adult incontinence

What is Incontinence?
Incontinence is the inability to control the passage of urine. This can range from an occasional leakage of urine, to a complete inability to hold any urine. The six types of urinary incontinence are:

  • Stress incontinence- occurs when pelvic muscles have been damaged, causing the bladder to leak during exercise, coughing , sneezing, laughing, or any body movement which puts pressure on the bladder. A problem that commonly affects women, stress incontinence may occur after multiple chilbirth or menopause. Pelvic fracture, radical prostatectomy, or bladder neck surgery can also damage the sphincter muscle and cause stress incontinence.
  • Urge incontinence involves a strong, sudden need to urinate followed by instant bladder contraction and involuntary loss of urine. You don't have enough time between when you recognize the need to urinate and when you actually do urinate.
  • Mixed incontinence is the combination of urge and stress incontinence. Many elderly (especially women) will experience symptoms of both urge and stress; this is called mixed incontinence.
  • Functional incontinence refers to incontinence that is secondary to factors other than urinary tract function.
  • Transient incontinence refers to temporary or occasional incontinence that may be related to a variety of causes and it is a potentially improvable or reversible cause.
  • Overflow incontinence refers to leakage that occurs when the quantity of urine produced exceeds the bladder's holding capacity. It can result from diabetes, pelvic trauma, extensive pelvic surgery, injuries to the spinal cord, shingles, MS, or polio.

Bowel incontinence is the inability to control or hold bowel movement, constipation and diarrhea could cause bowel incontinence.

How common is incontinence?
Incontinence is a very common issue in U.S.A. 34 million Americans are estimated to experience incontinence. Incontinence is common among the elderly however is not a part of normal aging process. Women are more likely than men to have urinary incontinence.

What should I do if I am experiencing incontinence?
Incontinence is a symptom not a disease. You should contact your doctor for more information and treatment.

What are some of the common causes?
Incontinence may be sudden and temporary, or ongoing and long-term. Causes of sudden or temporary incontinence include:

  • Urinary tract infection or inflammation
  • Prostate infection or inflammation
  • Stool impaction from severe constipation, causing pressure on the bladder
  • Side effects of medications (such as diuretics, tranquilizers, some cough and cold remedies, certain antihistamines for allergies, and antidepressants)
  • Increased urine amount, like with poorly controlled diabetes
  • Pregnancy
  • Weight gain
  • Short-term bed rest -- for example, when recovering from surgery
  • Mental confusion

Causes that may be more long-term:

  • Spinal injuries
  • Urinary tract anatomical abnormalities
  • Neurological conditions like multiple sclerosis or stroke
  • Weakness of the sphincter, the circular muscles of the bladder responsible for opening and closing it; this can happen following prostate surgery in men, or vaginal surgery in women
  • Pelvic prolapse in women -- falling or sliding of the bladder, urethra, or rectum into the vaginal space, often related to having had multiple pregnancies and deliveries
  • Large prostate in men
  • Depression or Alzheimer's disease
  • Nerve or muscle damage after pelvic radiation
  • Bladder cancer
  • Bladder spasms

What are some common treatment methods for managing incontinence?
See your doctor for an initial evaluation and to come up with a treatment plan. Treatment options vary, depending on the cause and type of incontinence you have. Fortunately, there are many things you can do to help manage incontinence.

The following methods are used to strengthen the muscles of your pelvic floor:

Bladder retraining involves urinating on a schedule, whether you feel a need to go or not. In between those times, you try to wait until next scheduled time. At first, you may need to schedule 1 hour intervals. Gradually, you can increase by 1/2 hour intervals until you are only urinating every 3-4 hours without leakage.

Kegel exercises contract the pelvic floor muscles for 10 seconds, then relax them for 10 seconds. Repeat 10 times. Do these exercises 3 times per day. You can do Kegel exercises any time, any place.

To find the pelvic muscles when you first start Kegel exercises, stop your urine flow midstream. The muscles needed to do this are your pelvic floor muscles. DO NOT contract your abdominal, thigh, or buttocks muscles. And DO NOT overdo the exercises. This may tire the muscles out and actually worsen incontinence.

Two methods called biofeedback and electrical stimulation can help you learn how to perform Kegel exercises.

Biofeedback uses electrodes placed on the pelvic floor muscles, giving you feedback about when they are contracted and when they are not.

Electrical stimulation uses low-voltage electric current to stimulate the pelvic floor muscles. It can be done at home or at a clinic for 20 minutes every 1 to 4 days.
Vaginal cones enhance the performance of Kegel exercises for women. Other devices for incontinence are also available.

For leakage, wear absorbent pads or undergarments. There are many well-designed products that go completely unnoticed by anyone but you.

Other measures include:

  • Regulate your bowels to avoid constipation. Try increasing fiber in your diet.
  • Quit smoking to reduce coughing and bladder irritation. Smoking also increases your risk of bladder cancer.
  • Avoid alcohol and caffeinated beverages, particularly coffee, which can over-stimulate your bladder.
  • Lose weight if you need to.
  • Avoid foods and drinks that may irritate your bladder like spicy foods, carbonated beverages, and citrus fruits and juices.
  • Keep blood sugars under good control if you have diabetes.