Urinary incontinence is a condition that affects millions of adults across the globe and is extremely common in our geriatric population. Defined as the loss of control over your bladder, there are multiple causes that may contribute to this condition and the symptoms vary from mild to severe depending on the individual. With help from our friends at Attends, the below blog post gives a break down of how the urinary system normally works, types of incontinence along with their symptoms, and tips for caregivers caring for patients with incontinence.
The Urinary System
The urinary system is a complex system of nerves and muscles responsible for maintaining the normal cycle of filling and emptying the bladder. The bladder is an involuntary muscle that contracts when it receives a signal from the autonomic or involuntary nervous system. When the signal is given, this is when emptying occurs. The bladder also has an internal gate or sphincter that gets a signal to relax and open. This is partly responsible for allowing urine to flow into your urethra. The entire process of contraction and the internal gate opening is based on a nervous system reflex that the human mind has no control over. However, there are specific things that the mind does have control over, like the external sphincter. This is the second gate leading to the urethra and the one responsible for the, “it’s time to go” urge. When the bladder is filling up with urine, its muscled walls are expanding. This sends notion sends involuntary reflex signals that cause small contractions of the walls. These small contractions and the pressure put on the external gate are what triggers the brain letting it know it’s time to go. When the body is ready to urinate, the mind instinctively tells the external gate that it is time to relax in coordination with the nervous system relaxing the inner gates and contraction of the bladder. Under normal conditions, the involuntary nervous system keeps the inner gate shut during filling while subconsciously keeping the outer gate shit as well. Unfortunately, when the systems don’t work together properly, The result is incontinence.
Causes and Symptoms of Urinary Incontinence in Adults
Urinary incontinence is defined as any uncontrolled leaking of urine. There are several different mechanisms that can lead to this. A minimum of one in every four adults in the US will experience this condition, though it does affect women more than men. Symptoms can range from mild to severe depending on the type of incontinence the individual has. Below are the four most common different types of incontinence with their descriptions!
Stress incontinence is the most common type of incontinence among middle-aged women. It is characterized by leaking small amounts of urine when laughing, coughing, sneezing, or doing exercises. This is due to the excess pressure placed on the bladder during these activities. This is caused by a weakness of the pelvic muscles or the sphincters that keeps them from staying shut when pressure is applied. It is commonly seen in women who are postmenopausal or have had vaginal childbirth, women who are currently pregnant or have participated in high-impact sports long term, and men that have had their prostate removed. Obesity can be a predisposing factor as well as smoking or other conditions that cause chronic coughing.
Urge incontinence also known as overactive bladder (OAB), is a type more often accompanied by underlying diseases such as diabetes, stroke, Alzheimer’s, or multiple sclerosis. The main symptom is having a sudden strong urge to urinate and not being able to get to a bathroom in time, resulting in leakage. This is caused by the bladder contracting when it isn’t supposed to. This is associated with many different things including diseases such as diabetes and Alzheimer’s, bladder or kidney stones, and urinary tract infections.
Overflow incontinence occurs when the individual cannot empty their bladder. It remains perpetually full and any new urine the body produces continuously leaks out.
Functional incontinence has outside factors that prevent the individual from getting to the toilet normally. Instead of something being wrong with the urinary system itself, this type happens when there is another condition that causes incontinence.
Urinary incontinence can affect every aspect of an individual’s life, and as a caregiver, you may often take the weight of this. Caring for an individual with incontinence can be one of the most demanding and stressful jobs on the planet. It’s important to recognize the weight of this responsibility and give yourself breaks when needed. With incontinence, the goal is to help your loved one function as normally as possible while being filled with questions like, “Where can I change him/her while minimizing mess and embarrassment?” on outings or, “Do I have what I need (briefs, wipes, change of clothes, etc)?” To minimize your stress while caregiving, consider carrying an incontinence care kit with you everywhere you go and have one on hand in every home visited. Plan ahead and remember to consider your loved one’s incontinence in everything you plan, including what you dress them in for easier removal and changing! Lastly, love yourself a bit more. Prioritize good self-care, eat well, exercise, sleep well, spend time in the sun, and doing the things you love with the people you love. Caring for an individual with incontinence will always be a piece of you and your daily routine but it doesn’t have to consume you or define you.