WHAT IS INCONTINENCE?

Incontinence is the uncontrollable loss of enough urine to cause social or sanitary difficulties. When we study the body and look at how we are able to control urination, we know that an infant does not have the proper connections between their brain and their bladder to be able to control the bladder. We also know that as the brain develops, young children can be taught to have control of when and where they empty their bladders. This learned control is then maintained, usually without much thought, throughout adulthood. To a child or an adult, any loss of bladder control feels like a return to infancy and can be an embarrassment and a source of terrible discomfort.

Incontinence can be a significant problem for young, middle age and older women. Life with incontinence, even mild incontinence, can become very stressful. Incontinence threatens self-image, body image and self-esteem. Concerns about having to deal with incontinence may hinder career opportunities for women in the workforce. The embarrassing loss of self-control makes a woman feel old and helpless. Outings for shopping and recreation may be planned around the availability of a bathroom. Travel to new places becomes difficult. The need to always have a change of clothes or to worry about odor is a constant concern. Or, women suffering from incontinence may stop some of the activities they enjoy altogether; they may avoid getting together with friends or family; they may avoid sexual contact; they may feel depressed.

Many people consider adult incontinence a natural part of aging. It is not! The vast majority of older women do not have incontinence. Most people are not aware that young women also can have incontinence. Since incontinence is so frequently associated with aging, those younger women are even less likely to talk about it or seek treatment. The good news is that there are now many ways to treat women of all ages who have incontinence.

IS ALL INCONTINENCE THE SAME?

Incontinence is a symptom- the loss of urine. The two most common types of incontinence are loss of urine with laughing, coughing or sneezing, called stress incontinence, and loss of urine proceeded by a strong urge to go, called urge incontinence or overactive bladder. Sometimes a woman has both types of incontinence at the same time. This combination of incontinence is called mixed incontinence. Different types of incontinence have different causes, and different treatments solve each type of incontinence. The first step to end the incontinence is for the doctor to determine which type of incontinence you have. This starts by having you answer questions about your symptoms. Following that, there are a number of simple tests performed to help pinpoint the nature of the problem, which we will discuss in chapter 3. But first, it will be helpful to understand what the possible types of incontinence are. The chart gives brief definitions of the types of incontinence, and more detailed explanations follow.

TYPES OF INCONTINENCE

STRESS incontinence.... urine loss with some type of physical stress to the body such as with a cough, sneeze, physical activity or laughing.

URGE incontinence.... urine loss proceeded by a sense of needing to urinate before reaching the bathroom.

MIXED incontinence.... urine loss with features of both stress and urge.

OVERFLOW incontinence.... urine loss occurring when the bladder is full, but the bladder does not contract properly to push the urine out. The urine then trickles out of the over-full bladder.

TOTAL INCONTINENCE.... the constant loss of urine.

WHAT IF YOU HAVE THE URGE TO URINATE FREQUENTLY?

Urgency is the sense that you have to urinate right now. When you gotta go, you gotta go. A constant urge to empty the bladder and all the necessary trips to the bathroom can be disabling to many women. They do not necessarily leak urine, but their lives are nevertheless taken over by their bladder problems. Urgency is basically the result of the bladder misbehaving, of the bladder being over-active. In fact, the term overactive bladder is now frequently used instead of urgency. Instead of quietly collecting urine, the bladder is constantly making a nuisance of itself. This is perceived as ever-present bladder pressure. The bladder feels as if it is always full, but, in fact, most trips to the toilet produce no more than a few ounces of urine. Some women may note urgency during the night that repeatedly wakes them.

Urgency and frequency are frustrating problems. Many women suffer in silence because they do not realize that, thankfully, there are many solutions to their problem. These include taking prescription medication, learning to urinate on a schedule or doing muscle exercises that can help reduce spasms. Simple dietary

changes may also help reduce frequency and urgency. These non-surgical treatments and others are fully discussed in chapter 5.

The Following Questions and Answers Can Be Found in The Incontinence Solution:

• WHAT HAPPENS WHEN A LAUGH, COUGH OR SNEEZE CAUSES LEAKING?
• WHAT CAUSES STRESS INCONTINENCE?
• HOW COMMON IS URGENCY?
• WHAT CAUSES A STRONG URGE TO URINATE?
• WHAT IF THERE’S A STRONG URGE TO URINATE AND THEN YOU LOSE CONTROL?
• WHAT CAN CAUSE LEAKAGE WITH EVEN MINOR ACTIVITY?
• WHAT IF YOU LEAK URINE ALL THE TIME?
• WHAT CAN CAUSE YOU TO LEAK ALL THE TIME?

Edited Excerpts from our book
The Incontinence Solution

By William H. Parker, MD, Amy E. Rosenman, MD, and Rachel Parker

Order The Incontinence Solution directly from Amazon.com.

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