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Understanding Urinary Incontinence 
for Today's Caregiver

By Jacek L. Mostwin, MD, DPhil & Rene Genadry, MD

(Page 1 of 3)  
 

Thanks to a growing awareness of the physical problems and social repercussions of urinary incontinence, more and more people—including doctors—are taking incontinence seriously. This is good news for women dealing with this condition: there are health professionals available who understand what incontinence is, what causes it, and how to successfully treat and manage it. 

It is also good news for children caring for parents who are seniors, and those in the health profession who work with and care for elderly patients. Urinary incontinence becomes more common as women age. In fact, this condition can be responsible for as many as 50 percent of nursing home admissions, so learning what you can do now to help may lessen or prevent problems in the future.

Childbirth, menopause and aging of the nervous system all contribute to the development of incontinence over the many stages of a woman’s life. When younger women bear children, labor and delivery may stretch and tear muscles and nerves of the bladder and urethra and can injure the structures providing vaginal support. Although some women will develop symptoms of stress incontinence (leakage with coughing, laughing or exertion) during their pregnancy or shortly after delivery, these problems often disappear, only to return 10-20 years later. Stress incontinence can be improved with pelvic muscle exercises, weight loss, and, if necessary, will usually respond well to surgical treatment.

As a woman passes through menopause, the muscle mass surrounding the urethra becomes thinner and resistance to leakage decreases. So even if there is good vaginal support, or very little sign of a “dropped bladder,” an older woman may start developing the same symptoms she had as a younger woman: leakage with coughing, sneezing or laughing.

Increasingly strong urges to urinate may begin to develop later in life, making it difficult to reach a toilet in time. This is called urge incontinence, and may become serious enough that a woman has to wear one or more pads a day to manage the leakage. These problems may respond well to treatments such as medications or injections of bulking agents like collagen (Contigen), although surgical repairs may still be required.

 

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