Common Problems in Seniors
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Urinary incontinence
Urinary incontinence is not just a female problem. It is common in both women and men of all age groups. Generally age is not the only cause. It can occur for many reasons such as constipation, certain medicines, urinary tract infections, vaginal infection or irritation. Incontinence can last for different length of time due to the following causes. An overactive or weak bladder muscles An enlarged prostate that can cause a blockage Diseases such as multiple sclerosis, parkinson's disease, or arthritis that damage nerves which control the bladder. The body stores urine in the bladder. During urination, muscles in the bladder contract or tighten. This forces urine out of the bladder and into a tube called the urethra that carries urine out of the body. At the same time, muscles surrounding the urethra relax and let the urine pass through. Spinal nerves control how these muscles move. Incontinence occurs if the bladder muscles contract or the muscles surrounding the urethra relax without warning.
Many people with bladder control problems hide this problem from their doctor. Talk to your doctor, as most cases of urinary incontinence can be treated and controlled, if not cured. The doctor will give you a physical examination and take your medical history and ask about your symptoms and if you are on any medication for any illness or surgery. Your doctor also may do urine and blood tests and a test that measures how well you empty your bladder.
There are several different 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 problem in 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. The type of treatment depends on the type of problem you have, how serious it is, and what best fits your lifestyle.
Bladder Control Training
Your doctor may suggest you try to get back control of your bladder through training. With bladder training you can change how your bladder stores and empties urine. There are several ways to do this.
Pelvic muscle exercises
(Also known as Kegel exercises) Work the muscles that you use to stop urinating. Making these muscles stronger helps you hold urine in your bladder longer. These exercises are easy to do. They can lessen or get rid of stress and urge incontinence.
Biofeedback
Helps you become more aware of signals from your body. This may help you regain control over the muscles in your bladder and urethra. Biofeedback can be used to help teach pelvic muscle exercises.
Timed voiding and bladder training
Also can help you control your bladder. In timed voiding, you keep a chart of urination and leaking to determine the pattern. Once you learn that, you can plan to empty your bladder before you might leak. When combined with biofeedback and pelvic muscle exercises, these methods may help you control urge and overflow incontinence.
Besides bladder control training, there are several other ways to help manage 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.
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