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A report done with the objective of investigating “the impact of urinary incontinence (UI) on health-related quality of life (QOL)…and to compare UI and non-UI elderly Medicare beneficiaries enrolled in managed care plans on the prevalence of depression and self-rated health” came to a fairly predictable conclusion.
The team doing the report indicated that “elderly patients with UI are more depressed and have worse perceived health. On certain domains of QOL, the negative impact of UI even surpasses that of other severe comorbidities.”
In other words, urinary incontinence made people depressed and feel they were in poor health, and sometimes had an even greater effect on them than other health issues they were suffering.
This, at first, seems odd. After all, urinary incontinence may not be impacting the body in a physical way, apart from any urge to urinate or the loss of control over urination. It does not weaken the body, cause tremendous pain or discomfort, or have a lot of other symptoms.
However, as Gladys Y. Ng, MD of UCLA Health Urology stated, “Urinary incontinence generally leads to a decreased quality of life. It can lead to depression and embarrassment due to leaking urine and smelling like urine. Sometimes, family members are unable to take care of incontinent family members, which is why they put them in institutions for care. Urinary incontinence also impacts clinical outcomes if there are ulcers in the area and if urine is leaking into wounds. Sometimes, if urine is leaking on the floor, it increases the risk for falls. Also, it can lead to sleep deprivation because of the awareness of leaking urine on the bed.”
It is also important to remember that it is not a condition itself, but a symptom of a condition. Whether it is as simple as muscle weakening in the pelvic floor as part of the aging process or another condition, it is caused by something. Often, the upset that the “symptom” causes, however, is worse for the individual than the issue actually impacting the body and its functions.
As another study explained, “Although not painful or life-threatening, urinary incontinence has an insidious way of affecting quality of life.” Yet, this same report pointed out that “Physicians who identify and treat urinary incontinence may be able to limit these deleterious effects for their patients.”
Understanding and Treating the Causes to Improve Quality of Life
Ask medical professionals and they tell you that there are several types of incontinence. Typically, they are describing bladder or urinary incontinence, though loss of bowel control is another form of incontinence (but one we are not focusing on here). The typical varieties of urinary incontinence include:
- Stress – Due to a loss in muscle control and not to emotional stress, it is when the muscles of the pelvic floor weaken, the urethra cannot remain closed or urine leaks when pressure is applied to the area. Coughing, laughing, exercising, sexual activity and many other activities can cause such incontinence.
- Urge – This is often called Overactive Bladder or OAD, and is experienced as an overwhelming need to urinate and may be due to nerve damage, muscle damage or nervous system issues. Those with MS, Parkinson’s or stroke victims often experience it, but its sources can also include infection, blockages, medications and more
- Mixed – Usually the combination of urge and stress
- Overflow – The inability to fully empty the bladder or to persistently dribble urine caused by nerve damage, constipation, weakened muscles, and more
- Functional – Often experienced by those with dementia or with arthritis, and manifested as failing to reach the bathroom in time
As you can see, living with untreated nerve or muscle damage, infection, life-changing conditions like MS or arthritis are good reasons for elderly people to experience a lower quality of life. But, repeatedly soiling garments, experiencing embarrassing moments of incontinence, or living with the constant discomfort of urinary leakage on garments or furniture and bedding may make the individual feel far worse. It is simple logic, and so it is essential to address the situation with medical intervention straight away.
Treatments vary as widely as the causes of incontinence. As an example, many with stress and urge incontinence are evaluated and if no medical intervention is needed or possible, daily pelvic floor exercises are indicated as a good treatment. Bladder retraining (usually done by carefully timing fluid consumption and eliminating at the same times daily) is also effective for many. Changes in diet (eating more fiber, avoiding alcohol and caffeine, drinking more water), smoking cessation, and daily exercise can also be part of a method for treating at home.
Naturally, urge incontinence may require alternative treatments, and overflow incontinence is also one that typically results in medical intervention. The good news is that regardless of the effectiveness of any treatment, whether medical or at-home, there are many incontinence products that greatly improve the individual’s quality of life.
While there are a diversity of adult diapers and disposable underwear, there are also deodorants, skin care products, and pads that can vastly improve the quality of life. Catheters can also improve quality of life and offer complete control. The use of incontinence products can also ensure that the individual’s home life will be greatly improved through the use of simple options like the comfortable and healthy disposable underwear or adult diapers, the single or reusable pads for furniture, cars and beds, and more.
Whether you are in need of resources for your incontinence issues or a caregiver trying to help a loved one or patient with this issue, speak with them about the many treatment options. Start with a medical exam as soon as incontinence manifests. It may not be as simple as a sign of aging or a symptom of something. Ensuring that any medical issues are addressed is the first smart step, then try any at-home options or other treatments, and then explore the many incontinence products that vastly improve the quality of life of anyone who struggles with incontinence. They offer discreet protection and enable them to live without worries, embarrassment, accidents, odor or any other unpleasant aspects associated with the condition.
If you live with urinary incontinence, you should not resign yourself to it as a fact of life or sign of aging. While all people experiencing urinary incontinence experience it as a lack of bladder control resulting in some level of urinary leakage, it is usually a symptom of something else. In other words, it is a symptom of a larger condition.
Because of that, it is often possible to reduce the risks of developing it as well as remedying the situation if it does occur. While there are some treatments that may effectively eliminate it for some, they may not work as well for others. And while there are definitely surgical treatments designed to address urinary incontinence, there are also a lot of non-surgical treatments available.
To understand how they work, though, it is necessary to understand how urinary incontinence occurs, as well.
What Happens with Urinary Incontinence?
We think of urinary incontinence as leaking urine, but it is the result of a series of glitches or malfunctions in the urinary tract. Our bodies send waste fluids to the bladder, which is an organ with muscles and nerves. We know when it is full because it expands and puts pressure on the sphincter that holds it closed at the bottom.
Early in life we don’t have control over the function of the bladder and will release urine when the bladder is full. Later, we learn how to control this sphincter and only contract the bladder, opening the sphincter, and releasing urine into the urethra, allowing urine to pass out of the body.
