Urinary incontinence and how to deal with it

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Various conditions might lower the quality of life in older adults. One such problem is urinary incontinence (UI). UI is any involuntary leakage of urine. It affects about 30-60% of women and 10-35% of men aged 65 years and older. It can often be cured or controlled. Therefore, it is crucial to seek medical care if you are dealing with UI.

Our body stores urine in the bladder (a hollow organ in the lower abdomen). During urination, the bladder muscles contract to move urine into the urethra. Meanwhile, the muscles around the urethra relax, which lets the urine pass out of the body. When those muscles are not functioning correctly, urine leakage may happen. UI usually occurs if the muscles relax uncontrollably. This can happen for multiple reasons, for example, urinary tract infections, vaginal infections, or constipation. UI can also develop because the nerves that control the bladder are damaged from diseases like diabetes, multiple sclerosis, or Parkinson’s disease. In men, blockage from an enlarged prostate may cause the condition.

There are different types of UI, most common of which are stress incontinence, urge incontinence, overflow incontinence, and functional incontinence. Stress incontinence occurs during activities that increase intraabdominal pressure: coughing, sneezing, lifting weights, or some exercises. Urge incontinence happens when a patient cannot hold their urine long enough to get to the toilet. It can be an issue for people who have Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, or diabetes. Overflow incontinence is characterized by an overly full bladder, even if the person does not feel the urge to urinate. It can happen because of spinal cord injuries or if an enlarged prostate blocks the urethra in men. Functional incontinence is the type of UI that is not related to bladder function but rather occurs in people who have trouble getting to the toilet because of other kinds of disorders.

These days, there are many treatments available to UI patients. The treatment choice depends on the type of UI, the severity of the condition, and some other factors. Behavioral treatments improve incontinence by developing muscle control and strength and assisting the patient in changing behavior. Most programs include various components such as bladder-control strategies, pelvic floor muscle exercises, bladder training, fluid management, caffeine reduction, weight loss, or other changes in lifestyle. For patients with both dementia and UI, a behavioral program of prompted voiding (for example, every couple hours while awake) can effectively reduce incontinence. These methods have shown to be effective in reducing leakage by 50-80% in older adults.

There are also several types of medicine that can be used for UI treatment. The drug of choice depends on the initial cause of the condition. Accurate diagnosis is crucial for achieving the best results. In addition, some devices are as well available for managing the condition. For example, men with UI can use penile clamps or collection devices such as condom catheters. For women, it was demonstrated that pessaries are as effective as pelvic floor muscle exercise therapy. Surgical intervention is another method for achieving the result. It may include mid-urethral slings or artificial urinary sphincter implants, as well as some other types of surgical procedures.

Urinary incontinence is a very common issue among older adults. Even though aging is correlated with decreasing functionality of some organs and muscles, UI should not be considered inevitable. UI can and should be treated to avoid any complications and related issues.


Sources:
1. National Institute of Aging
2. Mount Sinai Journal of Medicine

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