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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
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