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Managing Urinary Incontinence
Dear Friends,
Stress can be bad: losing a job, losing a loved one, moving
to a new city. Stress can also be good: taking an exciting
job in a new town, getting married, graduating from college,
or delivering an important speech.
If you have a problem with incontinence,
don't let your bladder dampen special occasions. In fact,
don't even think about it; instead, take control with one
of the many options described below. First educate yourselfthe
truth will set you free! Second, inform your urologist of
your difficulty because he or she is in the best position
to help you.
| Types
of Incontinence |
| Stress
Incontinence: does not mean emotional stress. Any
movement that puts pressure on the bladder causes stress
incontinence. In females, the pelvic walls that hold the
bladder in place become weakened, so the bladder slips
toward the vagina, weakening the sphincter. The sphincter
is a muscle that holds the bladder closed. Laughing
or sneezing can trigger your bladder if there is already
a weakness. The pressure of an unborn baby also
can cause stress incontinence when the uterus leans into
the bladder from the weight of the baby. That pressure
causes the bladder to leak or empty completely. In males,
stress incontinence is caused when the prostate enlarges,
thereby placing pressure on the urethra. |
| Urge
Incontinence: Patients who have urge incontinence
usually have a neurogenic (nervous) bladder: Sphincter
muscles become overactive, causing leaks or emptying.
A neurogenic bladder is caused by anything from nervousness
to a stroke, to Parkinson's disease, multiple sclerosis
or a spinal cord injury. |
| Overflow
Incontinence: When someone is unable to completely
empty the bladder because of a weakened sphincter, the
bladder overfills, causing leaks. It's common to have
both urge and overflow incontinence. |
| Functional
Incontinence: The physical inability to get to
the bathroom on time, either because of limited mobility
or mental impairment causes functional incontinence. It
is not caused by a dysfunction in the urinary tract. |
| Back
to Top |
| SOLUTIONS |
| Some solutions sound
scary at first, but keep an open mindthe appropriate
one for your situation will become simple to implement.
No one has to know about it but you. In fact, online medical
supply vendors protect your anonymity by delivering incontinence
aids directly to your home. Supplies are usually covered
under private insurance or Medicare. |
| Dryness
Aids: Most dryness aids contain a chemical developed
by N.A.S.A. for astronauts because they must wear protection
during space excursions. The chemical inside protective
pads and diapers turns into a solid substance when it
gets wet, thereby drawing wetness away from the body.
Dryness aids for incontinence contain enough of the
chemical to handle big spills. Customers may choose
from light absorbency to heavy or overnight strengths.
John Glenn, the accomplished astronaut, never suffered
any loss of dignity from wearing bladder protection
during space travel, so why should anyone else?
Some incontinence pads and adult diapers are made specifically
in male and female versions. Look for them in the catalogs
listed below. No one but you knows when you're wearing
protection, and it is far better than suffering the
consequences, unless you choose another way to effectively
deal with urine loss. Note: one drawback of dryness
aids is that some people get irritated skin
from the chemical inside; in that case, place a piece
of cotton cloth
between your body and the pad or diaper. |
| Bladder
Control Pads Often Work Best: Bladder control pads,
such as Serenity or Walgreen's brands are usually more
absorbent than Depends undergarments and less conspicuous
because they can't be seen through clothing. They will
hold you until you can reach a restroom to freshen up. |
| Medicine:
Your urologist can prescribe one of several medications
that lessen the urge and frequency to urinate and slow
down the bladder. Ditropan and Detrol pills
each come in time-released versions nowmore effective
than the regular versions. |
| Self-catheterization:
Not so terrible! Self-cathing gives a person control over
his or her bladder and it doesn't hurt. A urologist or
urology nurse will train you to use one. There is a brief
adjustment period and then it'll be second nature. After
that, you won't have to worry about having accidents because
you can keep your bladder empty. Along with self-catheterization,
your urologist may prescribe a medication to lesson urgency.
