When Incontinence is not because of your Bladder

  • Urinary incontinence in women has widely been accepted as a result of aging. We now know this is not true. As I have mentioned in several previous blogs, you don’t have to be wet. There are many cures for the multitude of causes of urinary incontinence. But what if the problem has really nothing to do with your bladder. What I’m talking about is referred to as “Functional Incontinence”.

    Functional incontinence is when a person has a physical condition that limits his or her ability to get to the toilet in a timely fashion, and the bladder will reflexively empty in a normal fashion. For example, someone who recently broke a hip or leg cannot walk quickly to the bathroom to empty the bladder.
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    This can be very frustrating not only for the patient but for family members. I often have patients brought to my office by family members who complain that, let’s say their mother, smells like urine and they want me to fix her incontinence. After a detailed history and physical I find that mom actually has control of her bladder, but it is hard for her to get to the toilet, and pretty much has given up trying to get there.

    Luckily, there are some solutions to this problem. The easiest is to wear protective undergarments like pads or adult diapers. Many people do not like this solution, but it does work well. Another option is to get a bedside commode. This commode does not need to be placed just in the bedroom. If the person spends most of the day in the living room on the couch, put the commode in the living room if the bathroom is too far away to reach it in a timely fashion.

    I have mentioned before that there are often behavioral modifications that can help incontinence as well. Teaching a patient to empty his or her bladder by the clock and not by sensation can make a world of difference. If you are having trouble getting to the toilet in a timely fashion after you get the sensation to empty, then we just have to get you to beat your bladder at its own game. If you usually get the urge to go to the bathroom about every four hours, then try to go every three hours instead. Many people find this works well.

    I am always asked about placing a catheter into the bladder for long-term management for this problem. Yes, this works, but it is not the ideal situation. First of all, it will set you up for recurrent infections. It is like a direct pathway for bacteria into your bladder. More importantly, there is a multitude of medical articles that have found the long-term catheter drainage of the bladder just irritates the bladder, can decrease the capacity, and over time cause kidney damage from increased pressure inside of the bladder.

    As always, my advice here is not meant to diagnose, but to give you some guidance, and make you feel more prepared to talk to your physician. If you think this sounds like you, please make an appointment to see either your primary healthcare professional or a urologist so that you can be fully worked up and make sure this is your correct diagnosis.

  • Talk about functional incontinence on the message boards.

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  • Find information on treament for urinary incontinence.

Published On: October 18, 2006