As we grow older, some of the things we spent a lifetime taking for granted become challenges. One of those things is bladder control. At some point, we find ourselves thinking differently about a road trip or a three-hour movie. These activities suddenly require extra planning. Welcome to incontinence.
Incontinence is a condition affecting older adults who accidentally leak urine. The loss of bladder control can be embarrassing and cause some folks to avoid their normal activities. The good news is incontinence can often be stopped or controlled.
Incontinence is not always a function of getting on in years. It can happen for many reasons, including urinary tract infections (UTIs), vaginal infection or irritation, or constipation. Some medications can cause short-term bladder control problems. When incontinence lasts longer, it may be due to:
- Weak bladder or pelvic floor muscles
- Overactive bladder muscles
- Damage to nerves that control the bladder from diseases such as multiple sclerosis, diabetes, or Parkinson's disease
- Diseases such as arthritis that may make it difficult to get to the bathroom in time
- Pelvic organ prolapse - when pelvic organs (such as the bladder, rectum or uterus) shift out of their normal place. When pelvic organs are out of place, the bladder and urethra are not able to work normally, which may cause urine to leak.
There are treatments to manage urinary incontinence. Deciding which one is best for you depends on the type of bladder control problem you have, how serious it is and what best fits your lifestyle. Talk to your Kelsey-Seybold doctor.
Among the techniques he/she might recommend are:
Bladder Control Training
- Pelvic muscle exercises (also known as Kegel exercises) strengthen the muscles that support the bladder, which can help you hold urine in your bladder and avoid leaks.
- Learn to control strong urges to pee so you can make it to the bathroom in time. For example, you can try distracting yourself to help keep your mind off needing to urinate, taking long relaxing breaths, holding still, and squeezing the pelvic floor muscles.
- Schedule time to pee. For example, you can set a plan to urinate every hour. As time goes on, you can slowly extend the time between bathroom breaks.
- Medications may be prescribed. However, some have been associated with a higher risk of cognitive decline in adults over age 65. Talk with your Kelsey-Seybold doctor about which medications, if any, would work best for you.
- Vaginal estrogen cream may help relieve urge or stress incontinence. A low dose of estrogen cream is applied directly to the vaginal walls and urethral tissue.
- Medical devices may also be used to manage urinary incontinence, such as a catheter that drains urine from your bladder; a urethral insert that helps prevent leakage; and a vaginal pessary ring that provides pressure to lessen leakage.
- Surgery can sometimes improve or cure incontinence if it is caused by a change in the position of the bladder or blockage due to an enlarged prostate.
"Urinary incontinence can severely impact the quality of life as we get older. However, patients don't need to suffer in silence. There are many possible treatment options that can be tailored to each patient's needs, ranging from non-invasive options (ie pelvic floor physical therapy) to minimally invasive surgeries. I would encourage patients to seek consultation with a urologist to see what options are available to them" - Chris Chon, MD
Talk to your doctor if you experience incontinence or detect any signs of a bladder problem, such as needing to urinate more frequently or suddenly, cloudy urine, blood in the urine, pain while urinating and urinating eight or more times in one day. Together, you will develop a treatment plan that's right for you.