(Self-catheterization is a little easier for females because
females have a shorter urethra.) |
| Female
Urinary Control Devices: A female urinary control
device is a tiny mechanical occlusive apparatus designed
to cover or be inserted into the female urethra to prevent
unacceptable urinary loss. Three types of urinary control
devices exist: external occlusive devices, simple occlusive
plugs and complex valved catheters. |
| The FemSoft®
Insert is a type of urethral insert (plug) for treating
stress incontinence in women. It is a narrow silicone
tube entirely encased in a soft, thin, mineral oil-filled
sleeve. The sleeve, also silicone, forms a balloon at
the internal tip and a soft, oval-shaped external retainer
at the opposite end. A disposable applicator is used for
insertion. The FemSoft® Insert is a disposable,
one-time use product available through doctors specializing
in incontinence. Patients insert the soft, sterile product
into the urethra to prevent unintentional urine leakage. |
| The Impress Softpatch
The Impress Softpatch is an external device made
of soft foam and shaped like a tiny missile. The Impress
Softpatch has an adhesive patch that attaches externally
to the meatus. (Avaialble through Uromed: http://www.uromed.com/index.aspx) |
| Pessaries:
If pelvic floor muscles are weakened, the uterus may slip
and lean against the bladder, causing pressure and stress
incontinence. A device called a pessary may be inserted
into the vagina to support the uterus and reduce the pressure
on the bladder. Various types are available in rings,
cubes and mushroom shapes. Some pessaries are inserted
by your urologist and left in for several months, while
other types are removed each night. Pessaries sometimes
cause vaginal irritation. |
| Kegel
Exercises: Kegel exercises work as long as there
isn't a more serious condition than a weak sphincter muscle.
Practice stopping your urine flow a couple of times while
urinating, to strengthen the sphincter muscle. |
| Portable
Urinals: Portable urinals are useful for persons
with limited mobility or who are bed-ridden; it's often
a lot easier to empty the bladder into a urinal than find
and negotiate a bathroom. Order from
a catalog. |
| Commode
Seats: A commode seat is another useful option
for persons with limited mobility. Order
from one of the catalogs below. |
| An Internal catheter
with leg bag can make one's life a lot simpler if
there is little or no way to manage otherwise. If this
is an option your doctor and you feel is appropriate,
you'll find yourself free to think of many more things
other than your next urination! You have to remember to
drain it a few times a day and the unit must be completely
replaced at a doctor's office every four weeks. The risk
of urinary tract infection can go up (depending on the
patient) so your physician may prescribe a very low dose
of antibiotics for prevention. |
| Nutrasweet®
Will Send You Running!: If you think coffee and
tea (well-known diuretics) are the only beverages that
cause problems, try this experiment: lay off the diet-soda
and artificially sweetened yogurt for a week and see how
you feel. You'll probably have a much better behaved bladder
because Nutrasweet® is a royal irritant to the bladder
lining! It seems to bother females the most. Don't spend
the day in the bathroom! Drink juice and sparkling water
instead-they're very refreshing. |
| Male external
catheters have traditionally been used for the management
of urinary incontinence due to surgery, injury and disease.
These "condom type" devices are placed
over the penis and attached to a collection device, usually
a leg- or bedside drainage bag. |
| External
Catheters for males and females: Wouldn’t
it be great to get through an entire movie without a bathroom
break, after paying the $9 admission? (You could even
have a soda!) Wouldn’t it be nice to concentrate
on a symphony, opera, play, or romantic dinner, without
worrying about your bladder? Imagine picnics at forest
preserves, outdoor activities, sports? For people who
don’t already have internal catheters, incontinence
is manageable with an external catheter, sold by BioRelief
and other companies, listed below. (A male catheter is
shaped like a condom, while females have a little pouch
with a locking drain at the bottom.) |
| Freedom Pak®
Seven leg bags and male external catheters provide
a good solution for male patients. Made by Mentor, the
Freedom Pak® Seven is worn like a condom. It
comes in several sizes and shapes, non-irritating to skin,
and odor-free. For a free sample, call 1(800) 525-8161
or visit http://www.mentorcorp.com. |
| Other options:
Botox can be injected around the urethra to add bulk;
that compresses it, increasing resistance to urine flow |
| Surgery: Surgery
can be performed for certain dysfunctions of the bladder
after conservative options fail. |
| A
Word on Bowel Incontinence: Bowel incontinence
is easier to correct because it can be done much less
frequently and because it involves solid waste, rather
than liquid. Talk to your urologist and explore home
health care remedies, such as digital stimulation devices.
