How Can I Prevent Pressure Ulcers
A pressure ulcer is a localised injury to the skin and underlying tissue. This occurs due to pressure exerted on the particular spot over a long period of time. Patients who are incontinent, have limited mobility, underlying medical conditions, and poor nutrition are prone to pressure ulcers.
Do take note of the following for proper care and the prevention of pressure ulcers:
What Causes Urinary Incontinence
The causes of urinary incontinence depend on the type.
Stress incontinence is usually the result of the weakening or damaging of the muscles used to prevent urination, such as the pelvic floor muscles and the urethral sphincter.
Urge incontinence is usually the result of overactivity of the detrusor muscle, which controls the bladder.
Certain things can increase the chances of urinary incontinence developing, including:
- pregnancy and vaginal birth
- a family history of incontinence
- increasing age although incontinence is not an inevitable part of ageing
Read more about the causes of urinary incontinence
Limit Alcohol Caffeine And Excessive Water Intake
A full bladder is more likely to cause urine leaks. Excessive consumption of liquids, including water, results in an urgent need to empty your bladder.
Alcohol and caffeine boost the production of urine, meaning youll spend more time in the toilet on a given day. Drink about 8 glasses of water daily. However, your intake must reduce post 4 p.m. into the night. This reduces urine concentration and prevents it from irritating your bladders lining.
The drinks cause more than an urge, leading to leaks.
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Pelvic Floor Muscle Exercises
The pelvic floor muscles support the bladder and the bowel . They can weaken with age, illness, or hormonal changes. Pregnancy and childbirth can weaken the pelvic floor muscles in women. Weak pelvic floor muscles can lead to urine leakage. Prostate surgery, and in particular radical prostatectomy, can weaken the pelvic floor muscles in men.
A structured programme of exercises to strengthen the pelvic floor muscles can improve urinary incontinence. It consists of a series of exercises to train the muscles, which is designed specifically for your needs.
Types Of Urinary Incontinence
There are different types of incontinence:
- Stress incontinence occurs when urine leaks as pressure is put on the bladder, for example, during exercise, coughing, sneezing, laughing, or lifting heavy objects. Its the most common type of bladder control problem in younger and middle-age women. It may begin around the time of menopause.
- Urge incontinence happens when people have a sudden need to urinate and cannot hold their urine long enough to get to the toilet. It may be a problem for people who have diabetes, Alzheimers disease, Parkinsons disease, multiple sclerosis, or stroke.
- Overflow incontinence happens when small amounts of urine leak from a bladder that is always full. A man can have trouble emptying his bladder if an enlarged prostate is blocking the urethra. Diabetes and spinal cord injuries can also cause this type of incontinence.
- Functional incontinence occurs in many older people who have normal bladder control. They just have a problem getting to the toilet because of arthritis or other disorders that make it hard to move quickly.
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What Are Kegel Exercises
Kegel exercises, also called pelvic floor muscle training, are simple exercises you can do to treat bladder problems and improve bowel control. The exercises strengthen the pelvic floor muscles that support the bladder, rectum, and uterus. These muscleswhich stretch like a hammock from the front to the back of your pelviscan help you avoid releasing urine, stool, or gas at the wrong times.
Tips To Keep Your Bladder Healthy
People rarely talk about bladder health, but everyone is affected by it. Each day, adults pass about a quart and a half of urine through the bladder and out of the body.
As people get older, the bladder changes. Visit Bladder Health for Older Adults for more information on how the bladder changes and common medical problems, including bladder infections, urinary incontinence, and urinary tract infections.
While you cant control everything that affects bladder health, there are some steps you can take to improve bladder health. Follow these 13 tips to keep your bladder healthy.
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Try Incorporating Deep Breathing And Relaxation
Begin by lying on your back with your knees bent and your feet flat. Focus on your breathing. Notice any areas of tension in your body as you inhale and exhale. Take notice of how your abdomen, rib cage, pelvis, and lower back feel as you inhale and exhale. Do they expand or feel restricted? Now bring your attention to your pelvic floor muscles. This is a group of muscles that attach to the pelvic bone and the sacrum . Notice any tension, discomfort, or pain that you may have.
When you inhale allow your abdomen to expand outward and feel this expansion outward with your ribs to the sides and your pelvic floor to expand and release. Exhale by allowing the air out of your lungs by relaxing at your ribs, abdomen and allowing your pelvic floor to gently lift. Perform every hour: Take 5 seconds for the inhale, pause for 1 second and take 5 seconds for the exhale, pause for 1 second and repeat 5 times.
Empty Your Bladder Regularly Even If It Doesnt Feel Full
Going to the bathroom on a schedule, say, every two to three hours, even if you dont feel the urge to urinate is a good idea for people who have urinary incontinence or overactive bladder , Griebling says. Similarly, emptying your bladder before leaving the house or other venues, such as your office or a restaurant, even if you dont feel an urge to go, can diminish leakage and prevent accidents.
