Let’s Talk: Adult Incontinence

Incontinence is a condition that most people who suffer are too embarrassed to talk about, however it affects 1 in 3 women...

Incontinence is a condition that most people who suffer are too embarrassed to talk about, however it affects 1 in 3 women and 1 in 9 men.

Urinary incontinence (UI) can have a hugely negative impact on a person’s quality of life, mood and confidence. Some sufferers may feel as though they cannot leave their homes because of it.

What is it?

Urinary incontinence is defined as “loss of control of the bladder,” and can affect anyone, regardless of age. It is a condition that can range from mild to uncontrollable and embarrassing wetting.

What causes it?

Incontinence can often be caused by an illness, such as a urinary tract infection (UTI). Often, when the infection gets better, the incontinence also improves. Weak or damaged pelvic floor muscles can also cause urinary incontinence.

4 Types of Incontinence

  • Stress incontinence happens when a person wets themselves during exercise, coughing, sneezing, laughing or other movements that but pressure or stress on the bladder. This is the most common type of incontinence and tends to mostly affect women, however men can also develop this type of incontinence after having a prostate operation
  • Urgency/urge incontinence happens when the person cannot hold on long enough to reach the toilet. This may be due to an overactive bladder, infection, medication or poor mobility, hence affecting the person getting to the toilet in time. In men, this type of incontinence may be a sign of an enlarged prostate
  • Overflow incontinence occurs when the person’s bladder does not empty completely. As a result, urine builds up and then may overflow, often resulting in frequent dribbling. This is more common in men and may also be due to an enlarged prostate gland, but can also be caused by constipation
  • Reflex incontinence is when the bladder empties when it is full, however the person is usually unaware of this. The cause is a break in the signals between the brain and the bladder, which may be caused by a stroke or spinal injury

How can I manage my incontinence?

While incontinence products are not a treatment for urinary incontinence, they are useful when it comes to managing the condition while a person is waiting to be tested or waiting for other treatment to take effect.

  • Absorbent products such as incontinence pants or pads. Liners, pads, disposable underwear and reusable underwear will absorb moisture. These products are designed to catch any leaks and pull moisture away from the skin, meaning a person can go longer between changes. Many of these products have a waterproof backing, which helps prevent any overflow from reaching your clothes, using a breathable plastic film that helps to reduce skin irritation.
  • Incontinence bed sheets are also available
  • A catheter is a thin tube inserted into the bladder to drain urine
  • Devices inserted into the vagina or urethra to prevent leakage, for example, during exercise

Treatments

The treatment your doctor/medical professional will recommend will depend on the type of urinary incontinence you are experiencing, as well as the severity of the symptoms you may have.

If your incontinence is caused by an underlying condition, for example, then you may receive treatment for this as well as the incontinence treatment.

Generally, treatments which don’t include medication or surgery will be recommended first.

Lifestyle changes

  • Reducing caffeine intake (tea, coffee, cola) as this increases the amount of urine the body makes
  • Altering your fluid intake – drinking too much or too little can make your incontinence worse
  • Losing weight

Pelvic floor muscle training (Kegel exercises)

The pelvic floor muscles are the muscles used to control the flow of urine as the body urinates. These muscles surround the bladder and urethra (the tube that carries urine from the bladder outside the body).

Weak or damaged pelvic floor muscles can cause urinary incontinence, therefore exercising these muscles is often recommended.

Your GP may refer you to a specialist to start a programme of pelvic floor muscle training. The specialist will assess whether you are able to squeeze your pelvic floor muscles and by how much. If you can squeeze/contract these muscles, you will be given an individualised exercise programme based on this assessment.

Bladder training

If you are diagnosed with urge incontinence, one of the first treatments that will be offered to you is bladder training. This involves learning techniques to increase the length of time between the feeling of needing to urinate and passing urine. This type of course tends to last for at least 6 weeks and will sometimes be combined with a pelvic floor muscle training course as above if it is a case of mixed urinary incontinence i.e. more than one type.

Surgery

Mid-urethral slings are (despite how they sound) minimally invasive procedures developed to treat female stress urinary incontinence. These slings are narrow tapes made from polypropylene and are placed beneath the middle part of the urethra to provide support and therefore stop leakage from the bladder.

These slings have been shown to be as effective as traditional, more invasive surgery, and have major advantages such as shorter operating and admission time, a quicker return to normal activities and lower complication rates.

Don’t suffer with incontinence in silence – it is more common than you think and there is help available. Speak to your GP or ask your local CarePlus Pharmacy for advice on products that could work for you.

Information adapted from PAI



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