With urinary incontinence, we lose our ability to control that bladder contraction fully and for many reasons, urine may pass into the urethra without our willing it to happen. The reasons are often described as the “type” of incontinence we experience. For example, the most commonly discussed types are:
- Stress incontinence which is when “the pressure inside your bladder as it fills with urine becomes greater than the strength of your urethra to stay closed”. Added pressure caused by coughing or even laughing may cause a urine leak.
- Urge incontinence is when there is an “urgent and frequent need to pass urine…caused by a problem with the detrusor muscles in the walls of the bladder”. The muscles will contract too frequently, making you feel you must get to the toilet, and often fail to make it because the sensation happens only briefly before urine leaks or flows
- Overflow incontinence is when the “bladder may fill up as usual, but as it’s obstructed you won’t be able to empty it completely, even when you try… At the same time, pressure from the urine that’s still in your bladder builds up behind the obstruction, causing frequent leaks”
- Mixed incontinence is when you experience both urge and stress incontinence.
As you can surmise, there are different remedies for such varied causes for urinary leakage.
Basic Treatment for Urinary Incontinence
Before any sort of non-surgical treatments can be used, you must meet with a physician to discuss the symptoms. Many people refrain from doing so out of embarrassment or an erroneous belief that they “should” have the issue because of something else (such as childbirth, prostate surgery, aging, and so on). However, by talking about the condition and type of urinary incontinence with a physician, they can often work with you to develop effective, non-surgical plans.
These will usually start with the most conservative, non-surgical treatments for urinary incontinence, including:
- Lifestyle changes such as smoking cessation, eliminating caffeine and alcohol, increasing fiber intake, and so on. Losing weight and increasing daily activity may also be part of the non-surgical treatment because many people experience urinary incontinence simply from being overweight and/or eating a diet that causes constipation. Constipation can actually put pressure on the bladder and cause leakage.
- Pelvic floor muscle work – Many people are aware of exercises known as Kegels, and while they are used to enhance sexual experiences by some, they are also quite remarkable for improving the muscles that support the bladder and urethra. As one expert noted, “Weak or damaged pelvic floor muscles can cause urinary incontinence, so exercising these muscles is often recommended”. Naturally, the strength of the muscles will be assessed and then you will be taught how to perform them. Most programs involve three sessions a day of eight or fewer kegel squeezes. Outlines for performing them can be found here for women, and here for men. Electrical stimulators are available for those who are unable to do Kegels and involves the use of a specialty device that “measures and stimulates the electrical signals in the muscles” and may help strengthen them.
- Bladder training – This is used for young people who struggle to overcome bedwetting, but it is effective as a non-surgical treatment for urinary incontinence, as well. It is often combined with muscle exercises and involves nothing more than increasing the length of time between experiencing an urge to urinate and allowing urine to pass. It may also involve controlled fluid intake that gets the body on a very fixed routine of urine production and release.
In addition to these effective remedies, many will be prescribed medications if they apply to the underlying cause of the incontinence. There are medications for most of the causes, and these may be a last resort before using surgical interventions.
Of course, in addition to the use of non-surgical techniques, there are also many incontinence products that make it far easier to live with mild to even heavy leakage. These include incontinence undergarments that are remarkably discreet, reliable and effective, pads and shields, skin care products, and devices that may be placed inside of the urethra (such as catheters), to control urine flow.
The impact of urinary incontinence on quality of life cannot be ignored. Many living with this issue refrain from socializing out of embarrassment or fear. The steps outlined above can alleviate those fears and eliminate them almost entirely when combined with incontinence products. Though it may end up being an untreatable condition, it is never a condition you cannot enjoy a normal life with.
If you are eager to understand more about the condition known as “stress incontinence,” you must first understand the more general meaning of incontinence. Generally, incontinence is defined as an “inability of the body to control the evacuative functions of urination or defecation : partial or complete loss of bladder or bowel control”.
As one might then imagine, incontinence can be caused by a long list of issues. For example, medical experts point to the following:
- UTI or urinary tract infection
- Prostate issues
- Multiple sclerosis
- Parkinson’s disease
- Bladder problems, such as infections and bladder stones
- Certain medications, among other issues
They also break incontinence into five different “types” that include:
- Urge – Often called overactive bladder or OAB, it is manifested as an urge to urinate whether the bladder is full or empty
- Mixed – A combination of urge and stress incontinence types
- Overflow – An inability to fully empty the bladder causes urinary leaks when the bladder is full
- Functional – This is often due to a medical condition that prevents an adequate amount of time to reach the bathroom (e., those with arthritis may be unable to move quickly enough to reach the bathroom)
- Stress – This is when you leak urine whenever you cough, lift something, workout or exercise, sneeze, or even laugh. Essentially, anything that causes pressure to the bladder will allow it to leak.
It is that last type, stress incontinence that we will focus on for the remainder of this article.
Stress incontinence is the involuntary leaking of urine when you are doing physical activity or caused by something putting pressure on the bladder, this means it is not nerve related or due to psychological stress (which many automatically think of when they hear the term “stress”).
It can occur in both genders, but is more common among women, usually because of issues relating to overuse or challenges in the pelvic floor area. For example, a woman who has given birth (whether cesarean or naturally) may struggle with bladder control issues and find that she experiences stress incontinence whenever she sneezes or lifts heavy items.
Generally speaking, stress incontinence is due to weakening of the muscles and/or tissues that support the bladder, also called pelvic floor muscles, weaken. Our bladders grow as they fill with urine, and the urethra remains tightly closed to hold the urine in until we consciously release it. Muscle weakening though, allows any pressure on the bladder to let urine out.
And while we looked at many causes for incontinence, many people must also consider that certain risk factors apply and may contribute to the development of stress incontinence. Age, body weight, the type of childbirth a woman experiences, and any surgical procedures on the pelvis can play a role.
What to Do About Stress Incontinence
Whether male or female, it is an embarrassing and unpredictable issue, and so yet it is quite treatable. Let’s first look at the basic symptoms that might help you determine if the urinary incontinence you are experiencing is, in fact, stress incontinence.