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Can Incontinence Be Prevented
Different events throughout your life can lead to many of the things that cause incontinence. The muscles that support your pelvic organs can weaken over time. For women, these muscles can also be weakened by big life events like pregnancy and childbirth. However, in the same way you work out to build strength in your legs or arms, you can do exercises to strengthen your pelvic floor muscles. Doing exercises to strengthen your pelvic muscles may not prevent you from having any issues with incontinence, but it can help you regain control of your bladder. Maintaining a healthy body weight can also help with bladder control. Talk to your healthcare provider about the best ways to maintain strong pelvic floor muscles throughout your life.
Tighten Your Pelvic Floor With Kegel Exercises
Kegels, or pelvic floor muscle exercises, can benefit both men and women who have urinary incontinence by strengthening the muscles that support the bladder. This, in turn, helps prevent urine leaks and the feeling of urgency that comes with overactive bladder. And Kegels couldnt be easier to do: Per the National Institute of Diabetes and Digestive and Kidney Diseases, simply squeeze or tighten your pelvic floor muscles these are the same muscles you use to stop the flow of urine or passing gas for a count of three and then slowly relax them for a count of three. Kegels are so easy, you can do them anytime even while sitting in your car at a stoplight or at your desk at work. Build up to doing one set of 10 to 15 squeezes, three times a day, and your bladder control should improve within six weeks.
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What Is Urinary Incontinence
Urinary incontinence is the accidental loss of urine. According to the National Association for Continence, over 25 million adult Americans experience temporary or chronic urinary incontinence. UI can occur at any age, but it is more common among women over 50. Urinary incontinence may be a temporary condition that results from an underlying medical condition. It can range from the discomfort of slight losses of urine to severe, frequent wetting.
The Management Of Urinary Incontinence
Jennifer A. Wilson, PharmD, BCACPAssistant Professor of Pharmacy
Rashi C. Waghel, PharmD, BCACP, CPPAssistant Professor of PharmacyWingate, North Carolina
US Pharm. 2016 41:22-26.
ABSTRACT: Urinary incontinence is a common problem, especially in women, and it can significantly impact quality of life. UI involves involuntary urine leakage, which can result in a number of symptoms, including urgency, frequency, and nocturia. UI may be classified as stress, urge, overflow, functional, or mixed, depending on the underlying etiology. First-line treatment involves nonpharmacologic measures regardless of UI type. When nonpharmacologic measures are insufficient, pharmacologic options may be considered for some types of UI. Many of the pharmacologic options for UI are associated with undesirable, yet manageable, adverse effects therefore, counseling is important in fostering patient adherence to medications used to treat UI.
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Medicine For Stress Incontinence
If stress incontinence does not significantly improve with lifestyle changes or exercises, surgery will usually be recommended as the next step.
However, if you’re unsuitable for surgery or want to avoid an operation, you may benefit from an antidepressant medicine called duloxetine. This can help increase the muscle tone of the urethra, to help keep it closed.
You’ll need to take duloxetine tablets twice a day and will be assessed after 2 to 4 weeks to see if the medicine is beneficial or causing any side effects.
Possible side effects of duloxetine can include:
Do not suddenly stop taking duloxetine, as this can also cause unpleasant side effects. A GP will reduce your dose gradually.
Duloxetine is not suitable for everyone, however, so a GP will discuss any other medical conditions you have to determine if you can take it.
Plan Ahead: Scope Out Bathrooms Before You Leave Home
If you have urinary incontinence, its a good idea to know where the bathrooms are located at unfamiliar destinations, such as restaurants, museums, shopping centers, and parks. Try finding a map or directory ahead of time online. One useful Procter & Gamble app, Sit or Squat: Restrooms Near Me, can help you find a clean public restroom near your current location. It can be downloaded for free from the App Store or Google Play.
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Quit Smoking To Help Keep Your Bladder Healthy
People who have urinary incontinence should do what they can to stop smoking. Studies have found that people who smoke are more prone to incontinence, says urologist Yvonne Koch, MD, of the Mount Sinai Medical Center in Miami Beach, Florida. Smoking damages the very small blood vessels in our bodies and causes tissue weakness, she explains. Furthermore, smoking can lead to coughing, which can cause urine leakage by putting pressure on the pelvic floor muscles. Plus, cigarette smoking triples the risk of bladder cancer, an early sign of which may be the need to urinate often or the urge to urinate immediately, even when the bladder isnt full, according to Memorial Sloan Kettering Cancer Center.
Lifestyle Changes And Exercises
If lifestyle changes do not control the incontinence or the leakage occurs too frequently it may require Kegel exercises in addition to lifestyle changes. Kegel exercises are done with the help of a specialized device that holds the penis in an erection position while it is pressed between the legs.
