What is urinary incontinence?

It refers to the condition where a person passes urine involuntarily. It is a common problem in the elderly, especially in females.

Causes

1. Weakened pelvic floor muscles may lead to leakage of urine when the pressure inside the abdomen is raised e.g. when coughing, sneezing, laughing and lifting heavy objects. It is more common in obese women past middle age, especially those who have had childbirths.
2. Over-excitement or irritation of bladder muscles in situations like urinary tract infection (UTI)
3. Stroke, dementia or other diseases of the nervous system that can affect the control of urination.
4. Other factors: Severe constipation, drug therapy, environmental and psychological factors

Possible consequences of improper management

1. Physical effects

• Rashes, poor skin integrity and skin infection
• Pressure sores may easily develop in bed-ridden elderly

2. Psychological effects

• Emotional disturbance such as anxiety, sense of insecurity, shame and embarrassment
• Reduced social activities
• Weakened interpersonal relationships as a result of social withdrawal
• Low self-esteem: feeling of low self-worth, helplessness and loss of control
• Reduced sexual activities due to possible embarrassment

Management of urinary incontinence

1. Positive attitude
   • Face the problem and seek early medical advice
   • Learn how to cope with negative emotions
   • Treat it as a health problem and not something which is to be ashamed of
2. Pelvic floor exercises (Kegel exercises)
   Pelvic floor exercises can strengthen muscle power and restore voiding control. For further information about the exercise, please contact health professionals
3. Drug therapy
   Drug therapy aims at tackling infections and controlling incontinence. It should be prescribed by the doctor and self-medication is not recommended

Other helpful measures to prevent urinary incontinence

1. Maintain adequate hydration
   Two liters of water or other drinks per day helps to reduce the chance of urinary tract infection. Avoid drinking alcohol, coffee, tea and softdrinks
2. Prevent constipation
   Adequate fluids, high fiber diet, and regular exercises all help to prevent constipation.
3. Weight control
   Obesity can increase the pressure inside the abdomen. Hence maintaining a healthy body weight by regular exercises and a balanced diet is important in reducing the chance of incontinence.
4. Bladder training
   Emptying the bladder regularly at 2-3 hourly intervals can improve the control of urination and increase the awareness of the need for urination.
5. Regular pelvic floor exercises
   Helps strengthen the muscle power and restore voiding control
6. Improvement of home environment
   Ensure an easy access to the toilet or use a commode in the bedroom if necessary
7. Choice of clothing
   Wear simple clothing such as trousers with elastic waist bands for easy undressing