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Monthly Archives: July 2019

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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
  • Age
  • Menopause and declining estrogen levels leading to muscle weakening
  • Obesity
  • Cystitis
  • Neurological issues, including stroke, Parkinson’s, and MS
  • Constipation may cause overflow incontinence
  • Bladder tumor
  • Urinary stones or crystals
  • Anatomical defect
  • Fistula
  • 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
  • Testing
  • 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.”

Start Now

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.

From U.S.News & World Report: 

Choosing the right nursing home is challenging. And chances are good you’ll someday face this decision for yourself or a loved one. More than half of older adults will eventually stay in a nursing home for at least one night, according to a September 2017 study. Of course, most residents stay much longer.

Obviously, you can’t just rely on facility tours or promotional brochures to make this crucial decision. First, get your ducks in a row. You can locate possible facilities and find inspection data by searching the U.S. News Best Nursing Homes rankings, as well as downloading a comprehensive checklist for visits.

When you’re ready to visit in person, turn to administrators, staff members and residents for answers to pivotal questions.

Read the rest HERE at U.S. News & World Report.

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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.

What is Incontinence?

Incontinence is the inability to completely control the bladder or bowels. Any type of incontinence will occur by degrees from mild to severe and will have an array of causes. Urinary incontinence, though most common among women, occurs in men and manifests in different ways, as well. The National Association for Continence indicates that in the U.S. alone there are more than 20 million people dealing with some sort of incontinence, and this explains the huge array of incontinence products available.

As the University of Rochester reports, “while sales of adult diapers now outpace sales of baby diapers, incontinence is rarely discussed”. In fact, it often goes unreported because urinary incontinence in men and women of any age can feel embarrassing or may even be (wrongly) viewed as a normal part of life and/or aging. In this article, we are going to review the basic facts about urinary incontinence in men, which is not as often discussed as incontinence in women. While it is not as common, it exists in men of all ages and must be addressed, examined by a doctor and treated accordingly.

Causes of Urinary Incontinence in Men

So, first things first – why would men experience a loss of bladder control or urinary leakage?

Urine leakage, a key sign of urinary incontinence in men and women, occurs in a similar manner regardless of gender. As the experts at WebMD explain , “urine moves from your kidneys to your bladder through tubes called ureters. Your bladder stores your urine until a signal tells your brain that your bladder is full. Then urine leaves your body through a tube … called the urethra. Urinary incontinence happens either because the signal to your brain gets scrambled or doesn’t happen, or because of a problem somewhere in your urinary tract.”

Leakage might be due to overactive bladder (also called urge incontinence), muscle weakening in the area around the bladder or urethra, problems with fully emptying the bladder which causes it to become overly full, blockage, structural issues from birth, infection, medication, medical conditions, and more. What you need to realize, though, is that urinary incontinence in men (and women) is a symptom, typically, and not usually a condition on its own.

For example, for many men, an issue with their prostate may cause leakage. So, in that case, their incontinence would be a medical issue with the prostate. It is important to determine the cause of urinary incontinence in men rather than just live with it and ignore it as a symptom of something larger.

Symptoms of Urinary Incontinence In Men

  • Prostate issues – Enlarged prostate glands can be benign or due to cancer. The enlargement blocks the urethra and cues the bladder to work harder, building up the walls of the bladder and causing great difficulty in fully emptying it over time. Those who have been treated for prostate cancer may also find that nerve damage leads to incontinence.
  • Disease – Neurological diseases such as MS, Parkinson’s, Alzheimer’s and even stroke can cause malfunctions in the nerves, leading to urinary incontinence in men and women alike. Allergies, though not a disease, may lead to behaviors like chronic bouts of coughing that can also weaken pelvic floor muscles and lead to urinary leakage. Urinary tract infections can also be a cause.
  • Obesity – A general lack of exercise may contribute to urinary incontinence in men but paired with obesity or too much extra body weight and it creates an amount of pressure on the bladder that can lead to urgency, an inability to hold urine, and urine leakage. Lack of exercise may lead to constipation, which itself can be a cause of urinary incontinence due to pressure on the urinary tract.
  • Surgery – An array of surgical procedures, in addition to prostate surgery, may lead to urinary incontinence in men. Back surgery, bowel surgery and other procedures might be a cause.
  • Lifestyle – It is known that consuming too much caffeine or alcohol (both diuretic in nature) may lead to incontinence, using narcotics or certain medications, and drinking too much fluid at once can also lead to leakage.

Of course, the loss of muscle tone over time and due to age may be a major contributing factor in the loss of bowel and/or bladder control. However, assigning blame to “old age” is unwise and not an excuse to skip a visit to a physician when urinary incontinence occurs.

Visiting the Doctor is a Good Choice

Whenever changes in bowel or bladder habits occur, it is wise to head to the doctor. For men, the following changes signify the need for a medical exam:

  • Leak urine if you cough, sneeze, laugh hard, lift something heavy or stand up quickly
  • Using the toilet more than eight times a day
  • Often fail to reach the toilet before some urine leaks out
  • Bladder has a sense of being full even after emptying
  • Pain with urination
  • Strain to pass urine
  • Lower abdominal area feels pressured

Your doctor will do a physical exam, look at your medical history, discuss your current lifestyle and may even run urine tests or more in-depth testing to determine the cause. They will then suggest the right treatment.

Treating Urinary Incontinence in Men

Just as there are many reasons that men develop urinary incontinence, there are also many treatments. These may range from more preventative measures such as bladder training (i.e., using a fixed schedule of fluid consumption and elimination), learning how to do kegel training, making lifestyle changes, and more. However, it could be that you may require medications or surgical intervention to improve your symptoms, including rubber sphincters being implanted around the urethra or male slings.

If the issue is not able to be entirely controlled, there are many male incontinence products that include well-designed undergarments with special materials that allow everyday activities, while maintaining discretion that a garment is even in use. There are skin care products, incontinence bed pads and sheeting, and much more to control odor and allow the user to have a normal and healthy life in spite of incontinence issues.