Incontinence In Alzheimer’s Disease
People in the later stages of Alzheimers disease often have problems with urinary incontinence. This can be a result of not realizing they need to urinate, forgetting to go to the bathroom, or not being able to find the toilet. These tips may help:
- Avoid drinks like caffeinated coffee, tea, and sodas, which may increase urination. But dont limit water.
- Keep hallways clear and the bathroom clutter-free, with a light on at all times.
- Provide regular bathroom breaks.
- Use underwear that is easy to get on and off, and absorbent briefs or underwear for trips away from home.
Visit Alzheimers Disease: Common Medical Problems for more tips.
Causes Of Urinary Incontinence
Stress incontinence is usually the result of the weakening of or damage to 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 muscles, which control the bladder.
Overflow incontinence is often caused by an obstruction or blockage in your bladder, which prevents it from emptying fully.
Total incontinence may be caused by a problem with the bladder from birth, a spinal injury, or a small, tunnel like hole that can form between the bladder and a nearby area .
Certain things can increase the chances of urinary incontinence, including:
- pregnancy and vaginal birth
Find out more about the causes of urinary incontinence.
How Can I Improve Incontinence After Prostate Surgery
Want to stop incontinence after prostate surgery? Kegels may be your answer! As mentioned above, kegels are a common treatment option for incontinence after prostate surgery. Among other things, the pelvic floor muscles help control bladder and bowel function and, like other muscles of the body, if they get weak they are no longer able to do their job effectively. To improve muscle function, kegels must be done regularly, every day. The good news is that they can be performed pretty much anywhere, anytime, and in a variety of positions . For a complete guide on performing a mens kegel, click here.)
Biofeedback can sometimes be used to determine if you are performing a kegel properly. And, electrical stimulation may also be used to help re-teach the muscles to contract.
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When To Seek Help
Seek treatment when symptoms arise. When you work harder to push urine out, you’re putting pressure on your bladder. This may lead to bladder abnormalities or other issues. It’s better to intervene earlier,” Summers says. “If you delay too long, your bladder undergoes irreversible changes. Patients can end up in renal failure because they’ve neglected their urinary symptoms. That’s one reason to stay on top of this.
The Mechanics Of Male Incontinence
Each type of bladder control issue is caused by different factors. Bladder control problems can be short-term or long-term. Most cases of short-term male incontinence result from a specific health issue or recent treatment. For example, taking certain medications, such as those for colds, depression, sedatives, narcotics and diuretics, can cause short-term bladder control problems.
Chronic male incontinence is a long-term condition, and thus of greater concern to the man who has it and to his urologist as well. Chronic male incontinence issues are often related to prostate problems or treatments for them.
A lot of men I see think urinary incontinence is another of those things that always happens with age. While it is more prevalent at older ages and more than 10 percent of men over 65 have bladder control problems it is not a normal condition.
Lets address why each type of chronic bladder control issue is likely to occur.
Cause of overflow incontinence. Two things can happen: you make more urine than the bladder can hold or the bladder cant empty when it is full. Maybe the bladder muscle cant contract as it should to squeeze the bladder, or there could be something blocking the flow. The result is urine dribbling or only urinating a small amount, but having to do so frequently. An enlarged prostate gland or benign prostate hyperplasia can cause overflow, as can a urethra that is too narrow.
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Is Incontinence More Common In Women
Incontinence is much more commonly seen in women than in men. A large part of this is because of pregnancy, childbirth and menopause. Each of these events in a womans life can lead to bladder control issues. Pregnancy can be a short-term cause of incontinence and the bladder control issues typically get better after the baby is born. Some women experience incontinence after delivery because of the strain childbirth takes on the pelvic floor muscles. When these muscles are weakened, youre more likely to experience leakage issues. Menopause causes your body to go through a lot of change. Your hormones change during menopause and this can alter your bladder control.
Men can also experience incontinence, but it isnt as common as it is in women.
What You Can Do About It
Hopefully, your bladder control issue can be taken care of primarily by your own actions. Here are things you can do.
- To strengthen your pelvic floor muscles, do exercises like Kegels, the ones women do that are essentially tightening your muscles like youre trying to hold back urine.
- Maintain a healthy weight, as carrying too many pounds means more pressure on the bladder.
- Reduce caffeine consumption because its a diuretic that increases urination.
- Dont have more than one alcoholic drink a day.
- Also limit carbonated beverages.
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Treating And Managing Urinary Incontinence
Today, there are more treatments and ways to manage urinary incontinence than ever before. The choice of treatment depends on the type of bladder control problem you have, how serious it is, and what best fits your lifestyle. As a general rule, the simplest and safest treatments should be tried first.
