Loss of urine control or urinary incontinence occurs in people of all ages, but it is common in older people. At least 1 in 10 persons aged 65 years or older suffer from incontinence. This condition can range from the discomfort of slight losses of urine to the disability and shame of severe, frequent wetting.
- pressure and thereby put pressure on the bladder. It is the most common type of incontinence and can almost always be cured.
- Urge Incontinence is the inability to hold urine long enough to reach a toilet. It is often found in people who have conditions such as diabetes, stroke, dementia, Parkinson’s disease, and multiple sclerosis. It can also be a warning sign of early bladder cancer. In men, it is often a sign of an enlarged prostate. It can, however, occur in otherwise healthy elderly persons.
- Mixed urinary incontinence is a combination of urge and stress incontinence.
- Overflow Incontinence is the leakage of small amounts of urine from a bladder that is always full. This may occur when the flow of urine from the bladder is blocked or loss of normal bladder sensations in some people with diabetes.
- Continuous urinary incontinence is the complaint of a continuous leakage of urine.
- Postmicturition dribble is the complaint of an involuntary loss of urine immediately after passing urine.
- Nocturnal enuresis is the complaint of loss of urine occurring during sleep.
- Extraurethral incontinence is the observation of urine leakage through channels other than the urethra (e.g., fistula or ectopic ureter).
TreatmentTreatment of urinary incontinence should be tailored to each patient’s needs and accurate diagnosis. The many options include:
- Certain behavioral techniques-including pelvic muscle exercises, biofeedback, and bladder training are helpful in controlling urination. These help a person to sense bladder filling and delay voiding until he or she can reach a toilet.
- Certain vaginal support devices called pessary can be used in women who have prolapse and this would improve continence.
- A number of medications can be used based on type of incontinence. However, they must be used carefully under a doctor’s supervision.
- Sling operation for stress incontinence in women is common surgical procedure. Artificial sphincter devices that replace or aid the muscles controlling urine flow have been tried in persons with continuous incontinence. These devices require surgical implantation.
- Specially designed absorbent underclothing is available. Many of these garments are no more bulky than normal underwear and can be worn easily under everyday clothing.
- Incontinence may be managed by inserting a flexible tube known as a catheter into the urethra. This can be done intermittently every 4-6 hours to empty the bladder or by means of indwelling catheterization, the latter may be suprapubic or transurethral, and collecting the urine into a container. Indwelling catheterization sometimes creates problems, including urinary infections or stone formation. In men, an alternative to the indwelling catheter is an external collecting condom device. This is fitted over the penis and connected to a drainage bag. Other alternative in men is the external application of a special clamp which is applied over the penis and this can be released intermittently to empty the bladder.
- It is important to remember that under a doctor’s care, incontinence can be treated and often cured. Even incurable problems can be managed to reduce complications, anxiety, and stress.