A Little More Conversation

Adult incontinence is much more prevalent in the United States than you might think. According to the National Association of Continence (NAFC, 2006), approximately 25 million adults in this country have experienced incontinence at some point in their lives. In fact, this number may be higher as most adults, especially men, won't admit or are embarrassed to discuss this condition with their healthcare provider, family, or friends. And 75-80 percent of those suffering incontinence are women.

Loss of bladder control don't use any product to manage their incontinence. The most important part in having the discussion about urinary incontinence is the understanding that while it is more prevalent in the aging population, it is not a normal part of aging, rather a symptom of a disease. (NAFC, 2006)

Where to begin

So how do you begin such a personal discussion with someone you love and respect? The best approach is to discuss the issue as soon as it is evident that someone you love is having difficulties with incontinence.

Tell your loved one that you understand this topic may be embarrassing to discuss. Sometimes using the "some people" approach will remove the focus away from them (National Institute on Aging). You may say something like "some people may become incontinent when they cough, laugh, or sneeze. Has this ever happened to you?"

You also need to be comfortable yourself about openly discussing the topic of incontinence. Getting accurate information is the first step. Remember that up to 15 percent of elderly men, and up to 30 percent of elderly women suffer from urinary incontinence.

You're not alone

Finally, remember that there are support organizations that can help you with your loved one when it comes to incontinence.

Talk to Your Doctor

(from the National Institute on Aging)

Is your loved one reluctant to talk to their doctor about a bladder control problem? She shouldn't be. There is help.

Aging does not cause incontinence. It can occur for many reasons. For example, urinary tract infections, vaginal infection or irritation, constipation, and certain medicines can cause bladder control problems that last a short time, or sometimes longer.

Many people with bladder control issues hide the problem from everyone, even from their doctor. There is no need to do that. In most cases urinary incontinence can be treated and controlled, if not cured. If you, or someone you know is having bladder control problems, don't suffer in silence. Talk to your doctor.

Diagnosis

The first step in treating a bladder control problem is to see a doctor. He or she will do a physical exam and take a medical history. The doctor will ask about symptoms and the medicines used and will want to know about recent illnesses or surgeries. The doctor also may do a number of tests. These might include:

• Urine and blood tests

• Tests that measure how well you empty your bladder

In addition, a doctor may ask the patient to keep a daily diary of when she urinates and when she leaks urine. The pattern of urinating and urine leakage may suggest which type of incontinence the patient has.
Types of incontinence
There are several types of urinary incontinence:

• Stress incontinence happens when urine leaks during exercise, coughing, sneezing, laughing, lifting heavy objects, or other body movements that put pressure on the bladder. It is the most common type of bladder control problem in younger and middle-age women. In some cases it is related to childbirth. It may also begin around the time of menopause.

• Urge incontinence happens when people can't hold their urine long enough to get to the toilet in time. Healthy people can have urge incontinence, but it is often found in people who have diabetes, stroke, Alzheimer's disease, Parkinson's disease, or multiple sclerosis. It is also sometimes an early sign of bladder cancer.
• Overflow incontinence happens when small amounts of urine leak from a bladder that is always full. A man can have trouble emptying his bladder if an enlarged prostate is blocking the urethra. Diabetes and spinal cord injury can also cause this type of incontinence.
• Functional incontinence happens in many older people who have normal bladder control. They just have a hard time getting to the toilet in time because of arthritis or other disorders that make moving quickly difficult.

Manage incontinence

Besides bladder control training, there are several other ways to help manage incontinence:

• Sometimes doctors suggest a small, throwaway patch; a small, tampon-like urethral plug; or a vaginal insert called a pessary for women with stress
  incontinence.

• A doctor can prescribe medicines to treat incontinence. Some drugs prevent unwanted bladder contractions. Some relax muscles, helping the bladder to empty more fully during urination. Others tighten muscles in the bladder and urethra to cut down leakage. These drugs can sometimes cause side effects such as dry mouth, eye problems, or urine buildup. Vaginal estrogen may be helpful in women after menopause. Talk with your doctor about the benefits and side effects of using any of these medicines for a long time.
• A doctor can inject an implant into the area around the urethra. The implant adds bulk. This helps close the urethra to reduce stress incontinence. Injections may have to be repeated after a time because your body slowly gets rid of these substances.
• Sometimes surgery can improve or cure incontinence if it is caused by a problem, such as a change in the position of the bladder or blockage due to an enlarged prostate. Common surgery for stress incontinence involves pulling the bladder up and securing it. When stress incontinence is serious, the surgeon may use a wide sling. This holds up the bladder and narrows the urethra to prevent leakage.
• You can now buy special absorbent underclothing. It is not bulky and can be worn easily under everyday clothing.

If you suffer from urinary incontinence, tell your doctor. Remember, under a doctor's care, incontinence can be treated and often cured. Even if treatment is not fully successful, careful managing can help you feel more relaxed and comfortable.