferer from involuntary loss of urine twice as often as men. Millions of them experience it - in varied degrees. Some may lose a few drops of urine while running or coughing. Some may feel a strong and sudden urge to urinate just before losing a large amount of urine. Others may experience both these symptoms.
Seeing a doctor would be your primary step toward relief. A urologist would first try to ascertain what type of urinary incontinence you are suffering from and then formulate the reasons for it. The first step towards treatment would probably be filling in a ''urine voiding diary'' for a week before treatment starts. You might be asked to provide a family or personal medical history and all details of medication you are taking. The doctor would then ascertain the reason for your condition and follow up with treatment.
- Short Term: This type of urinary incontinence is temporary and occurs because of the urinary tract and bladder infections, constipation, and side effects of medication. Can be readily treated and will provide relief after treatment.
- Long Term: There are many reasons for this type. It can happen because of childbirth, auto accidents or surgical procedures. The sooner the person recovers from the disease she is suffering from, the quicker will she gets relief from incontinence.
- Chronic: This type of incontinence takes a lot of managing and care. The chronic condition is because of birth defects and progressive illnesses such as Alzheimer''s disease.
Again, older women experience incontinence more often than younger women. But this should not give rise to the conclusion that this is because of age. that is the older you get the weaker your urethra muscles get. Because incontinence has nothing to do with age. It is a medical problem with many possible causes - some relatively simple and others not so.
The term incontinence describes involuntary leakage of large or small amounts of urine. It ranges in severity from minor dribble to complete bladder loss. Incontinence may be due to factors such as severe constipation, side effects of medication, obesity, diabetes and nerve damage to bladder.
Lifestyle changes that can assist in managing incontinence include:
- Healthy weight maintenance
- Exercises that strengthen urinary sphincter and pelvic floor muscles such as Kegel exercises
- Increased intake of healthy foods, i.e. a diet low in fat, salt and sugar
- Avoidance of tobacco and smoking
- Limited intake of caffeine or other liquids that are irritants
- Increased intake of fibers
- Moderate physical activity
There are several products that can help one manage incontinence. For e.g.
Disposable underwear have a cotton-like outer material with an efficient inner layer that can assist in absorbing greater liquid.
Absorbent panties are effective in absorbing several ounces of fluid and are suitable for women with mild to moderate incontinence.
Absorbent pads are the easiest solution for incontinence problem. They can be worn in regular underwear.
Skin cleanser has been designed for bladder control issues. This has been developed for removing urine or stool without the need for scrubbing.
Plastic pants can assist in protection against mild to moderate leakages.
These urinary incontinence products allow the wearer to carry out normal activities without hindrance. They have odor controlling capabilities and are also economical. Most of them are discreet and not bulky. These products help the person suffering from incontinence live a life of dignity and respect.
Incontinence pads are available in many absorbency strengths as well as regular or long lengths.
Poise Pads range from very light absorbency (#2), light absorbency in # 3, moderate absorbency is # 4, maximum is # 5 and ultimate is # 6. Poise incontinence pads are made for women. Prevail and Depends Pads makes
incontinence pads for men as well. They are shaped to better fit male anatomy and are available in a variety of absorbencies.
Those who have overflow or functional incontinence most often need briefs. These can be pull up or have tape/Velcro closure and are easy to remove for changing. They wick away moisture to keep skin protected and most offer odor control features. Depends is a popular brand. Reusable
briefs are available by Salk for men and women. Briefs are available in different sizes. Be sure to use the manufacturer''s measuring guide.
Some bladder control pads or liners are manufactured with “odor-lock” technology. Always Discreet pads for women offer this technology. Other pads such as Hartmann Dignity UltraShield Unisex Incontinence Liner use a “lock-away core” that reduces the pH of the urine, which decreases odor. Use disposable cleansing wipes such as McKesson’s StayDry Scented soft pack personal wipes with pad changes. It is recommended that incontinent pads be changed as often as needed to keep the skin dry. This will help control odor as well.
The
penile clamp is to be used for short periods of time, unclamping every 1-2 hours to allow the bladder to empty. It should never be used 24 hours a day, 7 days a week. Long wear time can cause injury, create swelling, scarring of the urethra and breakdown of the skin. If you note swelling or skin changes, call you doctor immediately.
Common causes of incontinence in men are typically related to an enlarged prostate (BPH or prostate cancer), prostatitis (inflammation of the prostate) or damage of the nerves or muscles after surgery. Incontinence pads for men are shaped differently and the absorptive core is in the front of the pad. Disposable briefs or under-garments also have absorptive core placed more appropriate to the male anatomy. A
condom catheter can be worn as well. This is a catheter that is worn over the penis rather than inserted and can be attached to a
leg bag to hold the urine. Common causes of incontinence for women include
child birth or prolapse of pelvic organs into the vagina (uterus, bladder, rectum). This occurs as a result of weak pelvic floor muscles. Incontinence pads, disposable briefs or under-garments have the absorptive core that is appropriate for the female anatomy. Other common causes that effect men and women include diseases such as
diabetes,
Parkinson’s disease,
Alzheimer’s or weak bladder muscles.
A
pessary can be left in place for a week. It should be removed and kept out for 1 night a week. Some women will remove it nightly and replace in the morning. Once removed, it should be cleaned with soap and water and left to air-dry overnight. Always check the pessary for cracks, tears, or changes in color. Have sexual activity with the pessary may cause discomfort. It is recommended to remove it prior.
UI can have many causes. A urinary tract infection (UTI) can cause incontinence. Fortunately, taking antibiotics for the UTI can solve the problem Taking a diuretic medication (water pill) will increase the need to urinate, sometimes causing UI. Weak pelvic floor muscles. This often occurs after childbirth Chronic constipation can contribute to UI since the same nerves that run along the rectum innervate urinary function as well. Life style factors such as diet. Drinking caffeine or alcohol can irritate the bladder and cause frequent urination, along with spicy foods.
Medication can help reduce bladder spasms by calming the muscles. Other medications can be injected into the bladder to decrease bladder contractions. Another medication can relax the bladder muscles, allow them to hold more urine.
Conservative treatments include weight loss, limiting fluid intake each day, and avoiding caffeine and alcohol. Physical therapy to strengthen pelvic floor muscles can help and include Kegel exercises and biofeedback.
An overactive bladder (OAB) causes urgent and frequent urination. OAB can be treated with medication. Your doctor will evaluate your pelvic floor muscles to determine if you have both UI and OAB.
- Frequent urination, strong urge to void or pain with voiding.
- Leakage of urine upon coughing or sneezing (or from any similar movement which puts pressure on the lower abdomen)
- Waking at night to void, or leaking urine while you sleep
Your doctor will ask you about your symptoms. Describe what is happening. The doctor will take a detailed history of the problem, including diet. Keep a diary of your symptoms including how often you urinate, how urgent it feels, and how much you void each time.
A pelvic exam should be done to check for prolapse of pelvic organs or any other defect that can contribute to UI. An ultrasound or CT scan can be done along with bladder function tests to evaluate the cause.
Once you’ve reported symptoms of incontinence, your doctor will take a history and do a physical exam. There will be a urinalysis (urine testing), and possibly other lab tests too. The doctor may also order an X-Ray or urodynamic testing.
Incontinence is not a normal progression of aging. Testing for UI is the same at any age. However, UI is more common in the elderly population.