These exercises work to strengthen the pelvic floor muscles. Chronic incontinence can also lead to weak pelvic floor muscles. A weak pelvic floor muscle allows urine to flow far slower and with much pressure. Therefore, weak muscles could contribute to an increased chance of urine leaking and therefore to incontinence.
The condition of the urethra is the tube through which urine flows from the bladder. When a person has incontinence, the urethra may be either too narrow or too wide. In some cases, the urethra can be so damaged that urine cannot pass out of the body from it.
In these cases, doctors recommend that patients wear adult diapers that cover the entire urinary tract to assist in the prevention of urine from escaping the body. There are many options for dealing with urinary incontinence.
Since the cause of the problem is usually stress, a good doctor will work with patients to reduce their overall stress levels. As well, they will likely recommend some lifestyle changes including diet and exercise to eliminate the underlying causes of the condition.
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Toileting Suggestions For Carers Of People With Incontinence
- Consider aids such as a raised toilet or a wall-mounted grab bar if the person is unsteady on their feet. Remove floor mats and make sure the seat is securely fastened to the toilet.
- Dont rush the person while they are on the toilet. Music can help create a calm and unhurried atmosphere.
- Run a tap or give the person water to sip if they have trouble urinating.
- Take note of the persons toileting patterns and suggest they visit the toilet at times that are appropriate to their pattern. Making notes on how often the person urinates and defecates can also help you and your doctor or continence professional to recognise and assess the severity of problems such as constipation.
- Consider keeping a portable commode by the bed if the toilet is too far away for the person to reliably reach in time.
- Use disabled toilets if they are available when you are out. A disabled toilet is usually unisex and has room to fit two people.
- Try to accommodate the persons need for privacy whenever possible. If privacy isnt possible, use a relaxed demeanour to set the mood. Humour may help to dispel embarrassment or upset.
Causes Of Urge Incontinence
The urgent and frequent need to pass urine can be caused by a problem with the detrusor muscle in the wall of the bladder. The detrusor muscles relax to allow the bladder to fill with urine, then contract when you go to the toilet to let the urine out.
Sometimes the detrusor muscle contract too often, creating an urgent need to go to the toilet. This is known as having an ‘overactive bladder’. The reason your detrusor muscle contracts too often may not be clear, but possible causes include:
- drinking too much alcohol or caffeine
- poor fluid intake this can cause strong, concentrated urine to collect in your bladder, which can irritate your bladder and cause symptoms of overactivity
- conditions affecting the lower urinary tract , such as urinary tract infections or tumours in the bladder
- neurological conditions
- certain medications
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Diagnosis Of Urinary Incontinence
The first step in treating incontinence is to see a doctor. He or she will give you a physical exam and take your medical history. The doctor will ask about your symptoms and the medicines you use. He or she will want to know if you have been sick recently or had surgery. Your doctor also may do a number of tests. These might include:
- Urine and blood tests
- Tests that measure how well you empty your bladder
In addition, your doctor may ask you to keep a daily diary of when you urinate and when you leak urine. Your family doctor may also send you to a urologist, a doctor who specializes in urinary tract problems.
Drink Enough Fluids To Keep Your Bladder Happy
Drinking less water and other fluids to decrease your risk of an accident is not a good idea, says Tomas Griebling, MD, a professor of urology at the University of Kansas Medical Center in Kansas City and president of the Geriatric Urological Society of the American Urological Association. While its true that chugging down a lot of fluids especially in a short amount of time can lead to leaks, not drinking enough can also make you need to pee suddenly.
When you dont drink enough water, the urine becomes more concentrated and that can be irritating to the bladder and increase urgency, explains Dr. Griebling.
How much fluid is enough varies from person to person, but the National Association for Continence estimates that six to eight 8-ounce glasses of water a day is about the right amount. Checking the color of your urine can help you know if youre on target, according to Harvard Health. In general, a pale yellow color means youre adequately hydrated, while a darker yellow suggests you need to drink more.
Causes Of Overflow Incontinence
Overflow incontinence, also called chronic urinary retention, is often caused by a blockage or obstruction to your bladder. Your bladder may fill up as usual, but as it is obstructed you will not be able to empty it completely, even when you try.
At the same time, pressure from the urine that is still in your bladder builds up behind the obstruction, causing frequent leaks.
Your bladder can become obstructed as a result of:
Overflow incontinence may also be caused by your detrusor muscle not fully contracting, which means that your bladder does not completely empty when you go to the toilet. As a result, the bladder becomes stretched. Your detrusor muscles may not fully contract if:
- there is damage to your nerves, for example as a result of surgery to part of your bowel or a spinal cord injury
- you are taking certain medications