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Dealing with incontinence
Millions of Americans have urinary incontinence. Many treatment options are available.
Being unable to control your bladder (incontinence) is a problem no one wants to talk about. It's frustrating and embarrassing.
In most cases, however, it's also treatable.
Millions of Americans have urinary incontinence, according to the American Academy of Family Physicians, and it's most common in women age 50 or older. But the problem isn't necessarily associated with growing older and can occur in people of all ages.
The causes of incontinence
Incontinence can be caused by a number of factors, including:
- Diseases or medical conditions such as stroke, Alzheimer's disease, Parkinson's disease, diabetes, cancer and bladder infections.
- Some medicines, such as diuretics, pain pills, sedatives or cold remedies.
- Conditions such as arthritis, which can make it difficult to reach a bathroom in time.
- Buildup of stool in your bowels.
- For women, weakened muscles around the bladder caused by childbirth, and drying of the skin around the vagina or the urethra—a problem that may be especially likely after menopause.
- For men, an enlarged prostate gland or the effects of prostate surgery.
Types of incontinence
There are several different types of incontinence:
- Stress incontinence occurs when there is pressure placed on the bladder, such as when you exercise, sneeze, cough, laugh or lift something heavy. It is the most common type, particularly in women, and can almost always be treated.
- Urge incontinence is when the need to urinate comes on so quickly you can't make it to a toilet. It's common in men and women.
- Overflow incontinence occurs when urine leaks. It is caused by an overfilled bladder and often occurs in men.
- Functional incontinence is when you have normal urine control, but a disease such as arthritis makes it difficult for you to get to the bathroom in time.
- Mixed incontinence involves two or more types of incontinence together.
Treating incontinence begins with a trip to your doctor. It's important that you discuss your symptoms with your doctor, even if it makes you uncomfortable. The doctor can usually identify the cause of the problem and present treatment options. These may include:
- A bladder-training program. With this treatment, your doctor will instruct you to urinate at specific times. Eventually, you can train your bladder so it only empties when you want it to.
- Kegel exercises. Kegel exercises can help strengthen the muscles that control the bladder. To do Kegel exercises, tighten the muscles you would use to stop urine flow and hold for a count of 10. Relax for a count of 10. Do this 10 times, three times a day. Men can do a similar exercise. Your doctor can help instruct you in doing this exercise.
- Medication. Medications can help tighten the muscles that control urine flow or help relax the bladder itself. Your doctor may also recommend changing the medicines you take for other conditions, if the medicines could be affecting bladder control.
- Weight loss. If you're overweight, shedding extra pounds may help.
- Incontinence pads. These pads soak up leaked urine. They are available in most drug stores and grocery stores.
- Biofeedback. Biofeedback uses machines to create pictures and sounds that show how well you are controlling your pelvic muscles. It may help you learn to control those muscles better.
- Injections. Materials can be injected to bulk up the tissue around the urethra, the tube that carries urine out of the bladder. This can make urine less likely to escape by accident.
- Devices. Women can wear devices called pessaries, which are inserted into the vagina and help support the bladder.
- Surgery. If other treatments don't work, or if the incontinence is severe, surgery may be helpful.
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