Incontinence in children is called
"training". In adults, it's often called embarrassing. Without
understanding the problem, people may jump to the conclusion that their
loved one is suddenly getting too lazy or simply doesn't care. This is so
rare, that it should be the very last consideration when seeking a cause.
Although incontinence is usually not an emergency, problems with
incontinence should be reported to the doctor. The gynecologist and the
urologist are the specialists who are most familiar with incontinence and
can evaluate the causes and recommend several treatment approaches.
There are a number of reasons your loved one may be
experiencing incontinence, thus, while it may not seem like a medical
emergency, it is wise to inform the doctor when problems are noticed. The
specialists more familiar with incontinence are gynecologists and
urologists. Depending on the cause of the incontinence, there are several
recommended treatments. These should be discussed in detail with the
doctor. The following possible causes are not arranged in order of
likelihood of occurrence. Such predictions are based on the individual and
aggravating or contributing factors.
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Dementia, mental confusion or psychological
factors.
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Cancer.
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Restricted mobility.
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Urinary tract or prostate enlargement or
infection.
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Side effects of medications.
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Impaired nervous system.
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Pelvic muscle weakness.
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Nerve or muscle damage after pelvic radiation.
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Developmental problems of the bladder.
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Pelvic, prostate, or rectal surgery.
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Bladder spasms.
When you do speak with the doctor, give the doctor
the most appropriate and applicable information. Here is a checklist of
things the care recipient should share with the doctor.
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Describe your problem.
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When does this occur?
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How long has incontinence been a problem?
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How much of a problem has this condition become?
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How many times does this happen each day? •Are
you aware of the need to urinate before you leak?
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Are you immediately aware that you have passed
urine?
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Are you wet most of the day?
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Do you wear diapers in case of accidents?
Occasionally? All the time?
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Do you avoid social situations in case of
accidents?
History and factors
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Do you have a urinary tract infection now? In the
past?
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Is it more difficult to control your urine when
you cough, sneeze, strain, laugh, run, jump or walk?
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Is the incontinence worse when sitting up or
standing?
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Do you suffer from constipation?
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Is there anything you can do to reduce or prevent
accidents?
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Have you ever been treated for this condition
before? Did it help?
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Have you tried pelvic floor exercises (Kegel)?
Did it help?
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What surgeries have you had?
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What injuries have you had?
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What medications do you take?
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Do you drink coffee? How much?
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Do you drink alcohol? How much? How often?
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Do you smoke? How much each day?
Expect and prepare your loved one for the likelihood of
a physical exam. For both men and women, expect an abdominal, rectal and
neurological exam. Additionally, men are given a genital exam and women a
pelvic exam. The doctor will also run a number of diagnostic tests, which
will include urinalysis, cystoscopy (checking the bladder) and procedures
to check urinary functioning.
You should encourage your loved ones and/or clients to
avoid items that irritate the urethra or bladder. Check with your doctor
for more specific information. Some of these items include liquids that
tend to increase urination (coffee, alcohol), diuretics (water pills),
some anti-spasmodic medications, antidepressants and antihistamines,
cough/cold medications (they should also avoid coughing, so this may be a
tricky one), ventolin (albuterol) or other beta agonists.
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