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You Are Not Alone

Even the healthiest among us can experience one or more types of incontinence. Nearly 25 million adults in the US live with some form of incontinence every day, yet the term is not widely understood or recognized. The most important fact to understand is that incontinence is a symptom and not a disease. Incontinence can be eliminated when the cause is removed, or it can be managed in varying ways to fit your lifestyle and personal preferences. In other words, incontinence does not have to change the way you feel about yourself or stop you from living your life to the fullest.

What Causes Incontinence?

Understanding the cause of your incontinence will help define your options. We can start by looking at how the urinary system works in normal urination. Normal urination involves the excretory organs, the brain and the communication pathways between the two. Any malfunction or disruption of the process of the brain sending a “bladder’s full” signal – or the excretory organ acting on that signal – can lead to incontinence. Just a few of the common causes include: childbirth, excess weight, illness, prostrate surgery, weakening pelvis muscles, hormonal changes to bladder support during menopause and certain heart and high blood pressure medications.

What Are The Types of Incontinence?

Stress (SUI) - intermittent, slight leakage of urine.

Causes: weakened pelvic or sphincter muscles associated with pregnancy, childbirth, surgery or radiation therapy.

Symptoms:  bladder leakage with cough, sneeze, physical activity, etc; bladder leakage in small amounts (drops, spurts); no incontinence at night; incontinence without sensation of urine loss.

Urge (UUI) – a sudden, involuntary emptying of the bladder.

Causes: the bladder contracts when it should not. This can be caused by urinary tract infection or by brain damage typical of stroke.

Symptoms: strong, uncontrolled urgency prior to incontinence;  more frequency of urination; Incontinence at night more than two times;  urine loss on the way to the bathroom;  moderate to large amount of urine leakage (gush).

Mixed (MUI) – symptoms of both Stress and Urge incontinence.

Overflow (OUI) – a continual leakage of urine. 

Causes: bladder fails to contract when it should, or becomes over-full because it cannot release the urine due to obstruction of the urethra. One of the reasons for this is the side effects of medication. Other causes can be constipation, or an enlarged prostrate gland in men.

Symptoms: difficulty starting urine streams. Weak or intermittent streams (dribbles).  Post-void bladder dribbling. Prolonged bladder voiding. Feeling of fullness after bladder voiding. Voiding small bladder amounts often.

Functional (FUI)– usually associated with strong emotional states, psychiatric problems, poor mobility or physical barriers in the environment which prevent a person from reaching a toilet in time.

Causes: no physical disorder in the excretory system; however, psychiatric/emotional problems or the physical inability to get to a toilet prevent normal continence.

Symptoms: mobility/manual dexterity impairments (arthritis, tendonitis in hands); lack of toilet access; medication usage (sedatives, hypnotics, CNS, diuretics, anticholinergics, alpha-adrenergic antagonists). Pain with movement.

Total (TUI) – a constant loss of urine.

Causes: neurological disorder causes lack of sensation.  Some causes are spinal cord injuries, birth defects, severe trauma and senility.

What Medications Contribute to Incontinence?

ACEI – Catapril, Lisinipril, Enalapril:  Increases cough leading to Stress Incontinence.

Alpha-Adenergic Agonists:  Increased urethral sphincter resistance causing post-void dribbling, straining, hesitancy in urine flow.

Alpha-Receptor Agonists – Pseudoephedrine, Ephedrine:  Urethral constriction, urinary retention (male).

Alpha-Receptor Antagonists: Prazosin, Teraosin, Doxazoin:  Urethral relaxation and decreases urethral sphincter resistance causing Stress UI (female).

Anticholinergics - H1 Antihistamines, Anti-Parkinsonian Agents:  Urinary retention with symptoms of post-void dribbling, straining, hesitancy in urine flow, overflow incontinence, fecal impaction.

Antidepressant, Tricyclic:  Anticholinergic effect, alpha-receptor antagonist effect causing post-void dribble, straining, hesitancy in urine flow.

Antipsychotics, Sedatives: Act as sedative causing confusion, may relax destrusor muscle leading to urinary retention.

Beta-Receptor Antagonists – Propranodol, Metoprolol, Atenolol:  Urinary retention.

Calcium Channel Blockers – Verapamil,  Dilitiazem, Nifedipine:  Urinary retention, fecal impaction.

Diuretics:  Increases urine production and volume (polyuria) leading to urgency and frequency. Late afternoon dose of a rapid acting diuretic may reduce nighttime symptoms.

