How I Manage Incontinence And Bladder Control
What many refer to sarcastically as adult diapers became, and to this day are, one of my best friends. I wear adult underwear any time I step foot out my front door, and if I’m having a bad day in my house too. I don’t want any mishap on my furniture, or when my family or friend are visiting. When you have end-stage COPD incontinence becomes a regular occurrence. Whenever I go out I not only wear protective underwear, I also carry an extra pair and some feminine wipes with me. I keep them in a small zippered bag, if I lose control and pee my pants, as soon as I can I go to a restroom, clean up, and I’m good to go again. The best part is no one knows what has occurred but me, no embarrassment, no weird looks. I know a lot of people refuse to wear adult underwear, they feel there is a stigma attached. In their minds wearing adult underwear is undignified, unmanly or un-womanly. Don’t become one of them, there are all types of products for dealing with incontinence.
Editors Note: We are extremely saddened to say that on March 2, 2018, Mary Ultes passed away. Mary was an engaged advocate for the COPD community who strived to help people live fulfilling lives. She is deeply missed.
What Is Bowel Incontinence
Bowel incontinence is when youâre not able to control your bowel movements. It’s a common problem, especially among older adults, and ranges from irregular stool leaks while passing gas to a total loss of control of your bowels.
Accidental bowel leakage isnât usually a serious medical problem. But it can dramatically interfere with daily life. People with bowel incontinence may avoid social activities for fear of embarrassment.
Many effective treatments can help people with bowel incontinence. These include:
- Medicine
Talking to your doctor is the first step toward freedom from bowel incontinence.
Caring For Someone With Incontinence
So far, weve covered managing your own incontinence, but what if youre caring for an older adult? Incontinence is a common issue faced by dementia caregivers, and can be one of the most challenging parts of providing care. Research shows that:
- Those with dementia have a 2-3-fold increased chance of urinary incontinence
- The more severe the dementia, the more likely that there will be incontinence
- Urinary incontinence contributes to caregiver burden and increases the risk that someone will be admitted to a nursing home.
Steps to take
Dementia may not be the only cause of incontinence, so the first step is to look for other causes, like those reversible ones mentioned earlier .
If there doesnt seem to be any of those issues going on, then managed continence is the approach that is most likely to help. Rather than using the bladder medications, which can worsen confusion and dampen alertness, managed continence includes the use of continence products and a schedule of timed toileting .
In some cases, environmental adjustments and equipment, like bedside commodes, catheters, and urinals, can make frequent toileting easier and less disruptive, especially overnight.
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Find Your Pelvic Floor Muscles
Overactive bladder is one common cause of bladder control problems, especially among women. Doing regular Kegel exercises can help treat this condition. These exercises also called pelvic floor muscle exercises.
Kegel exercises are relatively easy to do. But before you can start, you need to find your pelvic floor muscles. The next time you urinate, try to stop your flow of urine midstream. The muscles you use to do that are your pelvic floor muscles.
How Can I Manage Incontinence At Home
Incontinence can be uncomfortable and disruptive. It can cause sleeping problems, make you feel ashamed or angry, or affect your daily life in other ways. In addition to working with your health care team to find the best treatment, there are things you can do at home to help make incontinence better or more comfortable.
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Limit how much you drink, especially coffee and alcohol. Avoid foods that can irritate the bladder, including dairy products, citrus fruits, sugar, chocolate, soda, tea, and vinegar.
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Go to the bathroom right before bedtime and any vigorous activity.
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Wear an absorbent pad inside your underwear or disposable incontinence underwear.
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Maintain a healthy weight. Extra weight can put pressure on the bladder and muscles that support it.
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Go to the bathroom regularly each day. Do not wait too long or put off going.
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Quit smoking. Nicotine can irritate the bladder. It can also make you cough and leak urine.
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Do Kegel exercises. Ask your health care team about doing Kegel exercises at home. They can make your bladder stronger. To do Kegel exercises, first tighten the muscles you use to stop the flow of urine. Then, relax those muscles. Repeat the exercise several times. During this exercise, relax the muscles in your belly, buttocks, and thigh.
Finally, it can help to find support. Talk with your health care team or join a support group for people with bladder problems. It can help you feel better to know that other people are also dealing with incontinence.
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Types Of Bladder Control Problems
Anyone can have bladder control problems or incontinence. Incontinence caused by cancer or cancer treatment can last a short time or a long time, and it can be mild or severe. There are different types of bladder control problems.
Stress incontinence. Urine leaks out during activities such as coughing, laughing, sneezing, or exercising.
Overflow incontinence. Urine leaks out when your bladder is full.