Typically, a person living with or developing stress incontinence will leak urine whenever they:
- Stand up quickly
- Lift heavy items
- Exercise or run
- Cough hard
- Laugh hard
- Engage in sexual intercourse
Often, stress incontinence occurs with one or more of these activities, but may be limited to something unlisted, something as simple as a pet climbing on your lap may cause you to contract the muscles of the abdomen and leak urine due to the pressure increase on the bladder.
Of course, the fullness of the bladder may also have an impact on the condition, and you may not leak urine until your bladder has reached a fuller level.
There will, naturally, come a time when you recognize that something must be done about it. While there are simple pads and shields and a myriad of other incontinence products to protect you from embarrassing situations, you must first visit a doctor and rule out any medical issues. After all, as we saw earlier, stress incontinence is often paired with urge incontinence, and this can be medically related.
Visiting a doctor will allow the physician to look at your medical history, provide a physical exam that considers any issues with the abdominal area and the genitals, and ensure a urine sample is tested for such things as blood, infection and so on. Your doctor may also have you do a urinary stress test that checks to see if you do leak urine when you consciously bear down on the pelvic muscles.
When a medical issue is suspected, your doctor may order any number of bladder function tests that include measuring residual urine via catheter once your bladder is entirely empty. They may also do an ultrasound of the bladder. They may ask for a cystometry test that examines the pressure in the bladder, a cystoscopy to consider if there are cysts in the bladder, or even urodynamics testing to watch how the bladder behaves at all times.
Treatments Available for Stress Incontinence
There is no single treatment for stress incontinence simply because there is no single cause. For most people, it ends up being a number of steps to help overcome or live with the condition. These include:
- Behavioral therapies – These may involve daily pelvic floor training, such as kegel muscle exercises or the use of biofeedback. Scheduled fluid consumption to avoid bladder over-fullness, lifestyle changes like smoking cessation or dieting, and bladder training programs
- Medical intervention – There are some medical devices, such as urethral inserts and vaginal pessaries that can be used, and surgical options can include the use of bulking agents in the area around the urethra, procedures to reinforce certain tissues, artificial sphincter implants, or mesh slings to support the urethra
- At home options – Many find that weight loss, changes to the diet (particularly if living with constipation), skipping beverages that might irritate the bladder and smoking cessation all work well. Kegel exercises or pelvic floor work can also be of benefit to most.
Almost any can experience stress incontinence, and if you feel you may be experiencing it, a visit to your physician is a wise choice. Talk with them about any possible health issues, and then use whatever remedies they recommend, as well as those outlined above.
Urinary incontinence is often described with words like “embarrassing” or “uncontrollable,” and these terms are part of the reason that almost all types of urinary incontinence fail to be reported quickly. In fact, it is not unusual for someone with symptoms of urinary leakage to wait an average of six years before consulting with a medical professional about it.
Yet, regardless of when it is reported and addressed, it should never be viewed as a “condition” on its own. Urinary incontinence is typically a symptom of something else going on. When it occurs in men, it is usually due to:
- Prostate issues
- Lack of exercise
- Chronic cough
- Lifestyle choices
In addition to this long list of causes, there are also ways that urinary incontinence will manifest in men. It can be:
- Stress incontinence
- Urge incontinence
- Mixed incontinence
- Overflow incontinence
- Functional incontinence
Treating urinary incontinence as a symptom of something else will involve first identifying the underlying cause and seeing if it can be eliminated or remedied. Then, the urinary incontinence can be dealt with more effectively through non-surgical as well as surgical interventions.
No matter how it is addressed, though, one of the most important elements in living with this issue is investing in the right incontinence products designed specifically for men. As one expert noted, “Lots of men hate the idea of using incontinence products — so-called adult diapers, urine collection bags, and catheters. But if you’re having a problem with male incontinence, these products can really help.”
After all, if you want to eliminate those words mentioned at the opening of this article (embarrassing and uncontrollable) from your vocabulary, one of the simplest ways to do that is through the use of incontinence products for men. They prevent the “accidents”, the odors, the discomfort and all of the other issues associated with urinary incontinence.
The Basic Products for Men
What sort of incontinence products for men are recommended? The most useful include:
- Pads and shields – Used on bedding, furniture and even a car seat, they are able to capture any leaks, moisture and odor. There are also pads and shields for undergarments that are great at wicking moisture from the skin, preventing irritation and odor and ensuring that no one even knows you are wearing protection
- Underwear – There are also full-sized garments designed specifically for men with padding and “zones” in the ideal spots for the male body. These will vary in size, style, and design, with options for reusable and disposable always available. Some feature drip collectors and other specialty regions for heavier leaking or longer wear.
- Catheters – Many men with incontinence issues find that external catheters are quite effective. They are not inserted into the urethra but are instead slipped over the penis and are made of silicone or latex. They fit almost as snugly as a condom but have small tubes with collection bags at the end, and any urinary leakage is captured by the bag. Some wear them exclusively at night to ensure they are getting adequate and undisturbed sleep, while others will wear them throughout the day to enjoy the most worry-free
- External compression – Another term for these urinary incontinence products are penile clamps, which is a bit misleading. They are not as brutally clamp-like as their name sounds. Instead, most are made of easy to use and comfortable to wear foam. They put a small amount of pressure over the end of the penis, effectively pinching the urethra closed enough to prevent urinary leaks. They are not the most comfortable, but most who use them say that they are not uncomfortable, either.
- Portable urinals – Many men with urinary incontinence also feel better about the issue when they know they don’t have to race to the toilet at the moment the urge to urinate strikes. This is why toilet substitutes like hand-held, plastic urinals are popular. They can capture a large amount of fluid, trap odor and ensure peace of mind.
Making Plans to Use Male Urinary Incontinence Products
As already noted, many men are unhappy at the thought of using any of these male urinary incontinence products. For some, it can be due to the simple fact that they do not wish to enter a store and purchase something like a package of adult diapers or shields for their bed.
