Incontinence FAQ

These FAQs will answer questions about incontinence and other bladder control issues

Everything you wanted to know, but were afraid to ask

INCONTINENCE

1. What is incontinence?

Incontinence is the accidental release of urine due to loss of bladder control.

2. Are there different kinds of incontinence?

Yes. There are four major types:

• Stress incontinence is causes when increased pressure is placed on the bladder muscles by a physical activity, which can include laughing, sneezing, coughing and lifting heavy objects. Oftentimes with stress incontinence, bladder muscles are already weak.
• Urge incontinence happens when the urge to urinate is strong, but one cannot make it to the toilet in time. This, along with stress, are the two most common types.
• A third kind is overflow incontinence, which is almost a constant leakage, caused by the bladder failing to empty due to blockage, weak muscle contractions or nerve damage.
• Finally, mixed incontinence is a combination of both stress and urge.

3. How many people are affected?

If you suffer from incontinence, you are not alone. 13 million Americans, or one out or 11 people, have incontinence.

4. Who does incontinence affect?

Incontinence can affect men and women of all ages, however almost twice as many women are affected.

5. But I am so young? Why am I affected?

Age is not the only factor in incontinence. Biological, medical and lifestyle reasons can also lead to this.

6. What can cause incontinence?

Incontinence can be caused by anatomic, physiologic and pathologic (diseases) factors. In addition, congenital or acquired muscle disorders can affect the storage or control of bladder.

7. Can you be more specific?

In breaking down some anatomic, physiological and pathological factors that can cause incontinence, stem the following examples:

• Urinary tract infections
• Bladder infections
• Effects of medicine
• Constipation
• Surgery effects
• Stroke or multiple sclerosis
• Enlarged prostate
• Nerve damage
• Obesity
• Structural abnormalities of the urinary tract

8. Am I at risk to become incontinent?

In addition to the causes listed in Question 7, there are some associated risk factors that can play a role in incontinence:

• Age-related bladder capacity can decrease or physical frailty
• Obesity
• Smoking tobacco
• Injury to bladder or urethra
• Bladder infection or prostatitis

9. Will incontinence go away?

Possibly. Incontinence can be acute- or temporary. This could be in a case where the incontinence is a symptom of a condition or disorder. For example:

• Childbirth
• Limited mobility
• Urinary tract infection
• Side effect of medication

In these cases the body should return to normal, such as after the baby is born in pregnancy, or after a UTI clears up. In other cases, incontinence can be chronic:

• Birth defects
• Nerve damage
• Spinal cord injury
• Brain injury
• Bladder muscle weakness
• Blocked urethra
• Pelvic floor muscle weakness

10. Sometimes when I sneeze, cough or laugh, a little urine leaks. Does this mean I am incontinent?

When events like that happen in our bodies, it can put pressure on the muscles in our bladder. That can cause a small leakage. This does not always mean that you are a chronic sufferer of incontinence, but simply could be an isolated incident. Or, that you may suffer from a case of stress incontinence.

11. What are some products I can use to help cope with the symptoms?

There are a host of incontinency protective items available to help people cope with the symptoms and prevent embarrassing mishaps:

• Portable Toilets
• Diapers and other protective undergarments
• Bed pads
• Bedpans
• Skin creams and ointments

12. It almost seems like I have diaper rash. Why?

Just like a baby can develop diaper rash, adults with incontinence can also develop redness, rashes or even an infection caused by bacteria from the moisture. But don’t worry – there are skin care products that can help with this.

13. Aren’t there side effects to internal catheters?

People who use internal catheters can be prone to urinary tract infections as well as tearing and swelling. Users of external catheters such as the ones we sell can rest assured they will be at minimal risk of infection.

14. I don’t want to purchase these items in person. What can I do?

There are websites, such as ours, that offer these products for online order and delivery right to your home. In addition, if you are taking prescriptions to aid in any of these symptoms, many health insurance companies offer mail delivery of medications as well.

15. Are there natural methods or lifestyle changes I can make?

Yes. There are many things you can do to help get over incontinence:

• Avoid caffeine and other diuretics
• Avoid tobacco – nicotine irritates the bladder
• Avoid anti-depressants
• Eat fruit, veggies and grains- all which will prevent constipation
• Retrain the bladder by only urinating once every three to six hours
• Practice “double voiding,” which means when urinating, stop in the middle for a few moments, and then continue (This can strengthen the muscles)
• Kegel exercises

16. Is there a medical cure?

Incontinence itself is not a disease but a symptom of other diseases and disorders. As those diseases are cured, incontinence could disappear as well. There are drugs and even surgeries that can be performed to help with this. In women, collagen injections can be given, which will thicken the area around the urethra.

OVERACTIVE BLADDER

17. What is an overactive bladder?

You may have heard the term overactive bladder in many recent advertisements. The term OAB is often used interchangeably in place of urge incontinency, often times when specifically talking about women’s issues. In addition to the symptoms of urge incontinence, the urge to urinate is also very frequent.

18. How do I tell if I have OAB?

If you have the urge to urinate for than eight times per day or wake up more than twice in the middle of the night, your bladder may be overactive. In addition, symptoms of urge incontinency are the same.

19. What can I do about an overactive bladder?

There are several things you can do to help your overactive bladder. There are medications, such as Detrol LA and Ditropan XL available. A more natural approach can be found by practicing Kegel exercises, which strengthen the bladder muscles.

