Stress can be bad: losing a job, losing a loved one, moving to a new city. Stress can also be good: taking an exciting job in a new town, getting married, graduating from college, or delivering an important speech.
If you have a problem with incontinence, don’t let your bladder dampen special occasions. In fact, don’t even think about it; instead, take control with one of the many options described below. First educate yourself - the truth will set you free! Second, inform your urologist of your difficulty because he or she is in the best position to help you.
Types of Incontinence
Stress Incontinence: does not mean emotional stress. Any movement that puts pressure on the bladder causes stress incontinence. In females, the pelvic walls that hold the bladder in place become weakened, so the bladder slips toward the vagina, weakening the sphincter. The sphincter is a muscle that holds the bladder closed. Laughing or sneezing can trigger your bladder if there is already a weakness. The pressure of an unborn baby also can cause stress incontinence when the uterus leans into the bladder from the weight of the baby. That pressure causes the bladder to leak or empty completely. In males, stress incontinence is caused when the prostate enlarges, thereby placing pressure on the urethra.
Urge Incontinence: Patients who have urge incontinence usually have a neurogenic (nervous) bladder: Sphincter muscles become overactive, causing leaks or emptying. A neurogenic bladder is caused by anything from nervousness to a stroke, to Parkinson’s disease, multiple sclerosis or a spinal cord injury.
Overflow Incontinence: When someone is unable to completely empty the bladder because of a weakened sphincter, the bladder overfills, causing leaks. It’s common to have both urge and overflow incontinence.
Functional Incontinence: The physical inability to get to the bathroom on time, either because of limited mobility or mental impairment causes functional incontinence. It is not caused by a dysfunction in the urinary tract.
Some solutions sound scary at first, but keep an open mind - the appropriate one for your situation will become simple to implement. No one has to know about it but you. In fact, online medical supply vendors protect your anonymity by delivering incontinence aids directly to your home. Supplies are usually covered under private insurance or Medicare.
Dryness Aids: Most dryness aids contain a chemical developed by N.A.S.A. for astronauts because they must wear protection during space excursions. The chemical inside protective pads and diapers turns into a solid substance when it gets wet, thereby drawing wetness away from the body. Dryness aids for incontinence contain enough of the chemical to handle big spills. Customers may choose from light absorbency to heavy or overnight strengths. John Glenn, the accomplished astronaut, never suffered any loss of dignity from wearing bladder protection during space travel, so why should anyone else?
Some incontinence pads and adult diapers are made specifically in male and female versions. Look for them in the catalogs listed below. No one but you knows when you’re wearing protection, and it is far better than suffering the consequences, unless you choose another way to effectively deal with urine loss. Note: one drawback of dryness aids is that some people get irritated skin from the chemical inside; in that case, place a piece of cotton cloth between your body and the pad or diaper.
Bladder Control Pads Often Work Best: Bladder control pads, such as Serenity or Walgreen’s brands are usually more absorbent than Depends™ undergarments and less conspicuous because they can’t be seen through clothing. They will hold you until you can reach a restroom to freshen up.
Medicine: Your urologist can prescribe one of several medications that lessen the urge and frequency to urinate and slow down the bladder. Ditropan™ and Detrol™ pills each come in time-released versions now - more effective than the regular versions.
Self-catheterization: Not so terrible! Self-cathing gives a person control over his or her bladder and it doesn’t hurt. A urologist or urology nurse will train you to use one. There is a brief adjustment period and then it’ll be second nature. After that, you won’t have to worry about having accidents because you can keep your bladder empty. Along with self-catheterization, your urologist may prescribe a medication to lesson urgency. (Self-catheterization is a little easier for females because females have a shorter urethra.)
Female Urinary Control Devices: A female urinary control device is a tiny mechanical occlusive apparatus designed to cover or be inserted into the female urethra to prevent unacceptable urinary loss. Three types of urinary control devices exist: external occlusive devices, simple occlusive plugs and complex valved catheters.