The good news is that real-world shopping for these items is no longer required. The era of the internet has made it easier, and often far less costly, to do all of the purchasing online. Preferred products can be purchased in single packages or cost-effective cases, discreetly delivered, and many options can be explored through online resources.
If it is more a matter of “resigning” oneself to the use of items like male adult diapers, bed underpads, external catheters and deodorizers, it is understandable. Many people feel a bit defeated by the use of incontinence products, and worry that once they rely on them, they will never return to the days of living without them.
The first thing to remember is that you must see a doctor if experiencing male urinary incontinence. They will go over symptoms, do an exam and help determine the right treatment plan. It could be that some exercises and bladder training make such improvements that male urinary incontinence products are a temporary resource.
If the condition causing incontinence cannot be overcome, it is of the utmost importance to look at the male urinary incontinence products as one of the most important resources over the long term.
Why? They improve your quality of life from the moment you begin to use them. They enable you to socialize, do the kinds of activities you have always enjoyed, and live without constant worry about where you will find the nearest toilet. Take a car trip, go for a walk or a long game of golf, play with the kids, wear those snug-fitting clothes because male urinary incontinence products can work with you and allow you to confidently enjoy your life as you did before bladder issues occurred.
A 2014 report from the Centers for Disease Control entitled “Prevalence of Incontinence Among Older Americans,” detailed some surprising statistics. However, the report used a data set that made it impossible to supply any sort of averages because the data was sourced from:
- 2007–2010 National Health and Nutrition Examination Survey (NHANES) using in-home interviews with non-institutionalized participants
- 2010 National Survey of Residential Care Facilities (NSRCF) using reports provided by designated facility or agency staff members for 6,856 residential care facility and/or residents
- 2007 National Home and Hospice Care Survey (NHHCS) using data from 3,226 current home health care patients, and 3,918 hospice discharges
- 2009 Long Term Care Minimum Data Set (MDS) using data supplied by 2,416,705 nursing home residents
Response rates varied from 84% to 99%, and many medical groups took the reports apart and offered summary data to clarify the findings.
According to the team over at WebMD, the CDC report explained that more than half of all older Americans deal with some level of incontinence. Citing one statement from the research team, they explained that “half the population experienced urinary leakage or accidental bowel leakage, and about 25 percent had moderate, severe or very severe urinary leakage. And about 8 percent had moderate, severe or very severe bowel leakage.”
This far more than many might expect, especially because the impact of incontinence can be quite debilitating. After all, it has emotional, social, health and economic effects on those living with it. And because it does vary, it is helpful to take a few moments now to go over just what incontinence means if we are also to understand the many ways it affects older Americans managing it or living with it.
What is Incontinence?
A dictionary definition of incontinence says it is “inability of the body to control the evacuative functions of urination or defecation: partial or complete loss of bladder or bowel control”. It is caused by an astonishing list of issues, often more than a single issue, and when it is urinary incontinence, it can be described using five different types or categories:
- Stress – This is quite common and is NOT due to emotional stress but to physical strain such as coughing, lifting, or even pressure applied to the abdomen
- Urge – This is the type that many know as overactive bladder and which presents as a powerful urge to urinate only briefly before it is needed or even when the bladder is empty
- Mixed – This is a common issue and is a combination of the two types above
- Overflow – This is when the bladder cannot fully empty and results in bladder leakage as it refills
- Functional – This is incontinence that is a direct result of any issue that prevents adequate time or capability to reach the bathroom, e., a leg issue may cause incontinence because it is so difficult to get to the bathroom quickly
Urinary incontinence has many causes, but most relate to a weakening of the pelvic floor muscles that support the bladder and urethra. Additionally, overactive muscles may cause the condition, too.
Is it just a part of aging? No. In one summary report on the CDC investigation, “Dr. Tomas Griebling, a professor of urology at the University of Kansas and a spokesman for the American Urology Association, said incontinence increases with age,” but that it should not be viewed as inevitable or normal.
The CDC report said as much, pointing out that the percentages of adults with incontinence issues has maintained a flat line or remained the same. However, Dr. Griebling also explained that the aging of the current population signifies that there will be more with the condition in the future.
For example, those queried for the report who still lived in their homes demonstrated that over 50% had bladder and/or bowel incontinence (44% had bladder issues). Those in nursing facilities had similar rates.
Diagnosis is Important
Sadly, because many think that it is a simple part of aging, many do not get properly tested to determine the background cause, and if it relates to a medical condition or another issue. For example, at the first signs of bowel or bladder leaking, it is crucial to visit a physician.
This enables them to perform the proper physical exams, book the appropriate tests, ask questions about symptoms, and even do a review of medication regimens a patient might be using, and which could be a source of the problem. More in-depth testing may be required to examine how well a patient can empty the bladder, and whether there are any signs of cysts or infection. If a doctor suspects something other than pelvic floor muscle weakening, they may recommend a visit to a specialist known as a urologist.
Dealing with Incontinence
While there are medical interventions that can help, there are also many at-home remedies and incontinence products that can be used before any more extreme steps, such as surgery. For example, men and women alike can perform pelvic muscle exercises. These can be done by squeezing your pelvic floor muscles as if you were attempting to cut off a stream of urine or hold intestinal gas. Hold the muscles for a count of three, but as the National Institutes for Health warn, “Repeat, but don’t overdo. Pull in the pelvic muscles and hold for a count of 3. Then relax for a count of 3. Work up to 10 to 15 repeats each time you exercise”. Do them three times a day and you will start to feel changes.
You can also use “timed voiding” that sets your consumption of fluids and urination on a very fixed routine. Combining pelvic floor training, timed voiding, and alternatives like biofeedback can often produce profound improvements for an older adult. Lifestyle changes like cutting out caffeine, eating more fiber, shedding extra weight and smoking cessation are also extremely helpful. Incontinence may be wildly prevalent, but it is not inevitable. See a doctor as soon as you notice signs of the issue and work with them to develop a plan to reduce the issues or even end them.