A combination of treatments may help you get better control of your bladder. Your doctor may suggest you try the following:
What Are The Symptoms Of Incontinence
The main symptom of incontinence is a leakage of urine. This could be a constant dripping of urine or an occasional experience of leakage. If you have incontinence, you might have large amounts or small amounts of leaked urine. You might experience leakage for a wide variety of reasons often depending on the type of incontinence you have.
You might leak urine when you:
- Have an urge to urinate, but cant make it to the toilet on time.
- Have to get up in the middle of night to urinate .
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When To See A Health Care Provider And What To Expect
Talk to your health care provider if you have urinary incontinence or any signs of a bladder problem, such as:
- Needing to urinate more frequently or suddenly
- Urinating eight or more times in one day
- Passing only small amounts of urine after strong urges to urinate
- Trouble starting or having a weak stream while urinating
Your doctor may recommend urodynamic testing and perform the following to try to figure out what might be causing your bladder problem:
- Give you a physical exam and take your medical history.
- Ask about your symptoms and the medications you take.
- Take urine and blood samples.
- Examine the inside of your bladder using a cystoscope a long, thin tube that slides up into the bladder through the urethra. This is usually done by a urinary specialist.
- Fill the bladder with warm fluid and use a cystoscope to check how much fluid your bladder can hold before leaking.
- Order or perform a bladder ultrasound to see if you are fully emptying your bladder with each void.
- Ask you to keep a daily diary of when you urinate and when you leak urine. Your primary care doctor may also send you to a urologist, a doctor who specializes in urinary tract problems.
Types Of Urinary Incontinence
There are different types of incontinence:
- Stress incontinence occurs when urine leaks as pressure is put on the bladder, such as during exercise, coughing, sneezing, laughing, or lifting heavy objects. Its the most common type of bladder control problem in younger and middle-aged women. It also may begin later, 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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Solutions For A Leaky Bladder
Research has found that at least half of people with urinary incontinence dont discuss the condition with a health care provider. But theres no need to feel embarrassed. If you have a leaky bladder, youre definitely not alone. Bladder leakage, or urinary incontinence, affects women and men of all ages, though it becomes more common later in life.
And its definitely worth discussing, because of the many ways it can interfere with enjoying daily lifefrom exercise and travel to social outings and romance, says E. James Wright, M.D., director of urology at Johns Hopkins Bayview Medical Center.
Urinary Incontinence After Prostate Surgery: Everything You Need To Know
Undergoing a prostatectomy can be difficult. And for many men, finding that they are incontinent post surgery may come as a shock.
But rest assured that there are many treatments available to manage incontinence treatment after surgery. Read below for some of the most common questions we receive about incontinence after prostate surgery.
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How Is Leaking Urine Diagnosed
Your doctor will have to determine the type of urinary incontinence you have.
Starting a few days ahead of your appointment, your doctor might ask you to keep a bladder diary, MedlinePlus says. The diary would track how much and when you drink liquids, when and how much you urinate, and whether you leak urine.
During the appointment, your doctor will ask about your medical history and symptoms and perform a physical exam. This might include a rectal exam and, for women, a pelvic exam. They might also have you cough or do some other simple maneuver that can initiate the leaking.
To make a diagnosis, your doctor might also run some tests, including:
- Urine and/or blood tests
How Is Incontinence Diagnosed
Often, the diagnosis process for incontinence will start with a conversation with your healthcare provider about your medical history and bladder control issues. Your provider might ask you questions like:
- How often do you urinate?
- Do you leak urine between trips to the toilet, how often does this happen and how much urine do you leak each time?
- How long have you been experiencing incontinence?
These questions can help your provider figure out a pattern with your leakage, which often points to a specific type of incontinence. When your provider is asking about your medical history, its important to list all of your medications because some medications can cause incontinence. Your provider will also ask about any past pregnancies and the details around each delivery.
There are also several specific tests that your provider might do to diagnose incontinence, including:
While at home, your provider might recommend you keep track of any leakage in a journal for a few days. By writing down how often you experience incontinence issues over the span of a few days, your provider might be able to identify a pattern. This can really help in the diagnosis process. Make sure to write down how often you need to urinate, how much you are able to go each time, if you leak between trips to the bathroom and any activities you might be doing when you leak urine. Youll then bring this journal with you to your appointment and talk about it with your provider.
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Treatment Options For Men With Urinary Leakage
Topics in this Post
Urinary incontinence is a common and often embarrassing condition that results in the unintentional loss of urine. While women are more likely than men to experience symptoms of urinary incontinence, it can be particularly troublesome for men.