Urge incontinence. You feel the urge to go to the bathroom right away and urine leaks before you can get to the bathroom.
Continuous incontinence. Urine leaks out constantly, and you cannot control it.
These bladder problems can make you feel uncomfortable or embarrassed. Sometimes, people avoid activities they enjoy because of bladder problems. That can affect your quality of life. These are reasons why it is important to tell your health care provider about your experiences. They can help you treat incontinence. The treatment of side effects is an important part of your cancer care and treatment, called palliative care or supportive care. Talk with your health care team about how to treat or manage incontinence.
Common Causes Of Urinary Incontinence In Men
Urinary incontinence in meninvoluntary leakage of urine is not an uncommon problem. As estimated 3.4 million men in the United States currently experience UI, making life difficult both physically and emotionally. While often related to prostate problems, urinary incontinence has a variety of causes and can also be brought on by medical conditions such as diabetes and Parkinsons disease, and by pelvic surgical procedures including prostatectomy.
However, like many conditions that were once thought to be an inevitable fact of aging, UI in men is often due to underlying conditions that are treatable. Urologists are experts in the evaluation and treatment of UI with an array of evolving and cutting-edge techniques.
Treatment is an important consideration for any man affected. The healthcare community has lately begun to take a closer look at inequities in medical treatment, and although there is limited data on urinary incontinence in those of different races, in one study African-American men had the highest prevalence of incontinence. Hispanic men are also widely impacted. The study concluded that ethnicity appears to be a contributing risk factor for UI.
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What Happens To The Urinary System With Aging
The urinary system includes:
- the ureters
- the bladder
- the urethra
- the muscles of the pelvic floor.
There are sphincters that open or close the urethra, and nerves that run to the bladder muscles and sphincters which helps to control urinary release and flow. The brain and legs are also part of the urinary system: a person has to be able to decide when its time to go to the toilet, and have the ability to get to one when the time is right.
In this article, well focus mainly on the bladder and urethra, and the bladder outlet.
Normal Aging
With age, some of the muscle fibers in the bladder are replaced with stiffer, fibrotic tissue, and the neurological responses that we rely on to maintain normal urinary function decline slightly.
In practical terms, this means that:
- The sensation that the bladder needs to be emptied happens when the bladder is fuller than in a younger person
- The bladder muscle contracts less forcefully
- The urethral sphincter is looser in older women
- The larger prostate gland can obstruct the urethra in men
- Theres a more frequent need to pass urine
- 80% of those over 80 get up at least once in the night to pass urine
On top of the normal changes of aging, some age-associated conditions can also worsen incontinence, such as limitations in mobility, cognitive impairment, diabetes, obesity, congestive heart failure, medications that can affect urine output, and more.
Forms Of Urinary Incontinence That Affect Men Only
- Benign prostatic hyperplasia affects about 50 percent of men over the age of 60, and 90 percent over the age of 85 an enlarged prostate can cause sudden and frequent urges to urinate.
- Peyronies disease is the result of injury or damage to penile tissue, causing an abnormal curvature.
- Painful inflammation of the prostate gland
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Bladder Leakage 3 Things Women Should Know About Urinary Incontinence
To dispel misconceptions, a urogynecologist discusses the surprisingly common, lingering issue many women experience.
Bladder leakage. For some women, the condition runs their life from the inside, preventing them from playing outside with their kids, going to a workout class or staying the night with family or friends.
And theyre not alone. Living with some degree of urinary incontinence, defined as an uncontrolled leakage of urine, is actually common, according to Pamela Fairchild, M.D., a urogynecologist at Von Voigtlander Womans Hospital at Michigan Medicine.
She says that approximately half of all women over the age of 20 experience some degree of incontinence. This means urinary incontinence isnt just an issue that affects elderly or postpartum women, although aging and childbirth are risk factors.
But if so many women experience it, then why does the topic still seem embarrassing?
Women get the sense that this is inevitable, that its a natural part of aging and they have to live with it, says Fairchild. This false perception leaves women feeling powerless, even though there are ways to greatly improve their quality of life.
To help overcome the stigma, Fairchild shared three facts about urinary incontinence that all women should know.
There Are Different Types
If you experience incontinence when you sneeze, cough, or exercise, you may have stress incontinence, which is leakage from added pressure on the abdomen that pushes urine past the urethra.
If you stand up and are unable to hold off on emptying your bladder before you reach the bathroom, you may have urge incontinence, otherwise known as an overactive bladder.
Many women have a combination of stress and urge incontinence called mixed incontinence. And although less likely, some women experience overflow, a rare condition which causes frequent urinary leaks due to a constant full bladder.