Urinary incontinence ranks as one of the most under-reported symptoms among both men and women alike. This is due to a few basic misunderstandings:
- That urine leakage is something that is embarrassing or shameful
- That urinary incontinence is an unavoidable sign of the aging process or childbirth
- That there are no remedies for urinary incontinence
- That products to remediate urinary incontinence are noticeable, uncomfortable, unreliable, and so on
The good news is that none of these assumptions are correct and that the myths of urinary continence contribute to its negative effects on quality of life.
A report in the Global Library of Women’s Medicine said as much, concluding that “there are multiple facets of urinary incontinence that have the potential to affect health-related quality of life…The disorder may affect emotional and social facets and may also have an impact on activities of daily living and role fulfillment. Given the growing evidence of psychosocial impact, physicians caring for [patients] with urinary incontinence should become familiar with health-related quality of life assessments.”
Now, that is a tidy, but clinically phrased explanation of the realities of urinary incontinence on the individual’s mindset. Let’s consider it in more accessible terms.
As another scientific report explained: “If you’ve ever found yourself passing up an opportunity to go out with friends, go for a walk in the park with your kids or take a long road trip because of your overactive bladder or urinary incontinence, you’re not alone.
Over 25 million adults in the United States are dealing with the same issue, but you’ll most likely never hear anyone talk about it.”
In fact, this same report indicates that most people with urinary incontinence will wait an astonishing six years before seeking out any sort of diagnosis of treatment. Yet, “working with your doctor to find a solution can help you live a full, happy and active life without the dreaded fear of an unpredictable bladder accident.”
It would seem that fear is a driving force behind the harmful effects so many with urinary incontinence experience. So, let’s start with a look at the ways millions of others with urinary incontinence have tackled their fears and improved their quality of life.
What Are You Afraid Of?
Knowledge is power, they tell us, and where any sort of urinary incontinence is concerned, it is entirely true. The first thing to know in order to improve your quality of life is this:
- You are not alone – millions of other people have the identical struggle. The U.S. Department of Health & Human Service’s National Institutes of Health say that 500 million people (of all ages and backgrounds) around the world have urinary incontinence
So, don’t think of this as something you must suffer with in silence and isolation. There are support groups, online and real-world, as well as books, websites, and other resources to use to feel a bit better about this change in your body’s behaviors.
However, before you resign yourself to urinary incontinence, there is another thing to know, and it may be responsible for greatly improving your health and quality of life. It is that:
- Urinary incontinence is most often a symptom and NOT a condition. It is usually caused by something else.
This means that you must get in touch with a physician at the first sign of urinary incontinence to allow them to help you identify the “type” of incontinence. Why? Because this is often an indicator of the underlying cause.
The different types of urinary incontinence include:
Each of these types of urinary incontinence is caused by an array of different conditions and issues. They can even occur simultaneously, with stress and urge being quite commonly experienced. It is important to address the causes because they can be as simple as muscle weakening or aging, but might also be linked to neurological issues, cancer, disease, infection and more.
Identifying the type and cause then enables you to begin receiving treatment and taking steps to feel more comfortable with the condition. Again, this is where knowledge becomes power. How? This is yet another important point to know about improving your quality of life with urinary incontinence, and it is that:
- Your individual incontinence requirements can be mapped out. This can enable you to get it under control, and in turn, restore your quality of life to what it was before symptoms interfered. From the ongoing costs of your incontinence supplies (if needed) to the different exercises, treatment options, and steps you will take, knowing what to do, making plans and taking action is far better for your quality of life and mental well-being than simply resigning yourself to the issue.
It is important to keep in mind that treatment plans may actually alleviate or reduce symptoms. As an example of this, a man or woman with stress incontinence may find that learning how to properly exercise their pelvic floor muscles may be able to strengthen them enough to regain full control or reduce leakage. They might also use bladder training and timed fluid intake to regulate their bladder function to the most controllable level possible. This can help them learn when they will experience potential incontinence and take steps to address the situation.
Medications are also an option and surgical remedies may be able to reduce or eradicate the symptom. As we already noted, incontinence supplies will also make a world of difference, including specialty undergarments, devices for men and women, deodorants, skin care products, and many other types of pads and shields. These can be selected based on need and often worn or used discreetly enough not to interfere with everyday activities and even more athletic activities.
As one physician said, “If you’re experiencing incontinence problems, there really is no need to suffer alone. Your doctor can help you find a solution, which will get you back to living the kind of life you’ve been avoiding because of your incontinence.” However, it does take that first step – getting medical attention – and then you can get on with life!
Did you know that urinary incontinence is one of the most under-reported medical issues? This is for several very different reasons:
- Often, someone struggling with urinary incontinence is too embarrassed to admit they have the issue; or
- Many assume it is a “fact of life” that will occur due to age or other factors; and
- They might assume that there is nothing that can be done
It is unfortunate that such thinking is a common occurrence because it should not embarrass anyone to have urinary incontinence because it is a very common symptom of a surprisingly long list of conditions. Additionally, it is important to know that it is not a fact of life, nor something you have to learn to live with. After all, it is, as stated, a symptom. That means a physician may be able to work with you to identify, and in many instances, remediate the cause.
First and foremost, though, let’s answer a key question: Just what is urinary incontinence?
Urinary Incontinence Explained
The technical definition of urinary incontinence is the involuntary release of urine. We control urine through voluntary functions. As the Urology Care Foundation explains, “The brain and the bladder control urinary function”. And they do so in a very ordered manner.
- Your bladder stores urine until you are ready to release it, and you are able to “hold it” because of an array of muscles in the pelvic floor, including those around and in the bladder.
- Typically, smooth muscle in the bladder is “relaxed,” and this actually holds the urine inside of the organ. The bottom of the bladder features a sphincter that remains closed and also seals off the upper end of the urethra (the tube responsible for transporting urine out of the body). Clearly, you need the muscles of the sphincter to be responsive and healthy, too.
- To urinate, your brain transmits your conscious message to the muscles and bladder, opening the urethra and sphincter and emptying the bladder.
