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:
NIA Information Center
P.O. Box 8057
Gaithersburg, MD 20898-8057
1-800-222-2225
(1-800-222-4225 TTY)
E-mail: niainfo@access.digex.net
National Institute on Aging
U. S. Department of Health and Human Services
Public Health Service
National Institutes of Health
1996
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