DEFINITION:

What is Incontinence?
Urinary Incontinence (UI) is the involuntary loss of bladder control, most often occurring with women. It is a symptom of nerve or structural damage to the urinary system.  It may be either a chronic or temporary condition.  The loss of bladder control can occur with certain physical activities or with other stress, such as coughing or sneezing.  Pregnant women have often had symptoms but their symptoms are usually a temporary condition.

Urinary incontinence does not have to occur often.  Leaking can occur only during heavy activity. It can be once a week or less.  Regardless, any leakage may too much. Many women do not seek medical help regarding these symptoms.  They may treat their leakage with using absorbent pads and consider it a change in lifestyle. Others may feel embarrassed, ashamed or even depressed. Many women accept their incontinence condition as part of their aging process.  They do not believe it is treatable condition, but there may be a treatment available that could ease or cure their symptoms.

Normal Urination (Voiding)
The urinary tract is made up of four parts                                                              

• Kidneys - produce urine
• Ureters - take urine to bladder
• Bladder – urine is stored
• Urethra – carries urine out of the body

Normal urination (also called voiding) occurs when a woman is able to empty her bladder when she has a natural need to urinate. Normally, the muscles around the urethra relax.  The bladder contracts and urine flows to the urethra and out of the body.  Once the bladder is nearly empty, the muscles around the urethra contract. The bladder relaxes and the stream of urine stops flowing.

CAUSES:
There are many likely causes of urinary incontinence.  Some are short-term and easier to treat than others.
-Urinary Tract Infections - Loss of bladder control may be caused by an infection of the urinary tract. Symptoms include discomfort, urination frequency and possible blood in the urine.
-Pelvic Support Problems - Pelvic organs are held in place by supportive tissues and muscles. Support problems occur when these tissues are stretched or weakened by pregnancy, childbirth and aging. This lets the organs that they support sag out of place. If the tissues that support the urethra bladder, uterus and rectum become weak, these organs may drop down and press against the vagina. This may lead to leaks or may make it hard to pass urine. Many of these pelvic support problems are mild and cause no symptoms.
-Urinary Tract Abnormalities - A fistula is an abnormal opening from the urinary tract into the vagina. It can allow urine to leak out through the vagina. A fistula may result from:

• Pelvic surgery
• Childbirth
• Radiation treatment
• Advanced cancer of the pelvis
• Abnormal growths in urinary tract

Neuromuscular Disorders
Neuromuscular disorders (disorders that affect muscle control) may cause a woman to leak or retain urine.  This happens due to signals from brain to the spinal cord do not connect properly with the bladder and urethra. This problem may be linked to:

• Diabetes
• Stroke
• Multiple sclerosis

Medications
Loss of bladder control may be a side effect of medications, such as diuretics.  Your doctor may need to change the dosage or type of medication to relieve your symptoms. *Always consult your medical professional for a diagnosis of symptoms and recommendation of treatment. This overview is not intended in any way to substitute the advice of a medical professional.

  Diagnosis

A diagnosis can be made once the cause has been detected.  A detailed medical exam will be needed.  You may need to keep a voiding diary (below) and you may need to record your beverage intake.

A pelvic exam will be done to detect physical conditions that might be linked to the problem. Lab tests also may be done to detect a urinary tract infection. Other tests measure how well your bladder empties:

• Stress test—coughing a few times with a full bladder. Any loss of urine is recorded.
• Dye test—wearing a pad after a nontoxic dye is put in the bladder. If the pad gets stained with the dye, there was a loss of urine.
• Urodynamics—measuring the pressure and volume of the bladder as it fills and the flow rate as it empties.
• Cystoscopy—looking inside the bladder and urethra through a thin, lighted tube with a lens at the end.

There may be more than one cause of urinary incontinence. Knowing the cause helps your doctor suggest the best treatment for you.
Treatment
There are many options for treatment. Often treatments are more effective when used in combination. Talk to your doctor as soon as your leakage is at a point that it bothers you. Some treatments work best when the trouble is found early.
Behavioral Treatments
Behavioral treatment is to help a woman know why leaks occur and how to avoid them. Actions that put extra pressure on the pelvic muscles, such as coughing and straining, make some women leak more. Making the following changes in your lifestyle, if they apply to you, may help the problem:

• Lose weight.
• Avoid constipation.
• Avoid very heavy lifting (that causes urine leaks).
• Drink less caffeine (coffee, tea, some soda).
• Get treatment for lung diseases that make you cough.
• Stop smoking.

Depending on the type of the problem, behavioral treatments may include bladder training. With this treatment, you will be taught about normal and abnormal voiding patterns. You will be told to void at set times—even if you do not have the urge. You also may be told to void before exercise. You will learn about ways to ignore urges to pass urine. After a few weeks you should leak urine less often.

