Incontinence

Incontinence may seem like one of those things that everyone is bound to develop as they age, but though it seems ubiquitous, it’s not an inevitable product of aging. In other words, if someone does experience incontinence, it is something to discuss with their Primary Care Physician. When people refer to incontinence, they usually mean urinary incontinence, as it is much more common than other forms of the condition. And there are several patterns that urinary incontinence can exhibit, each of which requires a different approach.

What forms can incontinence take?

Urinary incontinence is a frustrating condition. It seems to always strike when it’s least convenient and when someone doesn’t have easy access to a bathroom. But even for those who stay home most of the time, it is still a source of constant annoyance. But what does incontinence look like and what are the underlying causes? The picture of incontinence may take on many forms, and some of them include:

  1. Urge incontinence – This is what most people think of when referring to incontinence. Urge incontinence is, like the term suggests, a sudden urge to urinate that may be uncomfortably intense. Soon after this urge sets in, there is an involuntary period of urination. There may be almost no time to react between the urge and when urination starts, which is why patients that suffer from it are often depicted as rushing to the bathroom.
  2. Overflow incontinence – Overflow incontinence means that the bladder never empties fully, even after going to the bathroom. As a result, urine frequently or constantly dribbles out. This form of incontinence can point to some serious underlying conditions, so it merits immediate examination.
  3. Functional incontinence – Sometimes, incontinence has less to do with the bladder and more to do with other physical or mental conditions. If someone has trouble getting to the bathroom due to a physical or mental impairment, then they have functional incontinence.
  4. Stress incontinence – Stress incontinence is unlike other forms of incontinence in that it only occurs when someone puts their bladder under physical pressure. Examples include sneezing, coughing, lifting something or laughing.
  5. Mixed incontinence – If a patients exhibits more than one form of incontinence, their condition is considered to be mixed.

Although there are several ways incontinence can manifest, there’s no doubt that it feels like a massive impairment on life no matter how it presents. Incontinence is something that patients should talk about with their doctor, but it is especially important to do so if incontinence is directly affecting quality of life or if there is significant risk of injury in rushing for the bathroom. For example, older patients have an increased risk of falling and hurting themselves, so any incontinence problems should be addressed before they cause injury.

There are some complications that may set in if incontinence is not addressed right away. When skin is wetted constantly, there is an increased chance of developing skin infections or sores, which can lead to increased discomfort. Also, incontinence raises the chances of developing urinary tract infections, which can themselves produce problematic complications.

What causes incontinence?

One of the reasons why incontinence must be investigated is that it can be caused by many obvious or not so obvious conditions. Some of them are quite serious and incontinence may be a warning sign that something major is amiss.

However, incontinence may only be temporary. Temporary incontinence is usually caused by dietary choices, including caffeine and alcohol, or other medical conditions. Medication like diuretics can also produce incontinence is some instances. Medical conditions that can aggravate or result in incontinence include urinary tract infections or constipation, as the rectum and bladder share a significant amount of nervous tissue.

The kind of incontinence that affects quality of life, though, tends to be chronic. There are plenty of conditions that can result in chronic incontinence, and some of them are:

1. Childbirth or pregnancy – Both are hard on the body in numerous ways, and the bladder takes a lot of the punishment. During pregnancy, the added weight of the fetus stretches and puts pressure on several internal organs, and the bladder may not be able to retain urine when the pressure becomes too great. Childbirth can produce immediate complications and long-term complications in regards to incontinence. During childbirth, vaginal delivery can damage some of the muscles required to maintain bladder control. In some cases, pelvic floor prolapse may be present, and this can produce many chronic conditions, including incontinence.

2. Enlarged prostate or prostate cancer – A leading cause of incontinence in men is an enlarged prostate. Benign prostatic hyperplasia is the term given to an enlarged prostate with no other symptoms. When the prostate enlarges, it can put pressure on the urethra, making it more difficult to control urine flow.

Prostate cancer is a serious medical condition that requires extensive treatment, but both the cancer itself and the treatment can produce incontinence.

3. Menopause – Menopause brings about comprehensive hormonal changes in women, and chief among them is a reduction in estrogen levels. Estrogen is required to keep the lining of the urethra and bladder in good shape, so a drop in estrogen levels can cause deterioration of those linings. This can exacerbate incontinence.

4. Hysterectomy – Whenever there is surgery done to remove an organ from the pelvic floor, there is a chance that damage is done to the pelvic muscles. This can lead to a lack of support for the bladder and urinary tract, producing incontinence.

5. Aging – It’s no secret that as the body ages, things don’t work as well as they once did. This is also true of the bladder. With age, the muscles used to contract the bladder weaken, leading to an increased risk of involuntary bladder contractions.

6. Neurological conditions – Any neurological condition that interferes with the brain’s ability to communicate with the rest of the body can result in incontinence. This includes acute issues like stroke, injury or a tumor, or a chronic neurological condition like Parkinson’s disease.

Clearly there can be a lot at stake when diagnosing the underlying condition that’s causing incontinence. And it is important to note that incontinence is always a symptom of some other medical issue.

This is why it’s critical to communicate any problems with incontinence to the family doctor. Healthcare providers have several diagnostic tools at their disposal, some of which can be performed without traveling to another facility.

There may be a stigma attached to admitting incontinence, but it’s far worse to wait until any underlying health problems become difficult to treat. Primary Care Physicians are trusted confidants in this way, managing the frustration that comes with incontinence and helping their patients take more control over their lives.