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Urinary Incontinence

Treatment Options

Treatment varies depending on the type of urinary incontinence. However, a few non-invasive treatments are available for individuals with all types.

  • Voiding Routine- patients can develop schedule in which they habitually use the restroom every few hours. Frequent voiding lowers the volume of urine the bladder holds at any one time, minimizing excessive filling thereby preventing an incontinent episode.35

  • Bladder Training- individuals with urge incontinence, or overactive bladder, can train themselves to handle greater periods between voids. The individual holds back their desire to urinate incrementally over time, ultimately increasing the duration between restroom breaks without having an episode.36

  • Pelvic Floor Exercises (Kegels)- useful for both stress and urge incontinence, patients can increase their control over urination by contracting their pelvic muscles in the same manner as holding back an urge to urinate. By holding for ten seconds and repeated three times a day, individuals can see improvement as early as six weeks.37

  • Lifestyle Modification- weight loss has been shown to decrease the severity of UI by reducing the amount of pressure placed on the bladder.38 Fluid intake reduction and avoiding certain foods and beverages can further reduce incontinent episodes. Common UI triggers include caffeinated beverages, alcohol, citrus, chocolate and spicy foods. Smoking should be avoided as well.3940

  • Containment Products- commonly used in conjunction with other treatments, many products exist that aid in the maintenance of UI. Absorbent undergarments, sheaths, intermittent/indwelling catheters and drainage bags are less invasive management options that serve to contain urine, promoting cleanliness and reducing anxiety caused by accidents.41

While non-invasive treatments may be effective, some individuals require a greater level of treatment. These include:

  • Pharmacological Treatment- doctors may prescribe anticholinergic medications which inhibit nerve cells and receptors in the detrusor muscle. This effectively reduces the contractions of the detrusor, thereby reducing the frequent urge to urinate.42

  • Botulinum Injections (Botox)- injections of botulinum toxin into the detrusor muscle inhibits the neurotransmitters responsible for contraction, reducing the symptoms of urge incontinence. Bladder paralysis and subsequent need for self-catheterization is a major risk.43

  • Surgery- reserved for when other options have been exhausted, surgeons may perform a “sling procedure” in order to elevate and reinforce the bladder neck and urethra. Surgery may also be used if UI is related to a urethral obstruction due to an enlarged prostate or pelvic prolapse.44

Post-Treatment/Recovery

While urinary incontinence may be treatable or even reversible, not all cases can expect a full recovery. Outcomes are greatly affected by the severity of the underlying issue, their psychological and overall physical health.45


References

  1. 1,3,4,10,11,13,15,28,29,40Leaver, R. (2017). Assessing patients with urinary incontinence: the basics. Journal Of Community Nursing, 31(1), 40-46.
  2. 2,5,12,16,19,23,26,31,32,33,42,43Bardsley, A. (2016). An overview of urinary incontinence. British Journal Of Nursing, 25(18), S14-S21.
  3. 6,14,17,18,20,30,35,37,38,39,44Testa, A. (2015). Understanding Urinary Incontinence in Adults. Urologic Nursing, 35(2), 82-86. doi:10.7257/1053-816X.2015.35.2.82
  4. 7,21,24,25,27,34,41,45Barrie, M. (2015). Identifying urinary incontinence in community patients. Journal Of Community Nursing, 29(6), 45-52.
  5. 8,9Gorina, Y., Schappert, S., Bercovitz, A., Elgaddal, N., & Kramarow, E. (2014). Prevalence of incontinence among older americans. Vital & Health Statistics. Series 3, Analytical And Epidemiological Studies, (36), 1-33
  6. 22Beeckman, D., Van Damme, N., Van den Bussche, K., & De Meyer, D. (2015). Incontinence-associated dermatitis (IAD): an update. Dermatological Nursing, 14(4), 32-36.
  7. 36Nazarko, L. (2015). Person-centred care of women with urinary incontinence. Nurse Prescribing, 13(6), 288-293.