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Tests Doctors Use To Diagnose Incontinence
Any procedure designed to provide information about a bladder problem can be called a urodynamic test. Most urodynamic testing focuses on the bladder’s ability to empty steadily and completely. It can also show whether the bladder is having abnormal contractions that cause leakage. The doctor will want to know whether their is difficulty starting a urine stream, how hard of a strain it is to maintain it, whether the stream is interrupted, and whether any urine is left in the bladder when done. The remaining urine is called the postvoid residual. Urodynamic tests can range from simple observation to precise measurement using sophisticated instruments.
Begin By Talking To Your Doctor
What should you do if youre experiencing bladder problems? First, speak up. People often dont bring up issues of incontinence with their clinical providers, either due to embarrassment or because they feel there are no available options that can helpor that surgery may be the only option, says Tomas Griebling, M.D., professor of urology and senior associate dean for medical education at the University of Kansas School of Medicine. But the symptoms can almost always be eased, Hochman says.
So start by working with a general practitioner, who can determine whether there may be an underlying cause for your symptoms. Urgency, incontinence, and urinary frequency can be caused by urinary tract infections or kidney stonesor, in men, a prostate infection or prostate enlargement. Medication you take to treat other conditions, such as anxiety, depression, high blood pressure, insomnia, and pain, can also lead to bladder leaks.
Your doctor might ask you to keep a diary of how often you urinate, when you have leaks, and how much liquid you consume. That will help define the problem and pinpoint the triggers.
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Do Regular Kegel Exercises
Once you find your pelvic floor muscles, you can complete regular Kegel exercises to strengthen them. Simply contract your pelvic floor muscles, hold them for five to ten seconds, and relax them. The Urology Care Foundation suggests that you complete at least two sessions of Kegel exercises per day. Up to 30 contractions per session.
How Urinary Incontinence Is Treated
Initially, your GP may suggest some simple measures to see if they help improve your symptoms. These may include:
- lifestyle changes, such as losing weight and cutting down on caffeine and alcohol
- pelvic floor exercises taught by a specialist
- bladder training guided by a specialist
You may also benefit from the use of incontinence products, such as absorbent pads and hand-held urinals .
If you are still unable to manage your symptoms, medication may be recommended.
Surgery may also be considered. The specific procedures suitable for you will depend on the type of incontinence you have.
Surgical treatments for stress incontinence, such as tape or sling procedures, are used to reduce pressure on the bladder, or strengthen the muscles that control urination.
Operations to treat urge incontinence include enlarging the bladder or implanting a device that stimulates the nerve that controls the detrusor muscles.
Read more about non-surgical treatments for urinary incontinence and surgery and procedures for urinary incontinence
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Common Causes Of Urinary Incontinence In Men:
The following are common causes of urinary incontinence:
Are There Other Ways To Treat Incontinence
Yes. Medicines or medical devices can treat some types of urinary incontinence. For example, estrogen cream to put in the vagina can be helpful for some women who have mild stress incontinence. Several prescription medicines are available to treat urge incontinence. For men, prescription medicine is available to shrink the prostate and improve flow of urine through the prostate. Talk to your doctor about possible medicine options for your type of incontinence.
In some cases, surgery may be an option. Treatment depends on what type of urinary incontinence you have and what is causing it.
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What Causes Bladder Leaks
There are two main types of urinary incontinence:
Stress incontinence
If you have this type, activities that raise the pressure inside your abdomen cause urine to leak through the ring of muscle in your bladder that normally holds it in. Coughing, sneezing, jumping and lifting heavy objects could lead to a leak.
Going through childbirth, smoking or being overweight can raise the risk of stress incontinence for women, Wright says. Stress incontinence in men is rare, and when it arises, its often due to prostate cancer treatment, such as radiation or surgery.
Urge incontinence
With this type, your brain, spinal cord and bladder dont work together properly to allow you to hold and release urine at the right time. Your bladder may suddenly empty itself without warning. Or you may feel like you need to urinate frequently, a problem called overactive bladder.
Some diseases that affect the nervous system, such as multiple sclerosis or stroke, can cause this kind of incontinence, says Wright. In men, an enlarged prostate may be the culprit. But in many cases, doctors dont know what causes urge incontinence.
It is possible to have both types of incontinence at the same time.
TRY IT: Keep Records
Your doctor will want to know as much as possible about your bladder leakswhen they occur, how much urine comes out, and what youre doing when leaks happen. Consider keeping a diary of when you urinate and when you have leaks, recommends Wright.