Why is Incontinence in Elderly Females so Common?

A recent cohort study found that incontinence affects more than a fifth of people aged over 85 years old.

 

Urinary incontinence is much more common in older people and is associated with considerable morbidity. 20% of community dwelling older adults have enough incontinence to limit some aspect of their lives. It is associated with considerable morbidity. The risk of incontinence, however, is much higher in older females. It is that is thought that up to 50% of older women suffer from urinary incontinence.

Dr Fleming, president at ACP asserts, “Urinary incontinence is a common problem for women that is often under-reported and under-diagnosed”.

Are You a Senior Woman with Incontinence? Post on our Forum for Tips and Advice

Why is Incontinence in Elderly Females so Common?

Risk Factors for Seniors

Seniors are more at risk of nerve damage, mobility issues and arthiritis. Problems with nerve damage affect the communication between the brain and the bladder. Parkinson’s disease is a common problem that causes individuals to lack control over their bladder. Mobility issues can cause functional incontinence, making it hard to reach the toilet and buy the correct products. In addition to this, seniors are also more likely to develop cognitive problems such as Dementia.

 

Changes to the Female Bladder

Elderly women differ from younger females by the presence of several changes in the urinary tract. As you get older, the bladder also changes. A woman's elastic bladder tissue toughens and becomes less stretchy with age. A less stretchy bladder doesn’t hold as much urine as before, causing you to urinate more frequently. The bladder wall and pelvic floor muscles also weaken with age, making it harder to empty the bladder fully.

Older women are also more likely to get UTIs as the bladder muscles weaken and make it hard to empty the bladder fully.

Health Factors Exclusive to Women

There are a number of key factors exclusive to women that play a factor in causing incontinence. Common contributing factors are the following:

  • Menopause. Oestrogen plays a vital role in continence mechanism with the bladder and urethral function becoming less efficient with age. During menopause, the body suddenly stops producing oestrogen. This can cause lack of bladder control.
  • Pregnancy. The weight of pregnancy puts extra pressure on the bladder, weakening the muscles. Childbirth further damages these muscles through the stretching and strain of the muscles during birth.
  • Hysterectomy. A hysterectomy is an operation to remove a woman’s uterus. This can also remove some structures that are required to provide pelvic support for bladder control.

 

The combination of these factors can alter the condition of the bladder and pelvic floor. This makes incontinence much likely later in life.

Find out how reduced oestrogen can cause female incontinence.

Although not exclusive to women, obesity is another key risk factor for incontinence in elderly females. In fact, this factor is a common cause of leaks along with a hysterectomy.

Interesting Fact:

Incontinence in Older Women is more Common than most Chronic Medical Conditions!

Older People and Seeking Treatment

Older people are more likely to delay seeking help for urinary incontinence. Symptoms are often also poorly managed in care. Drug treatments and conservative treatments have been proven to work in older people. However, older people still remain under treated. Embarrassment may be a key cause for this. Linda Brubaker, MS, professor of female pelvic medicine and Loyal University Chicago School of Medicine, states, “female incontinence is embarrassing. It can really affect your quality of life-your emotional state, body image, sexuality”. One main reason as to why senior women don’t seek help is due to normalizing the condition. We all know that incontinence is more prevalent in older people, so women often feel like they should just accept it. Brubaker asserts, "many women think it’s normal, part of having children or going into menopause and don’t seek help."

Is your incontinence caused by nerve damage? Read more about Neurogenic Bladder 

According to the Stroke Association, around half of the patients that are admitted to the hospital experience incontinence. As well as causing embarrassment, incontinence can also be very debilitating.

A Stroke can cause incontinence due to the following reasons:

  • Damage to the area of the brain that controls the bladder/bowel
  • Mobility problems resulting in not making it to the toilet in time. This is known as functional incontinence
  • Side effects from medication
  • Communication difficulties
  • Constipation. Being less mobile can result in constipation, which can lead to both urinary and faecal incontinence

Are you experiencing incontinence after a Stroke? Post on our Forum and Share your Experience

Living a Full Life with Incontinence after a Stroke

 

Explore new Things

If your old hobbies are no longer an option, explore new hobbies that are an option. If you have limited mobility, trying skills such as art and crafts can be rewarding and a great way to de-stress.