Healthy bladder function allows you to empty the bladder fully and then relax the muscles bringing your bladder from its contracted condition to its closed position. It will eventually refill and once you are ready to empty it, it will allow the process to be repeated.
Urinary incontinence, then, is when this very orderly process is somehow impeded or interrupted. There are ways that medical experts describe urinary incontinence, and they use the following terms:
- Stress – When urinary incontinence is due to stress, usually called SUI, it signifies some sort of weakness in the muscles. For example, you cough very hard and leak urine or you lift something and realize you’ve expressed some urine. This is one of the most common manifestations of urinary incontinence
- Overactive bladder – This is also quite common and frequently called urge incontinence because it manifests as an overwhelming (sometimes uncontrollable) need to urinate. As the UCF explains, “your brain tells your bladder to empty – even when it isn’t full. Or the bladder muscles are too active. They contract (squeeze) to pass urine before your bladder is full. This causes the urge (need) to urinate.”
- Mixed – This is the occurrence of both SUI and OAB
- Overflow – This is when the body makes more urine than the bladder holds OR a full bladder does not empty fully and it then leaks afterward
- Functional – This is not technically incontinence because it is caused by the inability to reach the toilet in a reasonable span of time. For example, someone with extreme arthritis may struggle for a length of time to reach the toilet and suffer from incontinence because of the overly long delay
Naturally, this means there are many causes for urinary incontinence.
What Causes UI?
Any sort of urinary incontinence should be seen more as a symptom of another condition. There are many causes for UI in men and women of any age, and these include:
- Pregnancy and childbirth
- Prostate issues
- Neurological disease
- Medical conditions
- Risk factors that include lifestyle (smoking, drinking, drug use)
Because the condition manifests in many ways, (i.e., one patient experiences urinary incontinence during the evening hours as they sleep while another experiences it whenever they strain or are active) it must also be treated very differently based on each individual case. Of course, there are also preventative measures everyone can take to reduce their risks for developing the condition.
Preventing and Treating Urinary Incontinence
It may not always be possible to avoid urinary incontinence, but the following steps will usually reduce the risks:
- Smoking cessation
- Consuming a high fiber diet to prevent constipation
- Skipping alcohol and caffeine that are both dehydrating and irritating
- Keeping a healthy weight
- Exercising daily
- Doing regular pelvic floor exercises to strengthen muscles around the bladder and urethra
- Getting regular checkups that include incontinence screenings
If the condition still develops, a physician must be consulted right away. They can best determine the cause and then steer patients towards the best treatment options. This may include behavioral methods that include limiting fluid intake to certain amounts and certain hours, timed voiding and bladder training, and double voiding (visiting the toilet to empty the bladder, waiting a few moments and emptying it again).
Muscle training using kegel exercises is known as a good treatment for those with periodic or light incontinence due to aging, muscle weakness and more. Biofeedback is also put to use in a similar way and for similar symptoms.
When behavioral and muscle training are not enough, there are also some medications as well as surgical interventions. And because such a huge number of people struggle with urinary incontinence, there are many well-designed and effective incontinence products available. From catheter products to protective bed pads and entirely undetectable urinary incontinence undergarments, it is possible to lead a normal healthy life even with incontinence that cannot be remedied through medical intervention.
The first step is to accept that it is not an embarrassing issue and that it is treatable, even if limited to incontinence products. Life can be enjoyed in the same ways it was before incontinence, and the first step is to speak with a medical professional to discuss the issue.
Are you a woman living with urinary incontinence?
Maybe you provide care to a loved one or patient struggling with urine leakage? Do they say that it is very embarrassing, distressing, or uncontrollable? These are very commonly used adjectives when patients discuss their urinary incontinence.
Unfortunately, many will not even speak about it because of some false thinking about it. For example, many women don’t mention it to their doctors during annual exams because they:
- Are embarrassed to say they are wetting themselves
- Believe that it is inevitable due to childbirth or pregnancy, menopause, hysterectomy or aging
- Believe that it is a natural part of aging
- Think there are no remedies once it begins
- That it is a condition rather than a symptom of something else
All of these thoughts and feelings are unfortunate because more than 500 million people on the planet live with urinary incontinence, with 25 million in the U.S. alone (and an estimated 70% of them are women). So, there is nothing embarrassing about it.
It is also not inevitable, part of aging or untreatable. It may even be something that can be remedied or treated through an array of different options. Lastly, it is far less a standalone condition than it is a symptom of something else.
Consider that it is often something that women live with because of such issues as:
- Nerve damage from childbirth and other health issues
- Diseases like MS, Alzheimer’s, diabetes, Parkinson’s and even stroke that damage nerves
- Surgery, including bowel surgery, hysterectomy or lower back surgery
- Lack of exercise
- Chronic cough
- Lifestyle choices such as smoking, drinking a lot of caffeine or alcohol, using certain drugs
In addition to the many causes behind female urinary incontinence, there are also ways that it actually occurs. These are known as the “types of incontinence,” and they include:
- Stress incontinence
- Urge incontinence
- Mixed incontinence
- Overflow incontinence
- Functional incontinence
So, it comes as no surprise that treating any instance of female urinary incontinence starts with recognizing the type of incontinence and then working to find out what is causing it. If the condition that has female urinary incontinence as a symptom can be treated, it may mean the urinary leaking is eradicated, too. If the condition cannot be treated, there are non-surgical and surgical remedies for incontinence.
Female Urinary Incontinence Products as a First-Line Defense
Among the most commonly used non-surgical options are female incontinence products. Unlike men, women are often used to reliance on similar products like panty shields and liners, menstrual pads, and deodorants.
In fact, women are at a bit of an advantage over men because of a life-long reliance on products similar in design to many of the female incontinence products. They already know that using them will allow them to become more active, more social and improve their overall quality of life.
It is important to note this because of those terms so commonly used by those living with any sort of incontinence, like embarrassing or uncontrollable. The use of the right female urinary incontinence products make it possible to avoid the leaks, odors and unpleasant moments that urinary incontinence can create. They can become a trusted resource at all times and a first line of defense against this issue; preventing it from interfering with quality of life.
