Urinary Incontinence
Urinary incontinence
(in-CON-ti-nents) is the loss of bladder control or the leakage
of urine. It can happen to anyone, but is very common in older
people. At least 1 out of 10 people age 65 or older suffers
from incontinence. It is a condition that rages from mild leakage
to uncontrollable and embarrassing wetting. Urinary incontinence
is a major health problem because it can lead to disability
and dependency.
Many people with
incontinence pull away from their family and friends. They try
to hide the problem from everyone, even their doctors. The good
news is that in most cases urinary incontinence can be treated
and controlled, if not cured. The bad news is that caregivers
may not know that treatment is a choice. They may think that
nursing home care is the only answer for an older person with
incontinence.
Incontinence does
not happen because of aging. It may be caused by changes in
your body due to disease. For example, incontinence may be the
first and only symptom of a urinary tract infection. Curing
the infection may relieve or cure the problem. Some drugs may
cause incontinence or make it worse.
If you are having
trouble with incontinence, see your doctor. Even if it can't
be completely cured, modern products and ways of managing incontinence
can ease its discomfort and inconvenience.
Types of Incontinence
The most common types
of urinary incontinence are:
Stress incontinence
happens when urine leaks during exercise, coughing, sneezing,
laughing, lifting heavy objects, or other body movements that
put pressure on the bladder. It is the most common type of incontinence
and can almost always be cured.
Urge incontinence
happens if you can't hold your urine long enough to reach a
toilet. Although healthy people can have urge incontinence,
it is often found in people who have diabetes, stroke, dementia,
Parkinson's disease, or multiple sclerosis. It can also be a
warning sign of early bladder cancer. In men, it is often a
sign of an enlarged prostate.
Overflow
incontinence happens when small amounts of urine leak
from a bladder that is always full. In older men, this can occur
when the flow of urine from the bladder is blocked. Some people
with diabetes also have this problem.
Functional
incontinence happens in many older people who have
relatively normal urine control but who have a hard time getting
to the toilet in time because of arthritis or other crippling
disorders.
Diagnosis
The first and most
important step in treating incontinence is to see a doctor for
a complete medical exam. The doctor will ask for a detailed
history of your health and give you a physical exam. The doctor
may want to check urine samples. You may be referred to a urologist,
a doctor who specializes in diseases of the urinary tract, or
to a gynecologist, a specialist in the female reproductive system.
Treatment
Treatment of urinary
incontinence should be designed to meet your needs. As a general
rule, the least dangerous procedures should be tried first.
The many options include:
- Behavioral techniques
such as pelvic muscle exercises, biofeedback, and bladder
training can help control urination. These techniques can
help you sense your bladder filling and help delay voiding
until you can reach a toilet.
- A doctor can prescribe
medicines to treat incontinence. However, these drugs may
cause side effects such as dry mouth, eye problems, or urine
buildup.
- Sometimes surgery
can improve or cure incontinence if it is caused by a structural
problem such as an abnormally positioned bladder or blockage
due to an enlarged prostate. Implanting devices that replace
or aid the muscles controlling urine flow has been tried in
people with incontinence.
Management
If your incontinence
cannot be cured, it can be managed in several ways.
- You can get special
absorbent underclothing that is no more bulky than normal
underwear and can be worn easily under everyday clothing.
- A flexible tube
(indwelling catheter) can be put into the urethra (the canal
that carries the urine from the bladder) to collect urine
in a container. Long-term catheterization--although sometimes
necessary--creates many problems, including urinary infections.
Men have the choice of an external collecting device. This
is fitted over the penis and connected to a drainage bag.
Remember, under a
doctor's care, incontinence can be treated and often cured.
Even if treatment is not fully successful, careful management
can help.
Resources
For more information
about incontinence, contact:
National Association
for Continence
P.O. Box 8306
Spartanburg, SC 29305-8306
1-800-BLADDER (1-800-252-3337)
Simon Foundation
for Continence
P.O. 835
Wilmette, IL 60091
1-800-237-4666
National
Kidney and Urologic Diseases
Information Clearinghouse
3 Information Way
Bethesda, MD 20892-3580
For a list of free
publications on health and aging from the National Institute
on Aging (NIA), contact:
National Institutes of Health
1996
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