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Urinary Incontinence, Diagnosis and Treatment Plans
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Urinary incontinence is the loss of bladder control that can happen to anyone, but is more common in people age 65 or older.  Women are more likely than men to have this problem.  Symptoms can range from:

•    Mild leaking
•    To uncontrollable wetting

The process of aging does not cause urinary incontinence.  Some of the reasons it can occur for short periods of time are:

•    Urinary tract infections
•    Vaginal infection or irritation
•    Constipation
•    Certain medicines

Urinary incontinence that occurs for longer periods may be due to:

•    Weak bladder muscles
•    Overactive bladder muscles
•    Blockage from an enlarged prostate
•    Damage to the nerves that control the bladder from disease like multiple sclerosis or Parkinson’s disease or
•    Arthritis that can make walking painful and slow

Urinary incontinence can be treated, controlled and sometimes cured.  There is no need to be embarrassed or to suffer in silence.

How does incontinence occur?

•    If the bladder muscles contract or the muscles surrounding the urethra relax without warning

Urine is stored in the bladder.  At the time of urination, muscles in the bladder contract or tighten.  When these muscles contract or tighten it forces the urine out of the bladder.  Urine then flows into a tube called the urethra.  The urethra carries urine out of the body.  At this time, the muscles surrounding the urethra relax and let the urine pass through.

How is urinary incontinence diagnosed?

•    A physical exam and medical history
•    The doctor will ask you about your symptoms and medicines
•    The doctor will want to know if you have been sick recently or had surgery.
•    Your doctor may perform a number of different tests.

Tests may include:

•    Urine and blood tests
•    Tests that measure how well you empty your bladder

Your doctor may also ask you to keep a daily diary of when you urinate and when you leak urine.  The pattern of urinating and urine leakage may suggest which type of incontinence you have.

Types of incontinence include:

•    Stress incontinence:  occurs during exercise, coughing, sneezing, laughing, lifting heavy objects, or other body movements that put pressure on the bladder.  It may also be related to childbirth or begin around the time of menopause, and is most common in younger and middle-age women
•    Urge incontinence:  occurs when people cannot hold urine long enough to get to the toilet in time, often found in people with diabetes, or who have had a stroke, Alzheimer’s disease, Parkinson’s disease, or multiple sclerosis.  Urge incontinence may also be a sign of bladder cancer.
•    Overflow incontinence:  occurs when small amounts of urine leak from a bladder that is always full.  This type of incontinence can occur in men who have trouble emptying their bladder if an enlarged prostate is blocking the urethra, or in people with diabetes or spinal cord injury.
•    Functional incontinence:  Occurs in older people who have normal bladder control who have a hard time getting to the toilet in time because of arthritis or other disorders that cause moving quickly difficult.

What kind of treatment is available for urinary incontinence?

•    There are more treatments available today than ever before
•    The choice of treatment depends on the type of bladder control problem
•    The choice of treatment also depends upon how serious the problems is and what best fits a person’s lifestyle
•    Generally, the simplest and safest treatments are tried first.

What is bladder control training?

Bladder control training is getting back control of your bladder through exercise training that change how your bladder stores and empties urine.  Some methods include:

•    Pelvis muscle exercise (also known as Kegel exercises)
•    Biofeedback
•    Timed voiding and bladder training

By Connie Limon
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