Question: This is embarrassing to
discuss with anyone, so I thought I’d write to you about it. I’m having
bladder-control problems. What can I do?
Answer: About 10 percent of men and women
over the age of 65 have trouble with bladder control,
also know officially as urinary incontinence. Women
suffer from this more than men.
During
urination, muscles in the bladder contract, forcing urine into the urethra, a
tube that carries urine out of the body. At the same time, muscles surrounding
the urethra relax and let the urine pass. If the bladder muscles contract or
the muscles surrounding the urethra relax without warning, the result is
incontinence.
Short-term
incontinence is caused by infections, constipation, and some medicines. If the
problem persists, it might be caused by weak bladder muscles, overactive
bladder muscles, blockage from an enlarged prostate, damage from diseases such
as multiple sclerosis or Parkinson’s Disease that affect nerves that control
the bladder.
In most cases
urinary incontinence can be treated and controlled, if not cured. If you are
having bladder control problems, go to your doctor. Doctors see this problem
all the time, so there is no need to be embarrassed.
Your doctor
may do a number of tests on your urine, blood and bladder.
You may be
asked to keep a daily chart about your urination.
There are
several different types of urinary incontinence. If urine leaks when you
sneeze, cough, laugh or put pressure on the bladder in other ways, you have
“stress incontinence.” When you can’t hold urine, you have “urge incontinence.”
When small amounts of urine leak from a bladder that is always full, you have
“overflow incontinence.” Many older people who have
normal bladder control but have difficulty getting to the bathroom in time,
have “functional incontinence.”
There are
many ways to treat urinary incontinence. The method depends upon the type of
problem.
You can train
your bladder with exercises and biofeedback. You can also chart your urination
and then empty your bladder before you might leak.
Your doctor
has other tools he can use. There are urethral plugs and vaginal inserts for
women with stress incontinence. There are medicines that relax muscles, helping
the bladder to empty more fully during urination. Others tighten muscles in the
bladder and urethra to cut down leakage.
Surgery can
improve or cure incontinence if it is caused by a problem such as a change in
the position of the bladder or blockage due to an enlarged prostate. Common
surgery for stress incontinence involves pulling the bladder up and securing
it. When stress incontinence is serious, the surgeon may use a wide sling. This
holds up the bladder and narrows the urethra to prevent leakage.
Even if treatment
is not fully successful, management of incontinence can help you feel more
relaxed and comfortable about the problem.
If you have a
question, please write to fredcicetti@gmail.com
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Reserved © 2007
by Fred Cicetti