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Treating Urinary Incontinence

It's important for caregivers and their parents to know that incontinence is not a normal part of aging and it can be treated. Often when incontinence becomes an issue, many caregivers decide to relinquish their role and place their parents in a facility.

Take note of the following six types of treatments that may help with one type of incontinence, or a combination of different types.

Six Treatments for Urinary Incontinence
Depending on the type, or combination of types, of incontinence your parent is suffering from, the following treatments may be effective:

  1. Kegel or pelvic floor exercises: These exercises are helpful if you have stress or urge incontinence. They specifically target the muscles of the pelvic floor. By contracting the muscles that support the bladder, you strengthen and tighten the bladder outlet. Kegel exercises need to be done regularly and consistently to work.
     
  2. Bladder or behavior training: This treatment may be useful if you have stress or urge incontinence — about 75% of people report some improvement. You learn to control urine output and toilet habits over a training period of weeks to months. Training consists of learning how to "hold on" for longer time periods before urinating, voiding at regular time intervals, and resisting the "urge to go."
     
  3. Combination of Kegel exercises and behavior training: These two therapies are sometimes combined with hypnosis or biofeedback. Treatments like these require a high level of determination and commitment, but the result is often worth the effort.
     
  4. Medications: When exercises and behavior training don't work, doctors may offer medication treatment. Some medications prevent bladder contractions, while others help increase bladder capacity. It's not recommended that you self-medicate with over-the-counter medications — if you have symptoms of incontinence, it's best to see your doctor for appropriate medications. There are several types of medications used to treat incontinence:
    • Antispasmodics help increase the bladder's storage ability and decrease bladder spasms. This delays the urge to urinate.
    • Estrogens are usually given to women with stress incontinence because they help build up the lining of the urogenital tract.
    • Calcium channel blockers are commonly used for heart conditions, but can be used to dry out a leaky bladder. They may cause urine retention, and so they are not as widely used.
  5. Bladder surgery: In women with severe stress incontinence, surgery can be helpful. Different types of surgeries are available, and the doctor will determine which one is best for a specific case.
     
  6. Collagen injection: This treatment can be effective if you have stress incontinence. It consists of injections of a protein called collagen into the urethral lining. This type of treatment can be done in a doctor's office under local anesthetic, and may be helpful for some types of incontinence. However, it is not permanent, so the effects wear off with time.

Other tips for managing incontinence:

  • Reduce intake of foods or beverages that increase urination or may irritate the bladder (e.g., parsley, coffee, tea, and alcohol).
  • Take measures to ease pressure on the abdomen (e.g., lose weight).
  • Drink plenty of fluids during the day, but limit fluid intake two to three hours before going to sleep.
  • Empty the bladder completely when you urinate and try to give an extra push to get the last drops of urine out.
  • Only use absorbent pads, belts, or adult diapers as a last resort. They're not recommended because people tend to rely on them and not get proper medical treatment. Check first with your doctor before buying any of these products.

1Source: "Incontinence: Silent No More," Seniors Info Exchange, Fall 1999, Vol. 8, No. 1, Health Canada



     
  • Older women who frequently must rush to the bathroom are 26% more likely to fall and 34% more likely to break a bone.
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  • Incontinence is a leading cause of nursing home placement. (Source: Harvard Medical School Healthbeat newsletter)