Writing and reading can also be productive yet relaxing things to do while you are recovering. They can also help take your mind off problems such as urinary or faecal incontinence. These hobbies can also help you develop a sense of accomplishment and stay occupied.

Plan your Time Well

If you get tired easily, try to do the most energy-consuming tasks at the time of day or week when you have the most energy. You can often be more productive when you plan time to rest as well, as this ensures you have energy when needed. Similarly, planning your time well to manage your incontinence is key. If you are going on a long journey, ensure you visit the toilet before setting off. By no means should you stop planning days out due to incontinence. However, you can simply make room for certain times in the day to visit a toilet and change your product. If you are going on holiday, for example, plan certain stops you can make at service stations on the airport drive. Once you know you have a plan if needed, you can relax and enjoy worry-free!

Are you Travelling with Incontinence Soon? Read our Guide to Choosing Travel Incontinence Products

Continue with Regular Commitments as Much as Possible

Socialising and building a routine are known to improve mental health. Try to continue with hobbies, interests, social and other regular commitments as much as possible. See how much you can manage, and try to engage in interests. Talking about incontinence with close friends and family can help, and they may be willing to offer new advice.

 

Spend Time Outdoors

Spending time outdoors has wide-ranging health benefits. health boost. Studies have shown that walking outside can improve blood pressure, boost mental health and decrease cancer risk. Nature walks are also proven to have memory-promoting effects and eliminate fatigue. Being overweight can actually worsen urinary incontinence, as more pressure is placed on the bladder muscles. Outdoor activity is therefore a great placed to start in improving overall health.

 

Have Fun with Meals

You probably already know that some foods can have a negative affect on the bladder and bowel. Spicy foods and caffeinated beverages are common triggers for more accidents. Similarly, excessive amounts of sugar and fizzy drinks can also worsen incontinence. When recovering from a Stroke, it is vital to eat healthy foods and get the correct vitamin intake. However, this doesn’t mean you should stick to boring salads and plain meals. Try switching up your meal choices, instead of having the same food every day. You can add some flavour to meals by experimenting with spices such as rosemary, dill, thyme and garlic.

Useful Professionals

The following professionals can help you manage incontinence after a stroke: 

  • Physiotherapists can help with your walking to ensure you reach the toilet on time. They can also provide you with exercises to strengthen your pelvic floor muscles. 

You can read about pelvic floor exercises here.

  • Doctors and GPs. A Doctor or GP with knowledge of incontinence treatment will ask you about your diet and any medications you are on that could be making it worse.
  • Continence Nurse Advisors. For toileting aids and equipment, continence nurse advisors will recommend useful models. They will also teach you bladder and bowel habits to improve incontinence. You can also speak to continence nurse advisors about exercises for incontinence.
  • Urologists. Urologists have specialist knowledge and are experts in improving people's bladder and bowel control.
  • Speech pathologists. If communication is an issue, speech pathologists can help you communicate the need to visit a toilet.

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Pads are suitable for light to severe incontinence, and are available in various different designs. Pads remain the most popular method. 

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If you have experienced stress incontinence, you may have heard of kegel exercise devices. These devices are becoming more and more popular.

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Two new clinics have been opened in Cheshire and Cheadle, offering the revolutionary Emsella Treatment. This week, Michelle Avery explains the story behind the new clinics:

“MUUUUUM” are usually the first words I hear when I wake in the morning! I know I am truly blessed to have my 4 children and it’s an honour not afforded to everyone. In the past however, my bladder and pelvic floors thought otherwise and showed me what a physical impact bringing those 4 beauties into the world has had! Some would say a small price to pay…but would they? Most women I know won’t openly talk about their “leaks”. It’s a taboo subject! Something that so many of us deal with each and every day yet no-one peeps a word about it…until someone else brings it up!! “oh yeah! I’ve not been able to get on a trampoline with the kids for years” as they laugh it off! No mum that I have spoken to that suffers from “leaks” believes that they are incontinent. It is not a word that they associate with and maybe this is why they haven’t openly searched for a solution other than the good old pelvic floor exercises that we are urged to do after child birth.