WOMEN’S ISSUES

20. How does pregnancy affect the bladder?

The added weight and pressure of the baby can weaken the pelvic floor muscles, which then leads to a more frequent urge in urinate.

21. How does menopause affect the bladder?

When women hit menopause, their estrogen levels decrease. This change in hormones can cause the bladder muscles to weaken.

22. How can the effects of menopause on the bladder be helped?

In this case, hormone treatment can be used to provide the body with more estrogen to help combat incontinence.

CHILDREN’S ISSUES

23. My child wets the bed. Is this an incontinence issue?

There is a type of incontinence referred to as nocturnal enuresis, which is commonly referred to as bedwetting. While this disorder can occasionally follow one into their teens and even adulthood, it is prominently found in children. In fact, over five million school age children suffer from this.

24. Is nighttime bedwetting caused by emotional problems or low self-esteem?

This is a misconception. There are actually physiological and physical factors that are involved. So, as a parent, you can rest assured that it is not your fault.

25. What can cause this nighttime bedwetting?

In a nutshell, when we are babies, we urinate all day. When we are adults, we only urinate while we are awake. During childhood, we make this transition, but sometimes it does not always happen correctly. There are three reasons for this:

• Bladder muscles are weak or imbalanced
• Bladders are too small to hold a normal amount of urine
• Make more urine than their normal size bladders can hold. This can be because they are drinking too much, using medication with diuretics or because they have a hormone imbalance.

In addition, because these children need to urinate at night, they should be getting a signal like adults do. However, sometimes that is not yet developed, or the children are just deep sleepers. Research has proved that these two factors need to be in place- need to urinate at night and inability to wake up at night.

26. What can be done about nocturnal enuresis?

There are many treatments available, which include motivational therapy, guided imagery, hypnosis, conditioning therapies such as a bedwetting alarm, bladder exercises, as well as medicines, and a new oral treatment DDAVP.
Protective gear can also be implemented, such as mattress pads and covers.

OTHER/GENERAL

27. Is it really bad to hold in your urine too long?

We’ve all done it- holding it in on a long car ride. But, this practice can have negative effects on the body:

• Urinary tract infections- these can be caused by retaining urine too long
• Overflowing bladder- can create a higher risk for a bladder infection because it cannot flush out the waste
• Urinary reflux- if the bladder overflows, urine can go back into the kidneys
• Kidney failure- can be caused by urinary reflux

As you can see here, holding in urine for a long time can snowball into health problems.

28. Is it bad to cut back on fluids so that I do not have to urinate?

Yes indeed. Limiting fluid intake cannot only cause dehydration, but it can also lead to kidney stones and gall stones.

29. I am afraid to use public restrooms. Am I normal?

Sure. Many people share this same fear. There are sometimes crowds in public restrooms, and that means people can hear noises. Privacy is often limited due to being able to be seen through cracks in the stalls. And, if there are lines, pressure to perform is heightened. For those reasons, many are apprehensive about going to the bathroom either in a public restroom, or even a shared private restroom.

30. I heard there is actually a phobia of restrooms. Is that true?

Yes. Seven-percent of the population, or 17 million people, suffer from the phobia paruresis, which is pronounced “pas-YOU-ree-sis. The term is Latin for abnormal bladder. Paruresis is classified as a social anxiety disorder, and is often more commonly referred to as “pee-shy.”

31. What exactly is paruresis?

Paruresis sufferers find it difficult or even impossible to urinate in the presence of others, either in their own home or in public facilities. Also, this can include people who have difficulty going to the bathroom under the stress of time pressure, when being observed by others who are close by who might hear or see them, or even while traveling on moving vehicles such as a bus, train or plane. This can also include having to provide a urine sample for a medical test or preemployment drug screening.

32. What causes paruresis?

Classified as a social anxiety disorder, paruresis can stem from childhood teasing or physical or mental abuse, particularly if those events occurred in a bathroom. Paruresis can also be linked with depression, OCD, panic attacks and other anxiety issues.

33. Is there help for people with paruresis?

Yes. You can get psychological help from a counselor, whom can suggest therapies or prescribe medications to get over the disorder. In addition, there is a support organization at www.paruresis.org.

34. Is it really a crime to urinate in public?

In many jurisdictions it is. You may want to consult your local ordinances to find out what the penalties are in your own area. A quick Yahoo! search revealed that many cities have fines varying from $100-$500, with some up to $1000. Several cities also required community service and even jail time. If you’ve got to go that bad, you may want to find a public restroom.

35. I am too embarrassed to ask for help. Is there somewhere I can get anonymous help?

There are many health-related websites, like www.webmd.com, that offer resources, literature, discussion boards, chats and even contact information to e-mail or post questions for medical professionals. In addition to health-related sites, there are also foundations and other non-profits for people just like you:

• www.urologychannel.com
• www.urologyhealth.org
• www.incontinence.org
• www.nafc.org
• www.simonfoundation.com
• www.bladderdir.com
• www.overactivebldder.com

But, when it comes down to it, you may have to see a doctor to get the proper help you need.

36. Okay. I’ll talk to someone. But who?

When looking for a medical professional to speak with about incontinence or OAB, you should consult a urologist or gynecologist. You may first want to discuss this with your family doctor as well.