By Mary Ann Wilson, RN
Urinary incontinence is the unexpected loss of urine on a regular basis. Loss of bladder or bowel control is a symptom – not a disease in itself. A broad range of conditions and disorders can cause incontinence, including birth defects, pelvic surgery, injuries to the pelvic region or to the spinal cord, neurological diseases and multiple sclerosis.
Most of us think of urinary incontinence as a natural part of aging, but surprisingly enough the incidence of incontinence in older adults is only 15-30%. That goes up to 50% in nursing homes. According to the Clinical Practice Guidelines on Urinary Incontinence in Adults published in 1996 by the Agency for Health Care Policy and Research, 13 million Americans are incontinent – 85% of them are women. Of those affected by this condition, only 1/2 have had an evaluation by a physician. The sad part is most cases can be cured, or at least improved.
Let’s look at some causes of incontinence.
• Your medicine cabinet is highly suspect. If you are taking drugs for the treatment of hypertension, depression, or if you are taking diuretics and have developed incontinence, check with your doctor.
• If you have stopped taking estrogen, that alone creates changes in the urethra and can cause incontinence.
• Urinary tract infections may cause incontinence as well as pelvic surgery or injury to the pelvic area or spinal cord.
• Neurological conditions including, multiple sclerosis, Parkinson’s, Stroke
• An underlying condition such as diabetes or obesity
• Degenerative changes associated with aging
According to Dr. J. Andrew Fantl (Department of Obstetrics and Gynecology, Medical College of Virginia Hospitals, and head of a study on bladder training), urinary incontinence can often be effectively treated by using non-invasive techniques.
A variety of treatment and management strategies are available to help with urinary incontinence:
• pelvic muscle exercises (such as Kegels)
• bladder training
Other management techniques to help with incontinence include:
• frequent toileting
• restricting bedtime fluid intake
• easier access to toilet facilities
• use of absorbent pads or undergarments
• avoiding bladder irritants such as caffeine (coffee, tea, soda), spices and acidic juices