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Urinary Incontinence

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of urinary incontinence.

Alternative Names

Incontinence

Lifestyle Changes

Maintaining good hygiene and diet are key components in sustaining a high quality of life. Many products are now available that help patients avoid embarrassment and, in some cases, prevent leakage. With recent improvements in paper technology, pads are now thin enough to be worn undetected, and a spare can be carried in a purse or pocket.

Hygiene Tips

Keeping Skin Clean. To avoid skin irritation and infection associated with incontinence, keeping the area around the urethra clean without causing it to dry out is key. The following may be helpful:

  • After a urinary accident, clean any affected areas right away.
  • When bathing, use warm water and dont scrub forcefully; hot water and scrubbing can injure the skin.
  • A number of cleansers are available that are specially created for incontinence and allow frequent cleansing without over-drying or causing irritation to the skin. Most do not have to be rinsed off; the area is simply wiped with a cloth.
  • After bathing, a moisturizer plus a barrier cream should be applied. Barrier creams include petroleum jelly, zinc oxide, cocoa butter, kaolin, lanolin, or paraffin. These products are water repellent and protect the skin from urine.
  • Anti-fungal creams that contain miconazole nitrate are used for yeast infections.

Preventing or Reducing Odor. Certain methods or oral agents may help reduce odor from accidents. They include the following:

  • Deodorizing tablets (e.g., Derifil, Nullo, Devrom, Chlorofresh) that can be taken orally or used in appliances are available. Most contain chlorophyll.
  • Some people report that taking a vitamin C supplement helps reduce odor. High doses of this supplement may have adverse effects. Patients should discuss this with their physician.
  • Some people have reported that taking an alfalfa pill four times a day reduces odor and does not interfere with any other medications. Alfalfa is a common grass and some people with seasonal allergies may experience an allergic reaction.
  • Drinking more water, not less, will also reduce odors and may not increase the risk for urinary accidents.

To remove odors from mattresses, some experts recommend using a solution of equal parts vinegar to water. Once the mattress has dried, baking soda can be applied on the stain, rubbed in, and then vacuumed.

Dietary Considerations

Weight Control. In women, pelvic floor muscle tone weakens with significant weight gain, so women are urged to eat healthful foods in moderation and to exercise regularly.

Fluid Intake. A common misconception among people with incontinence is that drinking less water will prevent accidents. In reality, limiting fluid intake has the following effects:

  • The lining of the urethra and bladder becomes irritated, which may actually increase leakage.
  • Concentrated urine also has a stronger pungency, so drinking plenty of fluids can help reduce odor.

Some experts recommend drinking two to three quarts a day.

Drinking plenty of cranberry juice may be particularly helpful. It is known to help prevent urinary tract infections. (Low calorie juices are available.)

People with incontinence, however, should stop drinking beverages two to four hours before going to bed, particularly those who experience leakage or accidents during the night.

Fiber-Rich Foods. Constipation can exacerbate urinary incontinence, so diets should be high in fiber, fruits, and vegetables. A diet rich in these foods is highly recommended anyway for overall well being.

Fluid and Food Restrictions. A number of foods and beverages have been reported to increase the incidence of incontinence. Some experts suggest that people who eat or drink the following items should try eliminating one a day over a 10-day period and check to see if removing them improves continence:

  • Caffeinated beverages. (In one major 2003 study, tea drinking--but not coffee drinking--was associated with incontinence. In general, however, it might be useful to try avoiding coffee as well, including decaf coffee.)
  • Carbonated beverages.
  • Alcoholic beverages.
  • Citrus fruits and juices.
  • Tomatoes and tomato-based foods.
  • Spicy foods.
  • Chocolate.
  • Sugars and honey.
  • Artificial sweeteners.
  • Milk and milk products.

Considerations for Exercising

Some otherwise healthy adults stop exercising because of leakage. There are a number of methods for preventing or stopping leakage during exercise. The following are some tips:

  • Limit fluid intake before exercising (but be sure not to become dehydrated).
  • Urinary frequently, including right before exercise.
  • Women can be helped with pads or urethral inserts.

Absorbent Undergarments

A variety of absorbent pads and undergarments are quite effective in catching spills and leaks. Many undergarments developed for incontinence are almost indistinguishable from regular briefs and underpants. The following are some examples:

For women, the following are available:

  • Normal and even attractive looking washable underwear that contains waterproof panels is available for women. Even stomach-control panties are available for women with incontinence.

For men, the following are available:

  • Drip collectors are available which can be worn under briefs and are not noticeable under normal clothing. Lined with absorbent material, the pouch-like collector surrounds the penis or scrotum and is fastened with a belt or pins.
  • Washable briefs made from polyester (Sir Majesty) are available that have a fully functional fly and waterproof panel and look and feel like normal underwear. Boxer shorts are also available that look regular but have a protective pouch.

Even for men and women with severe incontinence, disposable undergarments can be purchased that have a normal look to them.

All absorbent undergarments should be changed when wet to limit problems of chafing or infection. Some manufacturers names and numbers are included in this report.

Personal Urinals

A specially shaped plastic urinal (Feminal) is available for women. It avoids the use of a bedpan, and can be used while the woman is lying down, seated, or even standing.

Urinals for men are available that attach to athletic-like supporters.

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