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 such as
Panty-line, Pampers, Depends, Serenity, etc. There are
even some washable absorptive 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