Methyltrexates – Caffeine,  Theophyline:  Polyuria, bladder irritation.

Neuroleptics – Thioridazine, Chlorpromazine;  Anticholenergic effect, sedation.

Opiods:  Urinary retention, fecal impaction, sedation, delirium.

Sedatives-Hyptnotics:  Sedation effect may relax detrusor muscle.

Other (Caffeine & Alcohol):  Act as diuretic to urgency and frequency, induces sedation.

How Long Does Incontinence Last?

Depending upon the causes, incontinence may be permanent or temporary. An example of permanent incontinence could be traumatic injury to the spinal cord, where it is no longer possible for the brain to send signals to the excretory organs. Temporary incontinence may be caused by medication such as diuretics. When the diuretic is no longer taken, the incontinence may disappear. Since there are many causes and treatments for the loss of bladder or bowel control it is recommended you consult with your health care provider to discuss the treatments and options that are right for you.

What Will My Health Care Provider Ask?

Common Questions That Your Health Care Provider May Ask You Include:

Do you have strong, sudden urges to urinate? May indicate Over-active bladder.

Have you leaked urine on the way to the bathroom? May indicate Over-active bladder with Urge Incontinence.

How often do you use the toilet to empty your bladder during the day hours? May indicate Over-active bladder.

How often do you awaken at night to empty your bladder? May indicate Over-active bladder with nocturia (awakening at night to urinate).

Do you lose urine when coughing, seneezing, laughing, exercising or engaged in any forms of physical activity? May indicate Stress Incontinence.

Do you use pads, tissue or cloth in your underwear to catch urine? May indicate Urge, Stress or Mixed Incontinence.

What Can I Do?

For many people, behavior modification is the treatment of choice because it is the most natural. For most adults this is simply a matter of adopting new habits that can greatly enhance your quality of life.

Adults who remain physically active look and feel better and are more aware of their bodies. They tend to notice small changes in their physical ability to perform certain functions. They also notice physical reactions to food and drugs. Physical activity also helps you maintain your proper weight. This is a major benefit because excess weight increases pressure on the excretory organs and can contribute to incontinence.

Why Is Nighttime Different From Daytime?

Quality sleep is a restorative state providing the body with a chance to refresh and repair itself, and promotes the overall well-being of both wearers and caregivers. Incontinence may lead to frequent episodes of waking for the individual experiencing the incontinence and any caregiver that may assist the individual at home. The use of poor quality absorbent products that leak and do not wick fluid away from the skin to keep it dry can contribute to awakenings, discomfort, and may poorly effect the skin health of the wearer. The adverse effects of fragmented sleep include:

Behavioral changes

Decline in physical endurance

Listlessness

Anxiety

Depression

Knowledge deficits

Impaired mobility

Decreased physical, emotional, or cognitive disabilities

Why Is Skin Care So Important?

Preventing skin breakdown before it happens is an important concern for anyone experiencing incontinence. The use of a good quality perineal cleansing product can help eliminate the problems that are caused by soap and water. Soap and a washcloth are a fragile and/or damaged skin’s worst enemies. Soap is not recommended because of the drying effect and soap residue left on the skin can cause irritation and sensitization. High-quality perineal care products with moisturizing properties can help prevent skin irritation in sensitive skin areas before they begin.

What Is An Over Active Bladder?

An Over Active Bladder (OAB) is also known as a bladder spasm or urge urinary incontinence (UUI). This condition results from an involuntary contraction of the muscles in the urinary bladder and causes a sudden, unstoppable and unintentional urge to urinate. This condition is more common in the elderly and affects nearly 1:11 adults in the US today, but it is not considered a normal process of aging.

Symptoms of an over-active bladder include frequent urination (polyuria) or urge urinary incontinence causing substantial and significant physical, social, psychosocial, domestic, sexual and occupational concerns.

Treatments include a variety of options, including the use of high-quality disposable adult incontinence products, pelvic muscle rehabilitation involving kegel exercises, biofeedback, vaginal weight training (female), pelvic floor electrical stimulation, behavioral therapies and/or medication. Talk to your health care provider about the treatment regimens that are best for you.

Don't See Your Question?

If you do not see a FAQ that relates to your question, email us at tcollco@gmail.com. We will answer your question at that time, or, if needed research the matter and get back to you. We may then add your question to our 'FAQ' tab.