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Understanding Urinary Incontinence... /
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Understanding Urinary Incontinence
for Today's Caregiver
By Jacek L. Mostwin, MD, DPhil
& Rene Genadry, MD
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
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.