WASHINGTON, DC - Loss of urine control, or urinary incontinence, is especially common in older women but occurs in men as well. At least one in ten persons aged 65 or older has a problem of this nature. Incontinence can range from the discomfort of slight Josses of urine to the disability and shame of severe, frequent wetting.
People who are incontinent often withdraw from social life and try to hide the problem from their family, friends, and even their doctors.
Incontinence may be caused by an illness that is accompanied by fatigue, confusion, or hospital admission. Incontinence is sometimes the first and only symptom of a urinary tract infection. Curing the illness usually will relieve or clear up the incontinence.
When incontinence is more persistent it may be of one or more of the following types:
Stress incontinence describes the leakage of urine during exercise, coughing, sneezing, laughing, or other body movements that put pressure on the bladder. It occurs more often in women of all ages.
Urge incontinence refers to the inability to hold urine long enough to reach a toilet. It often is associated with conditions such as stroke, senile dementia, Parkinson's disease, and multiple sclerosis, but it can occur in otherwise normal elderly people.
Overflow incontinence describes the leakage of small amounts of urine from a constantly filled bladder. A common cause in older men is blockage of urine outflow from the bladder by an enlarged prostate gland . Another cause is loss of normal contraction of the bladder in some people with diabetes.
* A number of medications can be used to treat incontinence. However, these drugs may cause such side effects as a dry mouth, eye problems, and buildup of urine, and therefore must be used carefully under a doctor's supervision.
* Certain behavioral management techniques, including biofeedback and "bladder retraining," have proven helpful in lhe control of urination. These can help a person sense bladder filling and delay voiding until he or she can reach a toilet.
* Exercise can be used to strengthen the muscles that help close the bladder outlet.
* Several types of surgery can improve or even cure incontinence that is related to a structural problem such as an abnormally positioned bladder or blockage due to an enlarged prostate.
* Artificial devices that replace or aid the muscles that control urine flow have been tried in the management of incontinence. Many of these prosthetic devices require surgical implantation.
* Sometimes incontinence is treated by inserting a catheter into the urethra and collecting the urine into a container. However, long-term catheterization - sometimes necessary - creates problems, including urinary infections. In men, an alternative to the in dwelling catheter is an external collecting device. This is fitted over the male genitalia and connected to a drainage bag.
* Specially designed absorbent underclothing is available. Many of these garments are no more bulky than normal underwear, can be worn easily under everyday clothing, and can free a person from the discomfort and embarrassment of incontinence.
It is important to remember that incontinence can be treated and often cured. Even incurable problems can be managed to reduce complications, anxiety, and family stresses.