The most useful include:
- Pads – Think of them as similar to sanitary napkins with a similar design, but with an emphasis on wicking away and absorbing far more moisture than the average sanitary pad. They can be quickly changed, block odor and will effectively trap urinary leaks.
- Panties or briefs – You will find them as disposable or reusable options. The reusable styles wear similarly to traditional panties but have two layers. The outer layer is soft and comfortable while the inner layers often trap up to ten ounces of fluid. They are impregnated with odor-controlling compounds and will keep skin comfortable and dry. The disposable types may be styled as pull-on pants or as adult diapers that are quickly adjustable. These are even more moisture-trapping and can be found in “underwear” styles that can be worn beneath everyday garments without being easily detected.
- Underpads – Place them on your furniture, car seat, and bed to protect from any leaks.
- Pessaries – These are devices that slip into the vagina and compress the urethra. They are meant to be worn almost constantly, with cleaning done at least once a week. There are medically inserted models, but also over the counter designs. They take a bit of practice but can offer a great deal of control over urinary leakage.
- Electronic kegel trainers – Devices that are inserted into the vagina and which issue electronic impulses that are identical to the contractions done when doing pelvic floor exercises.
Making Plans to Use Female Urinary Incontinence Products
Using incontinence products is not a thrilling aspect of ones life. After all, it can be quite embarrassing to pick up packages of adult diapers and other items in the grocery store or pharmacy. However, with the option for online shopping, that sort of discomfort is over. Not only are many online retailers able to provide far more choices, but also better pricing. Products are available in single packages or cost-effective cases and then discreetly delivered right to the door.
For others, it is that concern mentioned a bit earlier, that using these products is a sort of resignation to a permanent reliance on female urinary incontinence products. This sense of failure is not an accurate response. Why not? Because you should not live with urinary incontinence without first seeing a doctor. They will examine you, run tests and treat the condition causing urinary leakage.
They may be able to give you treatments that erase the problem.
In the end, the female urinary incontinence products may be only a temporary thing, but even if a condition causing incontinence is not treatable, these products will improve your quality of life; often from the moment you begin to use them. They will allow you to socialize, do the kinds of activities you have always enjoyed, and live without constant worry about accidents. Wear your favorite garments, do the things you love, because female urinary incontinence products have you protected.
It might be surprising to learn that 51% of women, overall, live with urinary incontinence. And though the numbers increase with age (a recent study determined it occurred at “13% in young, nulligravid women to 25% in reproductive-age, 47% in middle-age, 55% in postmenopausal, and 75% in older women“), it was around double the rate experienced by men.
Though there are multiple kinds of urinary incontinence, the most common ways that women experience an involuntary loss of urine is through stress incontinence, urge incontinence, or a combination of both.
Because such a marked percentage of women experience this life-changing symptom, and because it can be caused by such a long list of issues, the findings in the study mentioned above were as follows: “WPSI recommends screening women for urinary incontinence annually. Screening ideally should assess whether women experience urinary incontinence and whether it affects their activities and quality of life. The WPSI recommends referring women for further evaluation and treatment if indicated.”
The Women’s Preventive Services Initiative is a U.S. coalition of women’s health care professional organizations aligned with patient reps, and the recommendations from the study are intended to shape and guide the Health Resources and Services Administration, among others. As the study explained, “The target audience for this recommendation includes all clinicians providing preventive health care for women, particularly in primary care settings. This recommendation applies to women of all ages, as well as adolescents.”
Why adolescents instead of the elderly in those higher brackets? As noted, urinary incontinence is not the condition, typically, but a symptom of something.
What is Urinary Incontinence?
Experts agree that urinary incontinence is simply an involuntary release of urine from the bladder. It may be accompanied by any number of other symptoms, such as the intense urge to urinate briefly before release, difficulty urinating, blood in the urine or dark urine, and so on. Any of these symptoms indicate different potential causes of the loss of urinary control.
For example, urinary incontinence in women could be due to:
- Pregnancy or childbirth
- Hysterectomy or similar surgeries
- Menopause and declining estrogen levels leading to muscle weakening
- Neurological issues, including stroke, Parkinson’s, and MS
- Constipation may cause overflow incontinence
- Bladder tumor
- Urinary stones or crystals
- Anatomical defect
- Problem from surgery for incontinence
- Excessive consumption of alcohol or caffeine
- UTI (urinary tract infection)
- Certain medications
Clearly, this represents an immense range of potential causes, and many of these issues are capable of being experienced by adolescents as easily as the elderly and all women in between those extremes.
And, more importantly, screening becomes significant because, as the report noted at the beginning of this article indicates, “Despite its high rates and adverse effects on health, well-being, and function, urinary incontinence is under reported by women and therefore infrequently recognized by clinicians.”
A survey revealed that more than half of women suffering from urinary incontinence failed to report the symptom “to their health care providers because of embarrassment, stigma, or acceptance as normal.”
This is troubling for many reasons. The first is that “symptoms may be treated by behavioral, nonpharmacologic, pharmacologic, and surgical interventions, depending on the type and severity of incontinence and patient preferences. Early intervention may reduce symptom progression, improve immediate and long-term quality of life, and limit the need for more complex and costly treatment.”
How Will Screening Be Done?
The report evaluated more than a dozen screening methods against the clinical diagnosis of incontinence or diagnostic test results. Their sample methods included:
- Brief clinician- or self-administered questionnaires describing symptoms
- Clinical diagnosis based on physical examinations
- Urodynamic testing
They discovered that two screening methods that yielded good outcomes. They described them in their report recommendation, saying that “Screening should include the use of validated assessment instruments that include questions about whether a woman has symptoms of urinary incontinence; the type and degree of incontinence; and how symptoms affect her health, function, and quality of life. Several brief clinician- or self-administered questionnaires for primary care settings identify women with stress, urge, or mixed incontinence and may be used to guide diagnostic evaluations and management.”
Though screenings are not mandatory, and few physicians use incontinence screenings with female (or male) patients during routine physical exams, you can ask your physician about them now. In fact, you must if you or a loved one has been experiencing such an issue.
