Continence Management

Incontinence is the loss of bladder and/or bowel control. Urinary incontinence is a condition that affects an estimated 12 to 20 million Canadians and Americans at some time in their life. Incontinence may be partial or complete. It may be temporary or a continuing condition. Contrary to popular belief, incontinence is not a disease. It is a symptom of an underlying physical condition. Incontinence can almost always either be cured, treated or successfully managed.

Cause of Incontinence
Two main factors contribute to incontinence:

  • immobility and impaired mental functioning. A physician’s assessment is recommended, because the types of incontinence vary. Causes can range from a birth defect of the urinary system, to a weakening of the pelvic floor muscles, to enlargement of the prostate (in men), or a loss of estrogen (in women).
  • conditions that affect the nervous system (ie. Stroke, Multiple Sclerosis, or Spinal Cord Injury), surgery or possible side effects of medication.

Awareness is the Key

Depending on the nature and cause of the incontinence, there are many management and treatment options. Awareness of these options is the first step in overcoming the challenges of incontinence. Community and homecare professionals can assist clients by facilitating the access to information and appropriate medical advice.

Self Image

According to a recent study conducted by the Canadian Continence Foundation, incontinence has, for most sufferers, impacted their overall sense of well-being. The majority of respondents experience embarrassment, discouragement and frustration during incontinence episodes. These experiences were especially acute in the lower income and education brackets.
Treatment Options

From lifestyle modifications (ie. time scheduled toileting routines, diet/fluid intake changes and exercises) or medication, to other options such as surgery or an artificial sphincter, there is a wide range of potential treatment solutions. Easy-to-use and discreet products are also available that can make a world of difference in effective management. Effective management becomes a reality when the necessary education has been provided and products can be selected and used appropriately.

Incontinence is a Symptom, Not a Disease

There are many types of urinary incontinence. The classification system that is often used describes the way that the urine is lost, but not the reason for the loss.

  • Stress Incontinence refers to the leakage of small amounts of urine when coughing sneezing or straining.
  • Urge Incontinence refers to the urgent need to pass urine and the inability to get to the toilet on time. The entire bladder contents are emptied.
  • Overflow Incontinence refers to the spilling over of small amounts of urine when the bladder is still full.
  • Reflex Incontinence refers to the loss of urine when the person is unaware of the need to urinate.

Ten Warning Signs of Bladder Problems (which suggest consultation with a physician):

  • Leakage of urine which prevents involvement in desired activities;
  • Leakage of urine which causes embarrassment;
  • Leakage of urine which began or continued after an operation;
  • Inability to urinate (retention of urine) following an operation;
  • Urinating more frequently than usual without a proven bladder infection
  • Needing to rush to the bathroom and/or losing urine if one does not “arrive on time”;
  • Pain related to filling the bladder and/or pain related to urination (in the absence of a bladder infection);
  • Frequent bladder infections.
  • Progressive weakness of the urinary stream with or without a feeling of incomplete bladder emptying
  • Abnormal urination or changes in urination related to a nervous system condition (stroke, spinal injury, multiple sclerosis, etc.)

Managing Incontinence

Many Canadians believe that incontinence is “something you just have to live with”. The reality is that it can be successfully managed. Here are some tips for gaining control.

  • Taking fluids periodically during the day and limiting fluid intake 2 to 3 hours before bedtime will improve control. Drinking “bladder friendly” fluids like water, apple, grape and cranberry juice will also help.
  • Caffeine causes the body to increase urine production and will fill the bladder more quickly. Beer, wine or hard liquor have the same effect. Intake of these should be monitored.
  • Frequently visiting the bathroom and not allowing the bladder to fully fill can cause problems. The muscle may lose its shape and will not be able to hold as much urine.
  • Kegel exercises can be helpful for stress and/or urge incontinence. A health professional can explain these exercise routines.
  • Bladder retraining and urge suppression can gradually increase the amount of time between bathroom visits.

Source: The Canadian Continence Foundation.