CARE AND MANAGEMENT OF INCONTINENCE

by the Incontinence Information Bureau

Introduction

Incontinence can often be cured. Even if this is not possible, there are a variety of treatments and appliances which can help with incontinence to lead active lives.

Surgery

Depending on the cause of incontinence, surgery may provide a cure. For example, if the prostate gland is causing an obstruction it can be removed; if the urethra has been stretched- it can be tightened; a prolapse can be repaired. If incontinence is severe, an operation to bypass the bladder is sometimes carried out.

Medicines

Drugs may be prescribed to calm an overactive bladder and hormone tablets can be beneficial in some cases of stress incontinence in post-menopausal women. Suppositories or an enema are usually given to resolve severe constipation.

Catheters

Some people can successfully manage urinary incontinence either by indwelling or intermittent catheterisation. A catheter is a sterile tube inserted into the bladder which allows urine to drain.

Indwelling catheterisation is often the most effective means of managing incontinence for people who have neurological disorders which may affect their bladder control. Normal catheterisation is undertaken via the urethra but a catheter can be surgically inserted into the bladder via the wall of the abdomen, just above the pubic bone - known as supra pubic catheterisation. With both catheters, urine drains into a bag which can be worn discreetly on the leg during the day.

Intermittent catheterisation may be useful for people with overflow incontinence or an atonic bladder. People are taught how to empty their bladder two or three times a day by inserting a temporary catheter via the urethra into the bladder.

Appliances

Men can wear a penile sheath, which is a fine latex appliance, similar to a condom, which fits over the penis and is attached to a urine collection bag worn on the leg. This device is discreet, quick and easy to fit, allowing the individual maximum freedom and dignity.

If normal bladder function cannot be restored, special incontinence pads are held in place by close fitting underwear can help alleviate discomfort and allow individuals to get on with their everyday lives. Health and local authorities may have home delivery and collection services for incontinence laundry.

Exercises

Simple pelvic floor exercises can help both men and women to control urine and bowel leakage. Bladder training exercises can be useful in controlling incontinence associated with urgency and frequency. Both types of exercise may need to be practised for several months before any benefits are felt.

Psychological Aspects

People of all ages are affected by incontinence. Often they do not talk about their condition, even with their doctor, because they are too embarrassed and in many cases think nothing can be done to help them. Without appropriate care and management, incontinence can lower an individual's self esteem, may cause loss of independence and therefore reduce their overall quality of life.

By encouraging people to come forward for help and support, many men and women can lead more fulfilling, active lives with dignity and confidence.

References

Incontinence. A Help the Aged Leaflet, Spring 1994. Help the Aged, St James's Walk, London EC1 R 0BE
Complete Family Health, British Medical Association, 1990. Published by Dorling Kindersley Limited, London.