Urinary Incontinence: Prevention and Treatment

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Prevention & Treatment

There are five major categories of possible treatment:

Behavioural modification (retraining the bladder)

  • Urination on a fixed schedule
  • Bladder training
  • Dietary changes (proper hydration; limiting or eliminating coffee, alcohol and tobacco; healthy eating; intestinal management, including increased consumption of fibre in the form of fruits, vegetables, whole grains, etc.) and physical exercise

Environmental improvement

  • Proximity of bathroom to bedroom
  • Sufficient and practical lighting
  • Unobstructed toilet access
  • Support bars installed near toilet
  • Easy-to-remove clothing, such as clothing fastened with velcro (especially people with reduced mobility and those who have had strokes)

Physiotherapy (strengthening of the pelvic floor)

  • Kegel exercices
  • Biofeedback

Pharmacology

  • Medication – certain medications can cause or increase urinary incontinence, such as diuretics, sleeping pills, certain antidepressants, tranquilizers and narcotics or codeine
  • Reduction of polypharmacy

Surgery

  • Burch procedure (lifting the bladder)
  • Sub-urethral sling
  • Collagen
  • Artificial sphincter

Other (adjuvant measures)

  • Pessary
  • Urethral obturator
  • Electrotherapy

 

Limiting liquid intake is NOT a solution

Not drinking can contribute to a higher concentration of urine, which can irritate the bladder. In addition, the risk of bladder infection increases when liquid intake is limited. A lack of liquid also increases the risk of constipation. With you doctor, you can determine the appropriate quantity of liquid for your situation.

Consult a healthcare professional

It is important to consult a healthcare professional in order to identify the causes of urinary incontinence; the problem is widespread but under-treated. While it’s not always easy to talk about, it is important to consult someone who can help you or direct you to the appropriate resources: nurse continence advisor, family doctor, urologist, geriatrician, physiotherapist, social worker.

It is possible that you’ll be asked to take an urodynamic test to help reach a more precise diagnosis. Among other things, this test measures the quantity of urine in your bladder, the time you take to void, and the pressure of the urine stream.

Since urinary incontinence is often experienced in silence, it is essential for sufferers to be reassured and informed about the solutions available to them. Living with incontinence should not mean staying home and limiting activities; it should be about finding ways to prevent leakage and living an active, happy life.

What’s the best treatment for me?

It’s never too late or too early to take charge of your health. There are many treatments available: physiotherapy, surgery, medication. To find the best treatment for you, you need to determine what type of urinary incontinence you suffer from. This diagnosis should be made by a healthcare professional.

Next: Tips and Strategies

 

We are pleased to house this series of FAQs supervised by Cara Tannenbaum, from the Centre de recherche de l’Institut universitaire de gériatrie de Montréal.

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