DRUG INDEX
Urinary Incontinence What Is Urinary incontinence?
Urinary incontinence (UI) is the unintentional loss of urine. UI is a problem for more than 17 million Americans - 85 percent of them women. Although about half of the elderly have episodes of incontinence, bladder problems are not a natural consequence of aging, and they are not exclusively a problem of the elderly.
Although UI can be improved in 8 out of 10 cases, fewer than half of those with bladder problems ever discuss the condition with their health care professional. The disorder, therefore, often goes untreated.
UI is also referred to as bladder incontinence. What are causes of UI?
UI has a number of causes. Women are most likely to develop incontinence either during pregnancy and childbirth, or after the hormonal changes of menopause , because of weakened pelvic muscles. Older men can become incontinent as the result of prostate surgery. Pelvic trauma, spinal cord damage, caffeine, or medications, including cold preparations and diet drugs that are available over-the-counter, can also cause episodes of UI. Diseases which affect the nerves that control the bladder, such as multiple sclerosis , can be associated with UI.
Other factors that contribute to bladder incontinence include decreased mobility or impaired thinking (such as forgetfulness, confusion, or senility), particularly in combination with drugs such as sedatives, sleeping pills, and alcohol. What are the types of UI?
There are four common types of incontinence: - Stress incontinence happens when the bladder can't handle the increased compression during exercise, coughing, or sneezing. This form of incontinence usually occurs in women under 60 and in men who have had prostate surgery.
- Urge incontinence is caused by a sudden, involuntary bladder contraction. This form is more common in older adults.
- Mixed incontinence is a combination of both stress and urge incontinence, and is most common in older women.
- Overflow incontinence, in which the bladder becomes too full because it can't be fully emptied, is a rarer type of the disorder. The condition is caused by a bladder obstruction or injury. In men, it can be the result of an enlarged prostate.
What treatments are recommended for UI?
Treatment for UI depends on the type of incontinence, its causes, and the capabilities of the patient. Here are commonly recommended treatments:
Pelvic Muscle Rehabilitation-to improve pelvic muscle tone and prevent leakage. - Kegel exercises. Regular, daily exercising of pelvic muscles can improve, and even prevent, urinary incontinence. This is particularly helpful for younger women. Should be performed 30-80 times daily for at least 8 weeks.
- Biofeedback. Used in conjunction with Kegel exercises, biofeedback helps people gain awareness and control of their pelvic muscles.
- Vaginal weight training. Small weights are held within the vagina by tightening the vaginal muscles. Should be performed for 15 minutes, twice daily, for 4 to 6 weeks.
- Pelvic floor electrical stimulation. Mild electrical pulses stimulate muscle contractions. Should be done in conjunction with Kegel exercises.
Behavioral Therapies-to help people regain control of their bladder. - Bladder training teaches people to resist the urge to void and gradually expand the intervals between voiding.
- Toileting assistance uses routine or scheduled toileting, habit training schedules, and prompted voiding to empty the bladder regularly to prevent leaking.
Pharmacologic Therapies - to improve incontinence medically. - Oxybutynin (brand name: Ditropan) prevents urge incontinence by relaxing sphincter muscles.
- Tolterodine (brand name: Detrol, Detrol LA) is indicated for the treatment of an overactive bladder with symptoms of urinary frequency, urgency, or urge incontinence.
- Estrogen, either oral or vaginal, may be helpful in conjunction with other treatments for postmenopausal women with UI.
Surgical Therapies-to treat specific anatomical problems. - Sling procedures, bulking injections (such as collagen) and other surgical procedures support or move the bladder to improve continence.
What are treatments for the chronically incontinent?
Although many people will improve their continence through treatment, some will never become completely dry. Sometimes treatment failures are due to concurrent use of necessary medications, such as diuretics (water pills that induce urination), that actually can cause incontinence. Some persons may have thinking or physical impairments that keep them from being able to perform pelvic muscle exercises or retrain their bladders. Many will be cared for in long-term care facilities or at home. The following recommendations can help keep the chronically incontinent drier and reduce their cost of care: - Scheduled toileting-take people to the toilet every 2 to 4 hours or according to their toilet habits.
- Prompted voiding-check for dryness and encourage use of the toilet.
- Improved access to toilets-use equipment such as canes, walkers, wheelchairs, and devices that raise the seating level of toilets to make toileting easier.
- Managing fluids and diet-eliminate dietary caffeine (for those with urge incontinence) and encourage adequate fiber in the diet.
- Disposable absorbent garments-use to keep people dry.
- Urinary incontinence (UI) is not exclusively a problem of the elderly.
- UI is not a natural consequence of aging.
- UI has a number of causes.
- There are several types of UI.
- Treatment for UI depends on the type of incontinence, its causes, and the capabilities of the patient.
|
DISCLAIMER:
Information on this site is provided for informational
purposes and is not meant to substitute for the advice
provided by your own physician or other medical professional.
You should not use the information contained herein
for diagnosing or treating a health problem or disease,
or prescribing any medication. You should read carefully
all product packaging. Not all Canadian drugs, Canada
prescription and Canadian prescription medicine is available
at discount Canadian on line pharmacies. If you have
or suspect that you have a medical problem, promptly
contact your health care provider. Information and statements
regarding diet supplements have not been evaluated by
Health Canada and are not intended to diagnose, treat,
cure, or prevent any disease. All trade and service
marks mentioned on this site are recognized as belonging
to their respective owners.
|
|
|
|
