What is incontinence?
Urinary incontinence, the involuntary loss of bladder control, can have a dramatic impact on one’s life!
Did you know there are over 3.3 million Canadians experiencing at least one of the different types of urinary incontinence?
Imagine not being able to travel, enjoy a movie and dinner with your partner, work out at your gym, lift your child or groceries, as you may have an accident. You can not be away from home any length of time, you absolutely must know where the bathrooms are located in the shopping mall, you are embarrassed to have intimate relations with your mate and in some cases individuals have quit their jobs.
There are ways to manage incontinence, and in many cases cure it. Due to embarrassment many people do not seek help and therefore are unaware of the many treatment options that are now available This web site is intended to give you some facts on incontinence – what it is and what it is not, and why it occurs. Most importantly, this information strives to give you the confidence of knowing that something can be done and you are not alone. This is the first step in preparing you to become an educated partner with an interested and knowledgeable healthcare professional.
Incontinence is not a disease.
Incontinence is a symptom of something else going on in the body, and should be discussed with a healthcare professional who is interested in and knowledgeable about incontinence. Incontinence can always be either cured, treated, or managed successfully. There is help available – see your healthcare professional.
Did you know that urinary incontinence means a loss of bladder control? If you did not, you are not alone. Almost half the Canadian population does not know what the word "incontinence" means, despite the fact that 3.3 million Canadians experience it!
- Incontinence affects over 3.3 million Canadians including men and women of all ages.
- Incontinence means the involuntary release of urine at the wrong time and/or place.
- The number of people experiencing incontinence will rise dramatically over the coming years due to the aging "boomer" population.
- Incontinence is not a disease. It is a symptom of something else going on in the body, and should be discussed with a healthcare professional who is interested and knowledgeable in the area.
- In one study, 74.5% of respondents reported that day-to-day activities had been modified at least a little because of urine leakage.
- People suffering with incontinence experience various emotions during. incontinence—84.3% reported feeling embarrassment, 73.4% reported feeling discouraged, and 83.1% reported feelings of frustration.
The causes of urinary incontinence:
- Incontinence can be caused by a weakening of the pelvic floor muscles as a result of vaginal childbirth, the result of a disease process such as multiple sclerosis or Parkinson’s disease, birth defects, injuries from an accident, or a consequence of medications or surgery.
- Incontinence is not caused by aging. However, changes which occur with the natural aging process may contribute to incontinence. For example, the natural enlagement of the prostate gland as men age, or the progressive decrease of estrogen which women experience with aging and after the menopause, and child birth can lead to incontinence.
- Since there are so many possible causes of incontinence, bladder weakness or bladder problems, it should be diagnosed by a physician in order to ensure that this is not a symptom of another medical problem, and so that the correct treatment options can be discussed and selected.
Some different types of urinary incontinence:
- Functional Incontinence — those immobile who are not originally incontinent fail to get to the toilet in time and are placed in absorbent products and therefore are considered incontinent.
- Stress Incontinence — happens when the urethra cannot handle the increased bladder pressure during exercise, coughing or sneezing.
- Urge Incontinence — can be caused by a sudden, involuntary bladder spasm. It is the inability to delay urinating long enough to get to a toilet when you get the feeling.
- OAB Incontinence — is the medical term denoting a group of symptoms resulting from involuntary bladder spasm that includes frequency of urination especially at night and urgency with or without involuntary leakage.
- Overflow Incontinence — happens when the bladder becomes too full and overcomes urethral resistance because the bladder can’t be completely emptied, and there is a frequent leakage of urine without the urge to urinate.
- Total Incontinence — results from the complete absence of urinary control which may lead to continuous leakage or periodic uncontrolled emptying of the bladder.
Some therapies for urinary incontinence:
- Kegel exercises or pelvic floor muscle training — Regular daily exercises of the pelvic floor muscles .May be done with or without Biofeedback equipment and electrical stimulation, which help identify the right muscles to contract.
- Bladder training — Teaches people to resist the urge to urinate and to gradually expand the interval between urinating.
- Diet — Helps people by avoiding foods and/or fluids which can irritate the bladder, like caffeine and excessive alcohol.
- Medications — One type can calm bladder spasms.
- Hormone replacement — Estrogen treatments to assist in improving stress incontinence in post-menopausal women
- Injections — These involve injections of a substance into the urinary passage (urethra) to improve its strength and resistance.
- Surgery — The most frequently performed one is a repositioning the neck of the bladder. There is also an artificial sphincter implant, which can be helpful for men who have incontinence after prostate cancer surgery. Sacral nerve stimulation device, an option for some adults, involves a device which can be implanted in the body to help stimulate nerves in the pelvis and improve bladder function.
For more information on incontinence or for a list of specialists in your area, call The Canadian Continence Foundation at 1-800-265-9575.
- Experiences, Perceptions and Needs Among a Large-scale Canadian Population Experiencing Incontinence: A Quantitative Study Report, by Malvina Klag, Executive Director, The Canadian Continence Foundation, March, 1999
- Angus Reid Poll, Unpublished, 1997
- Angus Reid Poll, The Canadian Continence Foundation, 1998
Myth vs. Fact
MYTH: Only a few, older people, most of who live in institutions, experience incontinence.
FACTS: Incontinence, the loss of bladder and/or bowel control, affects over 3 million Canadian men and women of all ages.
Incontinence affects the following groups of people:
- 10% of six-year-olds
- One in four women middle-aged or older
- 15% of all men aged 60 years and over
- Many individuals with neurological disorders and spinal cord injuries
- Over 90% of those affected by incontinence live at nursing homes
MYTH: Incontinence is a disease.
FACTS: Incontinence is a symptom of something else going on in the body, and should always be assessed and diagnosed by a healthcare professional interested and experienced in incontinence care.
Incontinence has many causes, including:
- Conditions that affect the nervous system and therefore the communication between the brain and the bladder/sphincter or bowel, e.g. stroke, multiple sclerosis, Parkinson's disease, or spinal cord injury.
- Consequences of surgery, e.g. prostate surgery.
- Side effects of medications e.g. anti-depressants, sedatives, diuretics, or muscle relaxants.
- A birth defect of the urinary system.
- Weakening of the pelvic floor muscles which may occur, for example, after vaginal childbirth or menopause and aging.
- Changes that occur with the natural aging process, such as enlargement of the prostate in men, or the loss of estrogen and weakness of the pelvic floor and urethral muscles in women.
MYTH: Individuals experiencing incontinence just have to learn to live with it.
FACTS: Incontinence can almost always be cured, improved or at least successfully managed. There are many treatment or incontinence management options depending on the nature and cause of the incontinence. Time-scheduled toileting routines, diet/fluid intake changes, or exercises, with or without biofeedback and/or electrical stimulation equipment, may help. For some, medications can help to increase the bladder's ability to empty, to relax the bladder and decrease urgency, or to tighten the sphincter to prevent urine leakage from the bladder. Other options such as surgery, an artificial sphincter, or an injection of a substance into the urethral sphincter muscle, may be recommended.
In the case of people who are physically or cognitively challenged, there are often potential options that can restore or improve continence, such as assistance with toileting, or by devices such as mobility or communication aids. If incontinence products are required, choosing the most appropriate conduction or containment product can make a world of difference in one's quality of life.
Awareness that incontinence is abnormal and that there are treatment and management options is the first step. You can help your clients with incontinence by either directly providing the treatment/management services, or by ensuring your client has access to a healthcare professional with a special interest and expertise in incontinence care. If you require a list of specialists in your area who have a particular interest in incontinence go to List of Professionals or call The Canadian Continence Foundation at 1-800-265-9575, or 514-488-9999.