Incontinence
Urinary incontinence affects over ten million individuals. Urinary incontinence is loss of urine for different reasons. Women are more likely to experience this condition because of hormonal changes and childbirth. Women may notice the problem of incontinence getting worse as they age, however it is not a normal part of aging.
Many times when a person experiences loss of bladder control the skin in the perineal area requires special care. Following the below guidelines for skin care may prove helpful in reducing the amount of skin irritation you experience.
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Skin Care
- After each incontinent episode wash the perineal area well with mild soap and water. Rinse well and dry.
- A blow dryer on the cool setting may be beneficial.
- After the skin is cleansed a small amount of moisturizer should be applied.
- If urinary leakage is continuous a moisture barrier ointment should be selected.
- Selecting the correct product to manage the moisture is essential to maintain your skin integrity.
- Be alert for yeast rashes which are very common with urinary incontinence. If you suspect a yeast infection call your doctor.
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Dietary Considerations
While it is important to realize that there is no diet to cure incontinence, many things we do everyday can aggravate urinary incontinence. Fluid intake: Good health habits dictate drinking 6 eight ounce glasses of water per day. This is important for everyone unless your physician has placed you on a fluid restriction for other medical problems. Many people reduce fluids in an effort to decrease urination. Many times this aggravates the problem by causing the urine to become very concentrated and act as an irritant to the bladder lining.
Some foods are thought to contribute to bladder leakage. The effects of these foods on the bladder are not fully understood but you may want to limit or eliminate some of these items to determine if they have an effect on your continence.
Alcohol, beer, wine, milk, milk products, coffee, caffeinated sodas, corn syrup, citrus juices, sugar, honey, chocolate, tomatoes, highly spiced foods and NutraSweet.
Grape, Cranberry, Cherry and Apple juice are thirst quenchers and nonirritating to the bladder. Cranberry and Cherry juice may also reduce odor. Tea has also been associated with bladder irritation. The newer herbal teas may prove to be an acceptable substitute.
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Stress Incontinence
Stress Incontinence is defined as an involuntary loss of urine occurring when abdominal pressure exceeds the maximum urethral pressure without the bladder contracting. This occurs with laughing, coughing, sneezing, exercising, high impact sports, lifting and other types of activities. Urine leakage tends to be in small quantities.
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Urge Incontinence
Urge Incontinence is defined as involuntary loss of urine because the bladder contracts to push the urine out without socially accepted circumstances. People with Urge Incontinence tend to experience a strong, sudden urge to urinate but are unable to reach the bathroom before leakage occurs (also known as overactive bladder). They tend to urinate frequently and lose moderate to large amounts of urine. You may also leak urine after drinking a small amount of liquid or when you hear or touch running water. Aging is a risk factor due to reduced bladder capacity, delayed recognition of bladder filling resulting in reduced "response" time. Bed wetting is also common.
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Mixed Incontinence
Mixed Incontinence is defined as involuntary loss of urine due to combination of both Stress and Urge Incontinence.
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Reflex Incontinence
Reflex Incontinence is defined as involuntary loss of urine without any desire to urinate. The bladder contracts without permission and the person does not feel the need to urinate. This type is seen with persons having traumatic or congenital disorders of the spinal cord and neurological disorders such as multiple sclerosis.
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Overflow or Retention Incontinence
Overflow or Retention Incontinence is defined by the bladder not emptying completely and/or dribbling of urine occurs. People with overflow incontinence do not feel the urge to urinate. The bladder never empties normally and remains at least partially full; small amounts of urine are leaked on a nearly continuous basis. This incontinence is seen with side effects of certain medications, history of "holding" your urine, or prostate enlargement or surgeries. Although not common in women, it may develop if a woman has ovarian tumors or pelvic organ prolapse. Spinal cord injuries or nervous system disorders are additional causes of overflow incontinence.
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Functional Incontinence
Functional Incontinence is defined as involuntary loss of urine because of cognitive impairment or loss of mobility (arthritis, difficulty in removing clothing). The cortex doesn't process the signals from the bladder. The lower part of the urinary tract system (bladder, urethra and muscles) is working normally.
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Signs of a Urinary Tract Infection
If any of the following conditions occur it is important to notify your physician as quickly as possible.
- Cloudy or concentrated urine
- Presence of blood in the urine
- Sediment in the urine
- Increased loss of bladder control
- Temperature greater than 100 degrees
- Nausea or vomiting
- Discomfort in the back
If you experience any of the first five symptoms then increase your fluid intake and notify the doctor immediately. If you experience symptoms 6 &/or 7 do not delay and notify the doctor immediately.
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Pelvic Muscle Rehabilitation
A group of muscles which support the pelvic organs are referred to as the pelvic floor muscles. As with many muscles in the body they can become relaxed and many times this will result in urinary incontinence. The area between the rectum and urethra becomes weakened and this can aggravate urinary incontinence. Strengthening of these muscles does not occur overnight but usually over a period of six to eight weeks. It is important to isolate the correct muscles for you to obtain maximum benefit.
For Men: Contract the muscles around the rectum as if you are holding back gas or a bowel movement.
For Women: Without tensing the muscles of your legs, buttocks, or abdomen, imagine that you are trying to control the passing of urine by squeezing the muscles of the vagina together. Hold one hand on your stomach to make sure the abdominal muscles are not moving as you slowly squeeze the sides of the vagina together. As you do this the ring of muscles around the rectum will also squeeze together. THIS IS NORMAL.
Another method women find helpful is to insert a finger into the vagina and try to squeeze the muscle. This is approximately one inch inside the vagina. You only need to do this to locate the muscles, not to perform the exercise. After you locate the muscle, squeeze for 4 seconds. DO NOT HOLD YOUR BREATH. Relax for 4 seconds and repeat the process. Repeat the process 10 times and make sure you do the periods of relaxation. When your muscles get stronger do the exercises sitting or standing. Working against gravity is like adding more weight.When you have mastered the technique, build up to 1-2 seconds per week until you can hold the contraction for 10 seconds. Do this procedure 4 times per day. Most people find it most effective when they do this exercise upon rising, then with meals and bedtime. It doesn't require much time and can be done in any position.
Remember, incontinence is sometimes curable, often treatable but Always manageable.