One of the more embarrassing physical possibilities as a person ages is incontinence. This can manifest itself in daytime enuresis and even nocturnal bedwetting1. Studies show that as high as 30% of people over sixty suffer at least occasionally from incontinence2. There can be many causes of incontinence, but it is mainly due to age related physiological changes.
- There may be a decrease in urethral closing pressure. Meaning the "valve" that holds in the urine is not as firmly shut off as it once was.
- There can be an increase in involuntary muscle contractions in the area of the bladder (detrusor muscle - which helps empty the bladder during urination.
- At the same time the detrusor muscle may also become weaker. The bladder is not completely emptied, necessitating more frequent urination and increasing the possibility of infection.
- The bladder becomes less elastic, causing the need for more frequent urination and the decrease in the ability to "hold it" longer when necessary.
- The kidneys become less able to concentrate urine. More water must be passed in order to expel the buildup of impurities.
- Stress and depression have been shown to be contributing factors.
- Other illnesses and diseases might also cause or contribute to incontinence, including diabetes, enlarged prostate, Alzheimer's disease and even the flu.
Anyone experiencing frequent incontinence would be well-advised to seek medical advice from a doctor. In any case, incontinence in the elderly cannot always be "cured". However, there are ways to cope with enuresis3.
- Retraining the bladder may be done by certain exercises called "Kegels"4. They are said to take about 15 weeks to be effective, and require a long term commitment.
- Medication can be used to treat incontinence. There are five drugs available to adults, Detrol, Ditropan, Sanctura, Enablex, and Vesicare. All these drugs act in a similar way to block the nerve impulses in the bladder that cause it to leak.
- There is a device, placed in the vagina or rectum, that can send painless electrical signals to the pelvic muscles that strengthen them against urge incontinence.5
- Women can use devices called "pessaries", these are one time use rubber plugs that are inserted to hold in the urine, and are then removed at the time of urination, to be replaced after by a fresh plug.6 There are similar devices available for men that come in the form of a ring.
- Bulking agents can also be surgically inserted around the opening from the bladder to help the muscles do their job.
- A surgery that can be effective in women "re-slings" the bladder after it has been pushed down do to birthing a child.
- Artificial sphincters can also be installed. However, these can have negative long term effects including a restriction of blood flow to important muscles causing them to atrophy.
- A more natural remedy is the use of herbal products containing equisetum, from an herb called marestail or horsetail.7
- Of course, adult incontinence pads are always available and useful for dealing with minor problems.
Incontinence does not have to restrict a person's lifestyle.
- Adult Enuresis
- Urinary Incontinence in the Elderly
- Controling Urinary Incontinence
- Kegels - Pelvic Floor Exercises
- Fecal Incontinence
- Medical Solutions to Bedwetting