The FemSoft® Insert is a type of urethral insert (plug) for treating stress incontinence in women. It is a narrow silicone tube entirely encased in a soft, thin, mineral oil-filled sleeve. The sleeve, also silicone, forms a balloon at the internal tip and a soft, oval-shaped external retainer at the opposite end. A disposable applicator is used for insertion. The FemSoft® Insert is a disposable, one-time use product available through doctors specializing in incontinence. Patients insert the soft, sterile product into the urethra to prevent unintentional urine leakage.
The Impress Softpatch™ The Impress Softpatch™ is an external device made of soft foam and shaped like a tiny missile. The Impress Softpatch™ has an adhesive patch that attaches externally to the meatus. (Avaialble through Uromed:
Pessaries: If pelvic floor muscles are weakened, the uterus may slip and lean against the bladder, causing pressure and stress incontinence. A device called a pessary may be inserted into the vagina to support the uterus and reduce the pressure on the bladder. Various types are available in rings, cubes and mushroom shapes. Some pessaries are inserted by your urologist and left in for several months, while other types are removed each night. Pessaries sometimes cause vaginal irritation.
Kegel Exercises: Kegel exercises work as long as there isn’t a more serious condition than a weak sphincter muscle. Practice stopping your urine flow a couple of times while urinating, to strengthen the sphincter muscle.
Portable Urinals: Portable urinals are useful for persons with limited mobility or who are bed-ridden; it’s often a lot easier to empty the bladder into a urinal than find and negotiate a bathroom.
Commode Seats: A commode seat is another useful option for persons with limited mobility.
An Internal catheter with leg bag can make one’s life a lot simpler if there is little or no way to manage otherwise. If this is an option your doctor and you feel is appropriate, you’ll find yourself free to think of many more things other than your next urination! You have to remember to drain it a few times a day and the unit must be completely replaced at a doctor’s office every four weeks. The risk of urinary tract infection can go up (depending on the patient) so your physician may prescribe a very low dose of antibiotics for prevention.
Nutrasweet® Will Send You Running!: If you think coffee and tea (well-known diuretics) are the only beverages that cause problems, try this experiment: lay off the diet-soda and artificially sweetened yogurt for a week and see how you feel. You’ll probably have a much better behaved bladder because Nutrasweet® is a royal irritant to the bladder lining! It seems to bother females the most. Don’t spend the day in the bathroom! Drink juice and sparkling water instead-they’re very refreshing.
Male external catheters have traditionally been used for the management of urinary incontinence due to surgery, injury and disease. These “condom type” devices are placed over the penis and attached to a collection device, usually a leg- or bedside drainage bag.
External Catheters for males and females: Wouldn’t it be great to get through an entire movie without a bathroom break, after paying the $9 admission? (You could even have a soda!) Wouldn’t it be nice to concentrate on a symphony, opera, play, or romantic dinner, without worrying about your bladder? Imagine picnics at forest preserves, outdoor activities, sports? For people who don’t already have internal catheters, incontinence is manageable with an external catheter, sold by BioRelief and other companies, listed below. (A male catheter is shaped like a condom, while females have a little pouch with a locking drain at the bottom.)
Freedom Pak® Seven leg bags and male external catheters provide a good solution for male patients. Made by Mentor, the Freedom Pak® Seven is worn like a condom. It comes in several sizes and shapes, non-irritating to skin, and odor-free. For a free sample, call 1(800) 525-8161 or visit http://www.mentorcorp.com.
Other options: Botox can be injected around the urethra to add bulk; that compresses it, increasing resistance to urine flow
Surgery: Surgery can be performed for certain dysfunctions of the bladder after conservative options fail.
A Word on Bowel Incontinence: Bowel incontinence is easier to correct because it can be done much less frequently and because it involves solid waste, rather than liquid. Talk to your urologist and explore home health care remedies, such as digital stimulation devices. Digital stimulation is a method of evacuating the bowels, typically at the beginning of the day, removing the problem before it starts.
Some people manage their bowels with a fiber supplement, mild suppositories, or stool softeners. There are plenty of options; one will be right for you.
It’s also advisable to watch your diet to be sure you get plenty of water and fiber, but use discretion - if you’re about to take the train to work, don’t have a large meal or large drink before leaving. Wait until you arrive and avoid coffee especially.