Options for Dealing With Incontinence
Urinary incontinence, or accidental leaking of urine, is a very common problem among older adults. You might suffer from stress incontinence, where pressure on your bladder causes leakage, or urge incontinence, where you suddenly feel the need to urinate and cannot get to the bathroom in time. If you have trouble draining your bladder, you might be suffering from overflow incontinence. You may also simply find that your restricted ability to move makes you take longer than you think you will need to get to a bathroom. The first step in taking care of any of these problems is to seek the help of your doctor, who will discuss your options with you. He or she might recommend behavioral changes, like special strengthening exercises and bladder training. There are also medications, devices and surgeries that could be used to help you deal with your incontinence in an efficient and stress-free manner.
Kegel exercises are often the first type of treatment tried for incontinence. These are exercises designed to strengthen the muscles of your pelvic floor, helping you to have better control over your urination. They can be greatly effective against stress incontinence and urge incontinence. The exercises involve tightening the muscles you normally would use to stop yourself from urinating. There are short contractions that last two seconds each and longer ones lasting five to10 seconds each. Each type of contraction should be performed between 40 to 50 times per day. You can perform these exercises while standing, sitting or lying down. It is important that you contract the right muscles, as you might tighten the muscles of your thigh or stomach instead. You should also be sure not to hold your breath while you perform the contractions.
Scheduled voiding is another option often recommended over drugs as an initial treatment, particularly for urge and overflow incontinence. It is generally intended to be used in combination with Kegel exercises. The schedule you set, possibly with the aid of a physician, may mean urinating once per hour to start with. This will make unintentional urination less likely to occur. You might then be able to extend the schedule, waiting a little longer each time.
Your doctor might also recommend you make some adjustments to your lifestyle. For example, you may be required to cut out alcoholic and caffeinated drinks. Additionally, drinking plain water instead of other drink choices could help to prevent incontinence. Physical limitations might also need to be imposed, such as avoiding lifting or carrying any heavy items. Certain foods, such as spicy dishes or citrus fruits, can act as bladder irritants. Your doctor might ask you to keep these out of your diet. If you smoke, constant coughing could be putting extra strain on your bladder, and it is important to stop as soon as possible. If you are overweight, this could also cause extra pressure on your bladder. You might be required to lose a certain amount of weight to help alleviate the strain that might be contributing to your incontinence.
There are a number of drugs you may be prescribed to help treat urge incontinence. However, many of them are anticholinergics, which can have unpleasant side effects. As a result, your doctor is more likely to recommend pelvic floor strengthening, scheduling and lifestyle changes before prescribing medication.
If medication and behavioral changes do not have an effect on your incontinence, you might be required to use absorbent pads, protective devices or catheters. Pads can be used if you are a female and should be easy to wear under your clothing. If you are a male, you will use what is called a drip collector. It is an absorbent garment in the shape of a pocket, worn over the penis and kept in place by your underwear.
For individuals whose incontinence is caused by their bladders not draining fully, catheters might be recommended. This is a small tube inserted into the urethra in order to completely drain the bladder. It will need to be used several times a day. A doctor will give the patient clear instructions on its use and cleaning when prescribed.
You might be given a device that can be inserted into the vagina or urethra. These can physically support the muscles that help to prevent unintentional urination, or to block overflow. These might include pessaries, intravaginal spheres or intraurethral plugs. These are particularly recommended in the treatment of stress incontinence. Another device that may be used in the treatment of incontinence is a chair that provides Extracorporeal Magnetic Innervation (ExMI). This is a low-level magnetic field that targets and strengthens the pelvic floor muscles.
There are several surgery options for those suffering from incontinence. These are all designed to help support or strengthen your urethra and bladder neck. For example, a surgery might involve what is called a colposuspension, or a peri-urethral bulking injection. You might be given a Suburethral Sling that is used for support, or Transurethral Collagen Denaturation, which tightens the tissue around your urethra and bladder.