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Urinary Incontinence

 

Definition

Urinary incontinence is the involuntary loss of urine or inability to hold oneís urine in the bladder. About one in three elderly people, or 10 million adult Americans, have a problem with bladder control. Women are affected more often than men.  

There are several types of urinary incontinence:

  • Urge incontinence describes the situation of a person who feels a sudden need to urinate and then loses urine. It can be caused by infection, stroke or other neurologic disorders, or by various prescription drugs. Sometimes there is no detectable cause.  

  • Stress incontinence denotes the loss of urine when the person is laughing, sneezing, lifting an object or otherwise exerting herself. Itís caused by weakness in the urinary sphincter, the muscle that is released to start voiding.  

  • Overflow incontinence means that when the bladder is full, small amounts of urine leak out. This can happen if a person has bladder muscle weakness, chronic retention of urine caused by disease (such as prostate cancer), or a blockage in the urinary tract. It may occur if a drug the patient takes weakens the bladderís signals to the brain. It can even accompany constipation.  

  • Total incontinence means urine leaks constantly; it is usually caused by injury.  

  • Psychogenic incontinence is the loss of urinary control caused by the personís emotional state.  

  • Mixed incontinence, in which there are several factors or causes involved, is also possible. For example, many older women suffer from both urge and stress incontinence. 

Urinary incontinence can be extremely embarrassing as well as unhygienic. All too frequently, people who suffer from it are afraid to admit they have a problem, even to their own doctor. 

They may become anxious or afraid to go out socially, and can even develop depression. However, they should understand there are many ways to control or even cure urinary incontinence; and that trying to ignore it can lead to other medical problems, such as pressure ulcers and skin irritations. 

Treatment

Treatment measures required depend on the cause and type of incontinence. Sometimes, no treatment will be needed if the root cause (infection, for example) is cleared up. 

If drug treatment is required, the type of agent given will depend on the cause of the incontinence, and such factors as whether extra relaxation or contraction of the bladder is needed. If the incontinence is caused by a blockage in the urinary tract, surgery may be required. 

Some of the other measures a physician may suggest are:

  • ensuring frequent and regular voiding, such as every two hours

  • making access to the toilet easier, with grab bars or other aids

  • using adult diapers or absorbent pads or undergarments

  • exercises to strengthen the muscles used in voiding (Kegel exercises)

  • avoiding drinks containing caffeine

  • changing a prescription drug

Seniors should know that incontinence is not just a problem they have to learn to live with. If you have any problem with bladder control, donít hesitate to discuss it with your doctor or another health care professional.

 

 

 

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