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by Jan Busby-Whitehead, MD and Kim Clarke,
RN, MSN, ANP
Joseph G. Ouslander, MD and Neil Resnick, MD – content experts
Urinary incontinence, or leaking urine ,
involves unwanted or unplanned loss of urine, sufficient enough
to cause social, cleanliness, or personal problems. With proper
treatment, most cases can be greatly improved or cured.
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Q. I thought
that leaking urine was just a normal part of aging. Isn't
that true?
A. Urinary
incontinence is not a part of the normal aging process. It
is a sign that there is an underlying problem. In most cases,
a health care provider can find out the cause of the incontinence.
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Q. What are the different
types and symptoms of urinary incontinence?
A. Urge incontinence,
or overactive bladder, is the most common type of incontinence.
It occurs when you suddenly feel as though you need to urinate,
but are unable to reach the bathroom in time. There can be many
different causes of an overactive bladder.
Stress incontinence happens when there is a sudden increase in
pressure (stress) in your stomach caused by laughing, coughing,
sneezing, exercising, or lifting something heavy.
Mixed incontinence is a combination of stress and urge incontinence.
Overflow incontinence occurs when the bladder cannot empty properly.
Because the bladder never empties completely, it may feel full
again very quickly. Some people may have periodic leaking without
any sensation of fullness. Overflow incontinence cannot be diagnosed
by these symptoms alone and tests must be performed.
Functional incontinence occurs when a person has difficulty getting
to the bathroom due to illness, arthritis or the environment.
This type of incontinence is uncommon and can only be established
as a cause after other causes have been excluded by a professional.
Q. What causes urinary
incontinence?
A. Remember,
urinary incontinence is a sign of an underlying problem. Among
the causes are:
- Weakened pelvic muscles that support the
bladder
- Medical problems that affect the bladder's
ability to hold and empty urine
- Urinary tract infections
- Constipation
- Dehydration
- Certain prescription and nonprescription
medications.
Q. How is urinary incontinence
treated?
A. A variety
of treatments have been successful in improving or curing urinary
incontinence. Treatment options include behavioral techniques,
medications, and surgery. Depending on the type of incontinence
you have, a combination of treatments may be prescribed.
Q. What is meant by
behavioral treatments?
A. Behavioral
treatments are techniques that you can use to help you to gain
control over your bladder. They include: bladder training; pelvic
muscle (Kegel) exercises; changes in your diet and fluid intake;
and management of constipation.
Q. What is bladder
training?
A. Doctors
will often prescribe bladder training, a technique that helps
a person control the urgent need to urinate. Often used in combination
with pelvic muscle exercises, it helps the person to learn to
regain control over the bladder and decrease the frequency of
trips to the toilet.
Q. What are pelvic
muscle or Kegel exercises?
A. Kegel exercises
involve squeezing and relaxing a set of muscles in the pelvic
or genital area. They are an effective treatment for many people
who suffer from stress, urge, or mixed urinary incontinence. If
not learned properly, however, they can make the leaking worse.
The success of these exercises depends upon good instruction and
daily practice.
Q. Are there medications
I can take?
A. Several
medications may help, including those that treat infection, stop
abnormal bladder muscle contractions, or increase the amount of
urine the bladder can hold. If you are taking medication to treat
incontinence, your health care provider will need to see you on
a regular basis until a correct dose is determined. If you experience
side effects from the medication, your doctor will want to be
sure that they are appropriately addressed.
Q. How can I prepare
for my doctor’s appointment?
A. Keep a
diary of your trips to the toilet and your wet episodes for three
days. Jot down what you were doing when the accidents occurred.
Bring to your visit all the medication you take on a regular basis,
including those drugs that a doctor prescribed and those you take
on your own. Be familiar with your medical history, especially
any problems you have had in the past with your bladder or kidneys.
This will help your health care provider recommend the best treatment
for you. You should also bring a list of questions to ask at your
visit. Then, talk to your health care provider about your problem.
Remember, an overactive bladder is not a normal part of aging!
The following organizations can provide resources
and more information:
AGS Foundation for Health in Aging
Incontinence in Eldercare at Home
(http://www.healthinaging.org/eldercare/chap10.html)
Bladder Health Council c/o American Foundation
for Urologic Disease
300 West Pratt Street, Suite 401
Baltimore, MD 21201
(410) 727-2908
National Association for Continence
P.O. Box 8310
Spartanburg, SC 29305
1-800-BLADDER or (800) 252-3337
Simon Foundation
Box 835
Wilmette, IL 60091
1-800-23-SIMON or (800) 237-4666
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