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Incontinence |
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What is Incontinence? Incontinence (in-CONT-ti-nunce), or loss of bladder or bowel control, is a symptom - not a disease in itself. A broad range of conditions and disorders can cause incontinence, including birth defects, pelvic surgery, injuries to the pelvic region or to the spinal cord, neurological diseases, multiple sclerosis, poliomyelitis, infection, and degenerative changes associated with aging. It can also occur as a result of pregnancy or childbirth.
Normally, the bladder stores the urine that is continually produced by the kidneys until it is convenient to urinate, but when any part of the urinary system malfunctions, incontinence can result. According to the Clinical Practice Guidelines on
Urinary Incontinence in Adults published in 1996 by the Agency for Health
Care Policy and Research, 13 million Americans are incontinent -- 85% of
them are women. More recent consumer research reveals that one in four women
over the age of 18 experience episodes of leaking urine involuntarily. One
in five adults over age 40 are affected by overactive bladder or recurrent
symptoms of urgency and frequency, a portion of whom don't reach the toilet
before losing urine. At least half of all nursing home residents are
incontinent of urine and many of them experience loss of bowel control as
well. In sum, the problem is widespread and affects people of all ages
including children and young adults. NAFC estimates on the basis of multiple
studies and expert opinion that 25 million adult Americans experience
transient or chronic urinary incontinence. Sufferers may experience emotional as well as physical discomfort. Many people affected by loss of bladder or bowel control isolate themselves for fear of ridicule and lose self-esteem. Adults may find employment impossible or compromised. Treatment: Approximately 80% of those affected by urinary incontinence can be cured or improved. Diagnosis includes a medical history and a thorough physical examination. Tests such as X-rays, cystoscopic examinations, blood chemistries, urine analysis, and special tests to determine bladder capacity, sphincter condition, urethral pressure, and the amount of urine left in the bladder after voiding may be required. Because incontinence is a symptom and not a disease, the method of treatment depends on diagnostic results. Sometimes simple changes in diet or the elimination of medications such as diuretics can cure incontinence. More frequently, treatment involves a combination of medicine, behavioral modification, pelvic muscle re-education, collection devices, and absorbent products. Despite the high success rates in treating incontinence, only one out of every twelve people affected seeks help. Many types of treatment are available for incontinent people. After considering your specific case, a qualified specialist can recommend the treatment that is appropriate for you. The three major categories of treatment are:
behavioral, pharmacological, and surgical.
Pharmacologic therapy (medications or drugs) is another common treatment for incontinence. Physicians can prescribe medications to help control incontinence, and sometimes they will take a person off a drug that is causing or contributing to incontinence. Of course, only your healthcare professional should tell you to stop using a drug he/she has prescribed. Surgical treatment should be performed only after receiving a thorough diagnosis from a healthcare professional. All appropriate nonsurgical treatments should be tried before deciding on surgery. There are many different surgical procedures that may be used to treat incontinence. The type of operation recommended depends on the type and cause of your incontinence. Some of the more common procedures performed to treat urinary incontinence include, bladder neck suspension or sling procedures, periurethral bulking injections (collagen injections around the urethra), or implantation of an artificial urinary sphincter or sacral nerve stimulator. Your healthcare professional will thoroughly discuss any procedure you might need. For those people whose incontinence cannot be cured or for those who are awaiting treatment, there are other devices or products to help manage incontinence. These include catheters, pelvic organ support devices, urethal inserts (plugs), external collection systems, penile compression devices, and absorbent products. |
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Incontinence
is a problem of the urinary system, which is composed of two kidneys, two
ureters, a bladder, and a urethra. The kidneys remove waste products from
the blood and continuously produce urine. The muscular, tube-like ureters
move urine from the kidneys to the bladder, where it is stored until it
flows out of the body through the tube-like urethra. A circular muscle,
called the sphincter, controls the activity of the urethra. It is not a part
of the urinary system but can play a role in incontinence.
.
nopausis : meno- + Greek pausis, pause;
see pause.]