Digital stimulation is a method of evacuating the bowels,
typically at the beginning of the day, removing the
problem before it starts.
Some people manage their bowels with a fiber supplement,
mild suppositories, or stool softeners. There are plenty
of options; one will be right for you.
It's also advisable to watch your
diet to be sure you get plenty of water and fiber, but
use discretionif you're about to take the train
to work, don't have a large meal or large drink before
leaving. Wait until you arrive and avoid coffee especially. |
The
Paralyzed Veteran's Web site http://www.pva.org
This site has several helpful publications for people
with spinal cord injuries and other disabilities. PVA
has a free, 57-page downloadable guide to bowel management. |
Access
To Recreation http://store.accesstr.com
Be sure to see Don Kreb's solutions for bladder and bowel
maintenance; he uses them himself and finds them practical
and successful. (Don is CEO of Access Recreation and a
quadriplegic.) |
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At Home Medical
http://www.athomemedical.com?ref=3
Medical supplies, bladder and bowel incontinence, wound
care, ostomy, aids to daily livingphone 1-800-526-5895 |
BioRelief
http://biorelief.com
A full product line of aids to solve incontinence problems,
including external male and female catheters. Also helpful
information. |
Drugstore.com
http://www.drugstore.com
Shop on-line for male and female dryness aids. |
Impress Softpatch
http://www.universityobgyn.com/impress.htm
Learn general information about the Impress Softpatch
here. The device is available with a prescription and
distributed through your doctor. |
Mail Order
Medical Supply (M.O.M.S.) http://www.momsup.com
1(800) 232-7443 Phone
1(800) 622-3429 Fax
Shop online or call for free catalogs. Incontinence aids
and daily living aids delivered to your door. |
National Association
for Continence (NAFC) http://www.nafc.org
NAFC is a USA not-for-profit organization that
aims to improve the quality of life for people with incontinence.
Its website has a helpful 'Frequently Asked Questions'
section, but you have to become a member to receive its
quarterly newsletter and resource guide of products and
services for incontinence. Write to:
P.O. Box 8310,
Spartanburg, SC 29305 8310, USA |
Rochester
Medical http://www.rocm.com
Rochester Medical offers a full line of latex-free continence
care products for men and women, including male external
catheters and intermittent catheters for men, women, and
children, as well as the FemSoft® Insert for
female stress incontinence. |
Sammons Preston
Rolyan
http://www.sammonspreston.com
Devices for eating, drinking, cooking, and all types of
rehabilitation and independent living aids. Call for the
free catalog: 1(800) 323-5547. |
Uromed http://www.umed.com/Index.asp
Owned and operated by individuals with spinal cord injuries,
Uromed assists customers to find useful products and services,
including sending out free samples. They will contact
your insurance carrier, or workers comp. administrator
to facilitate coverage of supplies and delivery. Uromed
will provide information on Medicare and Medicaid covered
products. Uromed supplies, urological, ostomy, bowel management,
wound care, aids for daily living, and wheelchair accessories.
Uromed staff will also help you locate hard-to-find urological
and other devices. Browse their online catalog. |
| If you have any consumer inquiries
regarding disability or assistive technology resources,
we can help you locate solutions. Please send email inquiries
to: candace.bennett@sbcglobal.net |
Sincerely,
The editors of Infinitec.org |
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