Loss of bladder control is a common and embarrassing problem for the elderly. The severity of the problem can range from a slight urine leak to a sudden urge to urinate (urgency) and total voiding of the bladder without being able to get to a toilet in time.
While some degree of loss of bladder control is normal with age, if it reaches a stage where the condition interferes with everyday life, it is time to consult a geriatric specialistat a hospital with a dedicated geriatric care[1] department.
Urinary incontinence is common in men and women.
The two main types of urinary incontinence are:
Stress incontinence (caused by coughing, sneezing, etc.)
Urge incontinence
Small changes in routine can help manage UI.
The Causes of Urinary Incontinence
Urgency may be caused by the consumption of certain foods, liquids, or medications. The causes may range from caffeine, alcohol, carbonated drinks, chocolates, chillies/peppers, artificial sweeteners and fruits that are rich in vitamin C to blood pressure medications, sedatives, muscle relaxants and so on. Changing dietary habits or medications may bring the urgency under control.
Urinary tract infections[2] and constipation can also lead to urgency or dribbling.
Several medical conditions could cause incontinence among women, and these include pregnancy, childbirth, menopause and undergoing a hysterectomy. In men, an enlarged prostate or prostate cancer are common causes.
Neurological disorders from trauma, surgery or diseases can cause true incontinence due to interruption in the nervous control of bladder function which can be truly disabling and can impact quality of life.
Diagnosing Urinary Incontinence
Medical History:
This could include the following.
Occurrence of UTIs
Lifestyle
Bowel movements
Medication that you may be having
Medical health
Previous surgeries
Physical Examination:
Rectal exam
Pelvic exam (for women)
A stress test may be given where you will be asked to cough to check if you have urine leakage.
Diagnostic Tests:
These are done to check for underlying health problems, to check your kidneys and other organ functions.
Bladder Function Test: This can give the doctor an idea of how well your bladder and urinary tract are functioning.
Urine Analysis: This requires a urine sample which will be tested for any kind of infection, kidney problems and diabetes.
Also Read: 6 Reasons to see a Geriatrician[3]
Living with Incontinence
There are things you can do to try and control your incontinence problem.
When going out of the house, plan your activities, as far as possible, so that there is a toilet nearby.
Try to reduce your water intake. Not drinking enough water can lead to dehydration, which is unhealthy. However, try a gradual reduction so that your water intake reduces by about 25%. If there are no signs of dehydration and urination frequency is reduced, you are fine.
Keep a watch on your diet. Often there are certain foods that trigger the need to urinate frequently. Alcohol, caffeine, carbonated drinks, spicy foods and citrus fruits are common triggers. Try cutting these out of your diet for a week and see if the incontinence problem comes down.
Try to have a bathroom schedule and urinate at set intervals even if you do not feel the urge to do so at that time. Slowly, increase the interval between bathroom visits. This will help to train your bladder to hold urine for a longer period of time than what you are able to achieve at present.
Perform pelvic floor exercises. Clench and unclench your pelvic muscles. Do 40 or 50 counts during the course of a day. You can do it anywhere, sitting, standing or lying down. It strengthens the muscles that control urine flow.
If you are a smoker, smoking is a known contributor to incontinence.
If you are overweight, getting rid of the excess flab will reduce the stress and pressure on your bladder, bringing down the frequency of urination.
If you are taking any medications, check to see if any of them could be making your incontinence worse and if so, ask your doctor to prescribe an alternative that will not have this side-effect.
When you know you will be away from toilet facilities for an extended period of time, wear adult diapers.
If these basic techniques don’t work, your doctor may recommend:
Electrical stimulation
Medications
Certain medical devices
Surgery
Get Medical Help
Incontinence is a common issue for the elderly. While there are many things you can do yourself to handle the situation, it is important that you visit a geriatric specialist[4] so that the causes and extent of your problem may be accurately diagnosed, and a treatment plan formulated, to either bring the condition under control or to provide you with the means to minimize the effect it has on your life. Incontinence is a medical condition and nothing to be ashamed of. While it can be embarrassing, with the right medical help, its impact on your life can be minimized so that you are able to live life to the fullest.
Last Edited : 31-07-2023
Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.