urinary incontinence

Urinary incontinence is a term used to describe poor bladder control.

There are different types of incontinence with a number of possible causes. The following are the most common:

what should you do?

The first step in improving bladder control is to have a full continence assessment carried out by a health professional. This assessment will take into account your medical history and current health, including diet and fluid intake, exercise levels and mobility, all the medicines you are currently taking, and any other factors that could affect bladder function.

Visit your doctor or other health professional if you have concerns about bladder control. Difficulty with bladder control can be prevented, treated, better managed or cured. You shouldn't be embarrassed to discuss your bladder problems as many other people experience problems too.

If you are caring for someone with bladder or bowel problems, practical tips and advice are available to assist you with your care.

caring for someone with incontinence

Many family members and friends find caring for a person with incontinence to be one of the most difficult aspects of caring. Incontinence can be unpredictable, add dramatically to your workload and be very costly. Many carers report feeling angry, frustrated, lonely, and not coping as they try to manage alone. It is not always easy to care for a person with incontinence, but the right advice and support from a health professional may make it more manageable for you.

Carers can be of any age, who provide unpaid care and support to family members or friends who have a disability, mental illness, chronic condition, terminal illness, an alcohol or other drug issue or who are frail aged.

If you have a question or cannot find the information you need, ring the freecall National Continence Helpline on 1800 33 00 66 or call bay continence care on 0402523730

incontinence associated with chronic retention

Incontinence associated with chronic retention is when the bladder is unable to empty properly and frequent leakage of small amounts of urine occurs as a result.

Signs that your bladder is not completely emptying include:

feeling that you need to strain to pass urine
a weak or slow urine stream
feeling as if your bladder is not empty just after going to the toilet
little or no warning when you need to pass urine
passing urine while asleep
frequent urinary tract infections or cystitis, and
'dribbling' more urine after visiting the toilet.

what causes incontinence associated with chronic retention?

There are several possible causes for this type of incontinence. These include:

a urethra blockage caused by a full bladder (the full bladder can put pressure on the urethra, making it difficult to pass urine)
an enlarged prostate
a prolapse of pelvic organs which can block the urethra
damage to the nerves that control the bladder, urethral sphincter or pelvic floor muscles
diabetes, multiple sclerosis, stroke or Parkinson's disease (these conditions can interfere with the sensation of a full bladder and with bladder emptying), and
some medications (which can interfere with bladder function) including over the counter medications and herbal products

stress incontinence

Stress incontinence is the leaking of small amounts of urine during activities that increase pressure inside the abdomen and push down on the bladder. This occurs mainly in women and sometimes in men (most often as a result of prostate surgery).

Stress incontinence is most common with activities such as coughing, sneezing, laughing, walking, lifting, or playing sport. Other factors contributing to stress incontinence include diabetes, chronic cough (linked with asthma, smoking or bronchitis), constipation and obesity.

stress incontinence in women

Stress incontinence in women is often caused by pregnancy, childbirth and menopause. Pregnancy and childbirth can stretch and weaken the pelvic floor muscles that support the urethra causing stress incontinence during activities that push down on the bladder.

During menopause, oestrogen (a female hormone) is produced in lower quantities. Oestrogen helps to maintain the thickness of the urethra lining to keep the urethra sealed after passing urine (much like a washer seals water from leaking in a tap). As a result of this loss of oestrogen, some women experience stress incontinence during menopause.

stress incontinence in men

Many men develop stress incontinence after prostate surgery. This can take 6 to 12 months to resolve and it is recommended that men seek help from a health professional to address the issue.

urge incontinence

Urge incontinence is a sudden and strong need to urinate. You may also hear it referred to as an unstable or overactive bladder, or detrusor instability.

In a properly functioning bladder, the bladder muscle (detrusor) remains relaxed as the bladder gradually fills up. As the bladder gradually stretches, we get a feeling of wanting to pass urine when the bladder is about half full. Most people can hold on after this initial feeling until a convenient time to go to the toilet arises. However, if you are experiencing an overactive bladder and urge incontinence, the bladder may feel fuller than it actually is. This means that the bladder contracts too early when it is not very full, and not when you want it to. This can make you suddenly need the toilet and perhaps leak some urine before you get there.

Often, if you experience urge incontinence you will also have the need to frequently pass urine and may wake several times a night to do so (nocturia).

what causes urge incontinence?

The cause of urge incontinence is not fully understood however it seems to become more common as we age. Symptoms may get worse at times of stress and may also be made worse by caffeine in tea, coffee and fizzy drinks or by alcohol.

Urge incontinence can be linked to stroke, Parkinson's disease, multiple sclerosis and other health conditions which interfere with the brain's ability to send messages to the bladder via the spinal cord. These conditions can affect a person's ability to hold and store urine.

Urge incontinence may also occur as a result of constipation (not being able to empty the bowel or having difficulty doing so), an enlarged prostate gland or simply the result of a long history of poor bladder habits. In some cases the cause of an over-active bladder is unknown.

functional incontinence

Functional incontinence is when a person does not recognise the need to go to the toilet or does not recognise where the toilet is. This results in not getting to the toilet in time or passing urine in inappropriate places.

what causes functional incontinence?

Functional incontinence has many causes, including:

dementia
poor eyesight
poor mobility
poor dexterity (a lack of fine motor skills makes removing clothing difficult)
an unwillingness to go to the toilet because of depression, anxiety or anger, and
environmental factors such as poor lighting, low chairs that are difficult to get out of, and toilets that are difficult to access.

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