Abdominal & Urinary Conditions
Urinary incontinence means you lose bladder control or can’t store urine like you should. This problem is not a normal part of aging. It often affects older persons because muscles used in bladder control don’t work as well with aging.
Signs, Symptoms & Causes
For Acute Incontinence
This form comes on suddenly. Often, it is a symptom of a new illness or problem. Examples are a bladder infection, diabetes (new or out-of- control), and inflammation of the prostate, urethra, or vagina. It can also be a side effect of some medicines, such as water pills.
This form is often easily reversed when the problem that caused it is treated.
For Persistent Incontinence
This form comes on gradually over time. It lingers or remains, even after other problems have been treated. There are many types of this form. The ones below cause 80% of cases.
* Stress Incontinence. Urine leaks out when there is a sudden rise in pressure in the abdomen. This can happen when you cough, sneeze, laugh, lift, jump, run, or strain to pass stool. This type is more common in women than in men.
* Urge Incontinence. With this type, the urge to pass urine is so strong and comes on so fast, that the urine is released before you can get to the toilet. This type can be caused by an enlarged prostate gland, a spinal cord injury, or an illness, such as Parkinson’s disease.
* Mixed Incontinence. This type is a mix of stress and urge types of incontinence.
* Overflow Incontinence. This is the constant dribbling of urine because the bladder overfills. This may be due to an enlarged prostate, diabetes, or multiple sclerosis.
* Functional Incontinence. With this type, you have trouble getting to the bathroom fast enough, even though you have bladder control. This can happen in a person who is physically challenged.
* Total Incontinence. This is a rare type with complete loss of bladder control. Urine leakage can be constant.
Treatment
The first step is to find out if another problem causes the incontinence and to treat that problem. Other treatments include:
* Pelvic floor exercises, called Kegel exercises. (SeeSelf-Care/Prevention.)
* Medication.
* Collagen injections. These treat a certain type of stress incontinence.
* Surgery, as needed, to correct the problem.
Overactive Bladder
With this condition, you have at least 2 of these problems:
* An urgency to pass urine.
* Urge incontinence.
* You pass urine 8 or more times a day and 2 or more times during night.
Questions to Ask
Self-Care / Prevention
* Don’t have caffeine. Limit or avoid fluids 2 to 3 hours before bedtime.
* Limit carbonated drinks, alcohol, citrus juices, greasy and spicy foods, and items with artificial sweeteners.
* Empty your bladder before you leave the house, take a nap, or go to bed.
* Go to the bathroom often, even if you don’t feel the urge. When you pass urine, empty the bladder as much as you can. Relax for 1 to 2 minutes. Then try to pass urine again.
* Keep a diary of when you leak urine. If you find that you have accidents every 3 hours, empty your bladder every 2 hours. Use an alarm clock or wristwatch with an alarm to remind you.
* Wear clothes you can pull down easily when you use the bathroom. Wear elastic-waist bottoms. Wear items with velcro closures or snaps instead of buttons and zippers.
* Wear absorbent pads or briefs, if needed.
* Keep the pathway to your bathroom free of clutter and well lit. Leave the bathroom door open until you use it. Use a night light in the bathroom when it is dark.
* Use an elevated toilet seat and grab bars if these will make it easier for you to get on and off the toilet.
* Keep a bedpan, plastic urinal (for men), or portable commode chair near your bed.
* Ask your doctor if your type of incontinence could be managed by using self-catheters. These help to empty your bladder all the way. A doctor needs to prescribe self-catheters.
Kegel Exercises
* Kegel exercises are pelvic floor exercises. These help treat or cure stress incontinence. Persons who have leaked urine for years can benefit greatly from these exercises. How do you do them?
* First, start to urinate, then hold back and try to stop. If you can slow the stream of urine, you are using the right muscles. You should feel muscles squeeze around the urethra and the anus. The urethra is the tube through which urine is passed. The anus is the opening through which stool is passed.
* Next, relax your body, and close your eyes. Imagine that you are going to pass urine, but hold back from doing so. You should feel the muscles squeeze like you did in the step before this one.
* Squeeze the muscles for 3 seconds. Then relax them for 3 seconds. When you squeeze and relax, count slowly. Start out doing this 3 times a day. Gradually work up to 3 sets of 10 contractions. Hold each one for 10 seconds at a time. You can do them when you lie down, and/or stand.
* When you do these exercises, do not tense the muscles in your belly or buttocks. Do not hold your breath, clench your fists or teeth, or make a face.
* Squeeze your pelvic floor muscles right before and during whatever it is (coughing, sneezing, jumping, etc.) that causes you to lose urine. Relax the muscles once the activity is over.
* Women can also use pelvic weights prescribed by their doctor. A women inserts a weighted cone into the vagina and squeezes the correct muscles to keep the weight from falling out.
It may take several months to benefit from pelvic floor exercises. They should be done daily.
Resources
National Association for Continence (NAFC)
800.BLADDER (252.3337)
Urology Care Foundation
© American Institute for Preventive Medicine
