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Coping with Urinary Incontinence 

When incontinence persists even after medical evaluation and treatment, the degree of the symptoms can vary, but urinary incontinence (the loss of control of urination), can still be difficult to live with. 

It is assumed that before one is relegated to those inconveniences and this lifestyle, a complete urological check has been performed for the four basic types of incontinence: overflow incontinence, total incontinence, stress urinary incontinence and urge incontinence. These four types of incontinence can be treated medically and/or surgically to maintain or at least improve continence. 

There are practical preventive measures which can be taken to assist in maintaining continence. Voluntary evacuation of urine in a timely fashion, whether the sensation or feeling to urinate exists or not, is often helpful. For example, voiding every two hours while awake, may minimize the unplanned loss of urine. Urination before leaving home or upon arriving at your destination, even when the desire to urinate is not present, makes good practical sense. When traveling, a change of undergarments, pads, and clothing may be needed in an emergency.
 
There are other practical measures such as controlling the amount of fluid intake. One might want to cut down to a maximum intake of 4-6 glasses a day, especially 4-6 hours before traveling, or going to someplace you know will not have an easily accessible restroom. In addition, there are medications and also Kegel exercises which can be used to help control continence. Check with your doctor about these alternatives. 

Today, there are even mechanical devices, such as urethra inserts, which are available to help women become continent between voidings. They are removed before each voiding and then replaced. For the male, there are devices such as external condom catheters or external clamps. All these measures can be tried before surgical intervention needs to be considered. 

Zinc oxide or corn starch can be applied locally for comfort, skin protection, dryness, and pleasant aromatics. The cleansing of urinary storage bags between uses can be accomplished with a soapy water solution. To help decrease odor and for an antibacterial effect, place 1-2 tablespoons of mouthwash in the urinary reservoir or drainage bag. Any absorbent product is acceptable from as simple as toilet tissues to paper towels to specialized absorbent commercial fabrics. There are even some washable absorbent underwear available. 

It should be mentioned there are additional measures which can be helpful, such as intermittent catheterization or even use of an indwelling Foley catheter. Certainly, the emotional support of family and love ones, along with the understanding that incontinence is beyond the person's control is very important. This support can help your loved one through this potentially socially embarrassing situation. 
 

For more information, Dr. Marshall M. Kaplan, M.D., F.A.C.S. can be contacted at Urology Associates of West Broward, in Sunrise, FL. (954) 741-6100

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