What should elderly people do if they have slight urinary incontinence?

Written by Zhou Yan
Geriatrics
Updated on November 29, 2024
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Urinary incontinence is relatively common in the elderly. After excluding organic causes of urinary incontinence through examination, we should consider functional causes. This is mainly due to the relaxation of the urethral sphincter, pelvic floor, and the muscles around the urethra, which decreases the urethral pressure. When the abdominal pressure increases, it can cause urinary incontinence. We can improve the muscles of the pelvic floor gradually by undergoing pelvic floor rehabilitation therapy, which increases their strength and improves urinary incontinence. The key to pelvic floor rehabilitation is to provide patients with guidance and exercises for lifting the anus. By persisting in these exercises, the symptoms of urinary incontinence can be alleviated or eliminated.

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How many types of urinary incontinence are there?

Urinary incontinence refers to the uncontrolled release of urine through the urethra. There are several types of urinary incontinence, including urge incontinence, stress incontinence, overflow incontinence, and true incontinence, each requiring treatment tailored to the specific type. The most common type is stress incontinence, which is often seen in women who have given birth. It is mainly caused by relaxation of the bladder sphincter and typically occurs when sudden increases in abdominal pressure, such as during coughing, laughing, or lifting heavy objects, cause urine to flow from the urethra. If the symptoms are mild, improvement can be achieved through exercises for the pelvic floor and bladder sphincter muscles. If the symptoms are severe, surgical treatment is recommended.

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What should be noted for fecal incontinence?

Patients with fecal incontinence should first pay attention to the cleanliness and hygiene of the anal area. Due to fecal incontinence, there will be fecal residue around the anus, so it is important to clean up promptly when there is fecal residue. Since feces contain certain irritating substances, these can irritate the skin around the anus, causing pain, eczema, or even provoking bedsores. Therefore, patients with fecal incontinence must frequently change positions, clean regularly, and further carry out local treatment. The most common cause of fecal incontinence is relaxation of the anal sphincter. If it is confirmed that it is due to the aforementioned reason, an anal constriction surgery can be chosen to tighten the local sphincter, thereby preventing the feces from being expelled abnormally from the anus. It could also be due to the patient being elderly and frail, with a nervous system disorder, and the primary disease needs to be actively treated.

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Can shock cause incontinence?

Shock patients often experience incontinence, which is very common in clinical settings. Various reasons can lead to shock, causing a decrease in the body's blood pressure. This results in severely inadequate perfusion of the brain, heart, and blood vessels, leading to the loss of control over the body's urinary and fecal reflexes and resulting in incontinence. Therefore, when shock occurs, we should strengthen nursing care, actively rehydrate, and actively treat the shock. It is also important to promptly identify and treat the cause of the shock. Only comprehensive treatment can save the patient's life. Moreover, enhancing nursing care is very important for shock patients, as they are prone to suffocation and incontinence.

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What should I do if spinal bifida causes fecal incontinence?

When patients with spina bifida experience fecal incontinence, it generally indicates that the condition is quite severe and often requires prompt treatment. Many of these patients have an overt form of spina bifida. In such cases, a localized bulging mass can be found at the lower back, possibly accompanied by protruding spinal cord, meninges, and nerve roots. For these patients, early surgical intervention is recommended. Clinically, surgery is usually advised to remove the bulging mass and effectively separate and release the adhered nerve roots. If possible, it is best to reposition them back into the spinal canal to achieve the surgical treatment goals. Such surgeries are generally recommended to be performed at well-known, top-tier hospitals locally.

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Urinary incontinence includes three types: stress incontinence, urge incontinence, and overflow incontinence.

Urinary incontinence, in clinical terms, is divided into the following categories: First, there is urge incontinence, where the main symptom is that as soon as one thinks of urinating, the urine comes out uncontrollably. This is commonly seen in urinary tract infections, among other conditions. Second, there is overflow incontinence, also known as pseudo-incontinence, which is actually due to an obstruction in the lower urinary tract, leading to an overfilled bladder that naturally overflows, causing involuntary urination. Third, there is true incontinence, which occurs because the mechanism controlling the urinary tract is damaged, resulting in leaks as soon as there is a small amount of urine in the bladder. If urinary incontinence occurs, it is recommended to visit a hospital. First, a routine urine test should be conducted; second, a color Doppler ultrasound of the urinary system should be performed, which can be done while holding urine or during routine times; lastly, a urodynamic test should be carried out to examine bladder function and determine the type of urinary incontinence.