As you can see from all of this, however, is that the severity of urinary incontinence as a symptom has made it clear that it must be evaluated on an annual basis for females in their adolescence and upward. While many experts felt that under-reporting might still occur, the screening methods recommended did yield good diagnoses and treatment plans.
What it tells the non-medical people of the world is that they must be honest about any level of urinary leakage, and particularly if it is a new symptom or issue. Urinary incontinence is clearly going to affect the health, but it also has an impact on the quality of life and even the day to day function a person experiences. Somehow, it remains under treated and often undiagnosed.
This may easily allow it to worsen into something that might have otherwise been treated or alleviated. Making a standardized screening part of any annual clinical exam or even gynecological exams can go a long way to bringing those numbers under control.
After all, urinary incontinence can often be due to something as treatable as an infection, a urinary stone, or muscle weakening. These can be remedied through medication and special exercises. Surgical interventions may also help to remedy the symptoms and improve quality of life.
When treatment does not erase the incontinence, though, there are many remarkable incontinence products just for women that exist to allow buyers to discreetly wear disposable or washable underwear that traps moisture, odor and allow a normal life. There are adult diapers, furniture and bed pads, deodorizers and skin care products, and any number of undergarments that can enable someone with incontinence of any level or type to enjoy a normal, active and social life without anyone knowing they are dealing with this often embarrassing issue.
When there is anything going on with the bladder, it can be difficult to determine just what the problem might be, and it is because so many issues involve identical symptoms. As an example, those with overactive bladders may find that they can “no longer hold urine normally…[and] often feel a sudden urge to urinate or experience an accident.”
And while you might say that urinary incontinence is the same, with loss of bladder control allowing urine to leak out, they are actually two different things. In fact, experts will tell you that incontinence is not a condition, but actually the symptom of one, including overactive bladder.
Just consider that you might have some urinary incontinence because you consumed far too much fluid, you have just had a baby or some sort of surgery, or you have something like a UTI (urinary tract infection). That, as you see, brings us to the third item in the question posed by the title of this article – the UTI.
Fortunately, we already have a partial answer – the main difference between an overactive bladder, UTI and urinary incontinence is, quite simply, that the first two are conditions while urinary incontinence is often a symptom of those conditions.
A Closer Look at Overactive Bladders
Of course, incontinence is not the only indicator of one or both conditions. Overactive bladder, typically called OAB is caused by muscles around the bladder behaving in an involuntary manner. This unusual behavior by muscles you normally control on your own can be due to a long list of causes, including:
- You drink excessive amounts of alcohol or caffeine that can overstimulate the muscles and act as diuretics the body needs to flush
- You have a medical condition such as multiple sclerosis or Parkinson’s disease that affects the nervous system
- You have bladder abnormalities or obstruction
- You have kidney disease or diabetes
- You are suffering from declining cognitive function due to age
- You are male and have an enlarged prostate
- You may have had a stroke and one of the effects was loss of muscle control in that area of the body
Regardless of the cause, your condition is typified by a sudden urge to urinate, and the urge may be almost impossible to halt, causing leakage. You may urinate more than eight times a day and wake at night needing to urinate.
It is a condition that can be managed through activities as simple as timed voiding and controlled fluid consumption, pelvic floor exercises and strengthening, and behavioral strategies. However, the first thing anyone must do with a sudden change in bladder control resulting in incontinence is to visit a physician to ensure it is not a serious medical issue at fault.
Urinary Tract Infections
UTIs can be quite painful and even destructive. They usually occur when bacteria are able to enter the urethra and then travel upward to the bladder. Because women are structurally different, with shorter urethras, they typically get UTIs more often than men. However, men will also suffer such infections.
Unlike OAB, though, no behavioral or lifestyle changes can help to overcome the issue. This is a difficult infection and has to be addressed with medical support, typically in the form of antibiotics. The type used depends entirely on your medical history and the level of infection (i.e., the severity) and the bacterial type.
Your doctor will do a urine test and then prescribe any one of a number of antibiotics, and it is imperative that you use the full course and follow up with the doctor. Why? UTIs can be so severe that they require hospitalization and may even travel as far as the kidneys.
The symptoms of a UTI include, as you know, urinary incontinence, but they may also present in the form of an abnormally strong urge to urinate, pain and burning during urination, blood in the urine and even an urge to urinate without passing any urine at all. Some men experience rectal pain while women can have general pelvic and lower back pain.
So, never think that a sudden urge to urinate is a sign of OAB or a UTI. Instead, head to your doctor immediately and let them make the determination. Chances are that urinary incontinence may be one of your symptoms, and it could be that you have neither an OAB or UTI but something else that causes your symptoms.
Types of Incontinence Matter
After all, if you speak with experts, they tell you that there are a few “types” of incontinence. Stress incontinence is one and can happen whenever pressure is applied to the area around the bladder. For instance, coughing, laughing hard, lifting something heavy, even having your cat jump on your lap or abdomen while you stretch out can lead to urinary leakage. The urge to urinate at such times may be mild to strong, and often cued by the sensation caused by your weakened urethra. This form of incontinence is often due to muscles around the pelvic floor, bladder and urethra weakening, and may not always be due to a UTI or even OAB.
The Costs of Bladder Issues
It goes without saying that any condition that presents you with the risk of wetting your pants can be quite life-altering. Many people do not realize the seriousness of the overall effects of incontinence or issues that might cause it. Additionally, there is that risk of feeling deeply upset by the condition, avoiding socializing, and even being injured if you find yourself rushing to the bathroom, but falling or tripping along the way.
While a CDC report from 2014 pointed out that roughly half of all older adults in the United States have some sort of incontinence, it is not an inevitable part of aging. If it does occur, it is not necessarily permanent. If it is going to be ongoing, the number of incontinence products is astonishing, and patients can easily find remarkably high-quality products such as incontinence undergarments or pads and shields that can trap moisture, be worn discreetly and allow for independence to remain. The key is to find out what is going on – UTI, OAB or muscle weakening – and work with a doctor to overcome the issue.
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