About 3% to 10% of men will experience symptoms in their lifetimes and report a high level of associated stress due to the condition. Some men say they would rather be impotent than incontinent.
Does Incontinence Happen If I Treat Prostate Cancer With Radiation
Some men need radiation therapy after prostate removal. During radiation therapy, some of the normal tissues around the urinary sphincter, urethra and bladder may be exposed, causing irritation to occur post therapy, leading to incontinence. This typically subsides within a few months after radiation therapy, however if it persists, additional treatments described below may be helpful.
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How Is Incontinence Treated
There are many different factors that your healthcare provider will consider when creating a treatment plan for your incontinence. The type of incontinence and the ways it affects your life are both big considerations. Your provider will also talk to you about the type of treatment you are most comfortable with. There are three main types of treatment you can explore for incontinence medications, lifestyle changes and surgery. Each option has pros and cons that your provider will discuss with you.
Medications to treat incontinence
There are quite a few medications that can reduce leakage. Some of these drugs stabilize the muscle contractions that cause problems with an overactive bladder. Other medications actually do the opposite thing relaxing muscles to allow your bladder to empty completely. Hormone replacement therapies can often involving replacing estrogen thats decreased during menopause may also help restore normal bladder function.
In many cases, medications can work very well to return normal function to the bladder. Your provider will carefully select a medication that matches your specific needs. Often, your provider will start you on a low dose of the medication and then increase it slowly. This is done to try and reduce your risks of side effects and to keep track of how well the medication is working to treat your incontinence.
Common medications that can be used to treat incontinence include:
- Oxybutynin , oxybutynin XL , oxybutynin TDDS .
When Should I See A Doctor About Incontinence
Its important to know that incontinence can be treated. Many people believe that its something that just goes along with aging and is an unavoidable issue. If you find that incontinence is disturbing your daily activities and causing you to miss out on things you typically enjoy, talk to your healthcare provider. There are a wide range of options to treat incontinence.
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Conditions That Cause Urinary Incontinence
There are several health and lifestyle issues that can make you start to leak urine. They can include:
Problems with your prostate. Itâs common for prostate issues to cause urinary incontinence. Your prostate may be larger due to a non-cancerous condition called benign prostatic hyperplasia . Your prostate may also be bigger than usual because of cancer. An enlarged prostate can block your urethra. When your urethra is blocked, your bladder has to work harder to squeeze pee out. This makes its walls thicker and weaker. That makes it hard for your bladder to empty all the urine in it.
You can also struggle with urinary incontinence with prostate cancer or after having certain treatments for it — such as radiation treatment or surgery to remove your prostate. The surgery may cause problems with the nerves that control your bladder.
Certain diseases. Multiple sclerosis is a disease that can damage the nerves that tell the bladder when to empty and can also lead to bladder spasms. Some other conditions that can damage your nerves and keep your bladder from sending or receiving the signals it needs to work correctly are:
- Diabetes
- Stroke
- Parkinsonâs disease
Surgery. Major bowel surgery, lower back surgery, and prostate surgery can all cause problems with your bladder. This is usually because some of the nerves in your urinary tract have been damaged during surgery.
Urinary Voiding Symptomatology In Male Genital Lichen Sclerosus
Chris B. Bunker1,2, Neil Patel2 and Tang N. Shim1,2
Departments of Dermatology, 1University College Hospital, 250 Euston Rd, London NW1 2BU and 2Chelsea & Westminster Hospital, London, United Kingdom. E-mail:
Accepted August 13, 2012.
Symptomatology associated with the leaking or dribbling of small amounts of urine in men may not be readily volunteered or elicited. However, it has become apparent to CBB over many years of interviewing men with GLSc that such symptomatology is frequently present.
METHODS
To attempt to quantify the presence of this symptomatology in MGLSc three approaches to the clinical records of cases were employed.
The second approach was to review the initial clerking forms of all new cases of male genital skin disease seen in 4 consecutive MGDCs and correlate the responses to the questions about voiding with the working clinical diagnosis in each case.
Finally, we retrospectively reviewed the records and/or clinic letters of all the patients diagnosed clinically with MGLSc in the general dermatology clinics done by one of us in another institution over a one-year period.
RESULTS
In the third study , 63 patients were seen of whom 23 were diagnosed clinically with MGLSc: 21 were dribblers, one patients answers were equivocal and one denied the symptomatology.
DISCUSSION
ACKNOWLEDGEMENTS
Dr Shim has a fellowship from the Sir John Fisher Trust, UK and also receives support from the charity START , UK.
REFERENCES
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