Physical Therapy
Different types of physical therapy are available for incontinence treatment. For urinary incontinence the  *Kegel exercise can help strengthen the pelvic muscles and may improve urine control in 40–75% of women who use them. Like any exercise, they work only as long as you keep doing them.
Other types of physical therapy include biofeedback. This process teaches you how to strengthen pelvic muscles. It might be used with physical therapy or bladder training.
Kegel Exercise:  Will tone pelvic muscles and strengthen the muscles around the openings of the urethra, vagina and rectum.  Follow instructions below:

• Squeeze the muscles that you use to stop the flow of urine (do not do while urinating)
• Hold for up to 10 seconds, then release
• Do 10 to 20 times in a row or 5 minutes (3 times a day)

Please note:  Do not squeeze the muscles of the leg, buttock, or abdomen.  You should see improvement in 6-12 weeks if you do this exercise on a regular basis. Always speak to your doctor before beginning this exercise.
Devices
There are a few devices available that can be used to make the pelvic muscles stronger or to block urine. The most common ones are:

• A weighted cone shaped like a tampon is placed in the vagina for a few minutes twice a day. When a woman contracts her pelvic muscles to keep the cone in place, the muscles get stronger.
• A pessary is a firm ring with a knob that is placed in the vagina. The knob supports the pelvic organs. It also may help prevent leaks by pressing on the urethra.

Medications
There are several medications that may help control muscle spasms and help prevent leakage.  Others may strengthen the muscle of the urethra and some may relax an overactive bladder. Your doctor will be able to offer the best medication for you.  Some of the drugs may have some side effects such as:

• Dry mouth
• Constipation
• Nausea
• Blurred vision
• Change in sleeping patterns

Antibiotics may be prescribed for any infections you may have. Leaks may stop when the infection is cured.
Surgery
Surgery can be done to treat stress urinary incontinence. Your doctor may want to consider the following factors prior to electing surgery as an option:

• Your age
• Your lifestyle
• Any other condition that may be present
• Your medical history (if you have had surgery for loss of bladder control or radiation therapy)
• Your general health

For certain types of incontinence, injecting a bulking agent around the urethra can help with the leakage. The effect usually lasts for about a year and the procedure can be repeated.  

SUPPORT FOR CAREGIVERS
Is a Loved One Experiencing Incontinence?
Incontinence can be a sensitive subject to discuss with friends and family.  You must handle the subject with your loved one with care. It will help for you to become well-educated on the condition in seeking support for yourself and our loved one.
Give Yourself A Break
It can be exhausting and very stressful when you are the caretaker.  Your emotions can go from feelings of fulfillment to feelings of resentment.  Remember to make time for yourself.
Ask for Help
Do not hesitate to ask friends and family for help.  You can ask for someone to make dinner, pick up prescriptions, or even help with the laundry. You may need an afternoon for yourself now and then.  These little acts of kindness from family and friends can give you enough relief to get through another day.  
Caring for Elders
Incontinence is most common in the elderly.  They are more likely to have had physical experience that would cause pelvic muscles to weaken.
Caring for the Sick
When people are suffering from serious diseases such as cancer, caregivers are understandably concerned with providing the most efficient and effective way to manage the patient's incontinence while maintaining the patient's dignity.
Caring for Young People with Incontinence
Because people tend to associate incontinence with the elderly, there can be a sense of feeling like one is living with a "hidden disability" or coping with an "invisible" problem for young people suffering from incontinence.
SUPPORT FOR WOMEN:
Pregnancy
It is not uncommon for pregnant women to experience temporary incontinence problems.  Pregnancy can cause physical stress on the bladder and entire pelvic area. The good news? You are not alone! You can manage it with the right treatments and products.
High-impact Exercise & Smoking
Two habits that can increase the risk of incontinence include certain exercise routines and smoking.
High-impact exercise such as running and jogging can weaken the muscles in the pelvic floor that control urination. Lower-impact exercise regimens such as bicycling and swimming do not seem to have this negative effect.
Smoking can increase your chances of suffering from urinary incontinence to up to 50%.

SUPPORT FOR MEN: It is more common in women than men to suffer from urinary incontinence,  although more men than you might expect also suffer through these symptoms and too often without seeking the support and help of your loved ones or from their doctor. Men often temporarily suffer from the symptoms of incontinence as a result of related conditions of the prostate, such as an enlarged prostrate, prostrate cancer, urinary tract infections, or bladder stones. Chronic incontinence, long-term difficulty controlling urination, may be a result of structural or nerve damage. AVAILABLE PRODUCT AIDS: Loss of bladder control is a common problem and there are many treatment options available. However, it is important to seek professional help. If you have symptoms that affect your daily life, tell your doctor. A complete and thorough exam is needed to find the cause of the problem. In most cases, urinary incontinence can be greatly improved with treatment. Incontinence is a physical disorder that should not be looked upon as a shameful condition.  It can be treated and may even be cured with medical treatment. Always consult with your doctor for your treatment options. There are many different products available that can make a BIG difference in improving the quality of life for the user in need, as well as simplifying the life of the caregiver. Today’s incontinence products are not only convenient they also provide many benefits for both the user and the caregiver.  These products can improve skin irritations, eliminate odors, neutralize urine pH, reduce leakage, control bacterial growth that can lead to urinary tract infections, and sleep patterns will be less interrupted. There are many varieties of incontinence product aids offered by We Care Medical Supply, Inc. that will provide comfort and save you from any embarrassing situations.