 It isn’t just mums that suffer from Stress Urinary Incontinence (SUI). Sports women both professional and amateur are affected by this issue each and every day. Studies show that 25-28% of young athletes that have never been pregnant report SUI. These figures are higher where the activities they take part in increase the intrapelvic pressure, like gymnastics and trampolining where 60-80% of athletes report SUI. The more pressure that is put on the intra pelvic area the more the SUI is likely to take place. Female elite athletes are three times more likely to suffer with SUI than a non-athletic female. They are also likely to have a family history of Urinary Infections significantly associated with SUI.

As a qualified and practicing nurse for 15 years, I have witnessed first-hand incontinence on a daily basis. It is a condition that comes to many elderly ladies. Little did I know that I would be dealing with it in my late 30’s and early 40’s.  Dealing with this earlier in life would stop me suffering worsened problems in later life and make it highly unlikely I will suffer from bladder prolapse in the future.

There is an new treatment option available now that fills the gap between pelvic floor exercises and surgery- often the usual step when exercises haven't fully resolved the problem. The BTL Emsella treatment is revolutionary and has been changing ladies lives in the USA and Australia for a couple of years. There are currently 11 clinics with these chairs throughout the UK and due to my own personal experiences, as a family we decided to invest in bringing this to the UK to help many more ladies like me…and those not like me! My running days are over!!

3 hours over 6 x 28-minute sessions, will result in a 95% success rate of curing Stress Urinary Incontinence.

The three clinical trials have shown a 95% success rate in improving quality of life but what does this mean in real terms. I can speak from our experience from the reports given by our clients on how this has impacted their quality of life.

Reports from our clients are varied in nature from depriving themselves of fluids before a run, having to squat in a well-hidden bush along the route, taking a spare pair of pants everywhere, making bit a mission to find a pad that doesn’t stand out under their leggings and even influences the choice of colours they wear- black is the ideal colour as its harder to see the wet patch! And the queue for the ladies before a race says it all! In fact, have you ever wondered why wherever you go, at any time the queue for the ladies is always massive and the gents is non-existent?

Julianne, from Cheshire came to us after taking part in a local running event , she had been experiencing leaks for years since her last child was born but just thought that was her lot in life however when she decided to start running she found her problems getting worse, she would have to run home mid jog to change clothes after only a short time out ( and more importantly away from the kids!) and then psych herself up to get out there again. At the first event she was doing competitively she deliberately didn’t drink much beforehand as she was scared of wetting herself in front of everyone and ended up feeling dehydrated and in any case still had an accident 20 minutes into the race.

More than anything she didn’t want to give up running and why should she? Julianne came for 6 treatment sessions lasting 28 minutes each. After the third session she braved the jog pants and went for a run and was over the moon to find she made it round dry and in the same pants she started in. She also reported that she was getting a full nights sleep for the first time in years which meant she had more energy. After 6 sessions she is pad free, and doesn’t feel the need to go to the toilet constantly, makes it through he run with no leaks and reports having more confidence !

“This treatment has literally change my life, I feel liberated not having to plan ahead everywhere I go. I look forward to running now without that niggling dread in the back of my mind that I’m going to have an accident“ Julianne, 36, Cheshire.

I am one of the smug ones now able to laugh, sneeze, cough and even trampoline without a drop of leakage. What I love about this chair is that it is so discreet. It is non-invasive. Ladies can be treated without removing one item of clothing, which for ladies dealing with SUI is a huge consideration.

We call it the Happy Chair! Our clinics which are in Congleton, Cheshire and Cheadle near Manchester are small, comfortable, relaxed and private and we are a team of 4, Michelle and Sarah – both past “leakers” will greet you in Congleton and Anneliese and Frankie in Cheadle.

 You would be more than welcome to come and see us!

Alternatively have a google and find one in your area if you live further afield.

Visit the Estrada Clinics

Cheshire Clinic: Annex, Chapel House,
Chapel Street Congleton, Cheshire
CW12 4AB - Ran by Michelle and Sarah

Phone Number: 0800 772 3952

Phone Number: 0800 772 3952

Visit the Estrada Clinic Website for more information.

Stress incontinence remains the most common type of incontinence, and is particularly common in women. Urodynamics is a popular procedure that assists in the diagnosis and understanding of stress incontinence.

 

Why is it Performed?

Urodynamics is used either to diagnose stress incontinence, or before incontinence surgery to predict the outcome and find out more information. It is often used to measure nerve and muscle function. Doctors also use urodynamics to measure pressure in the bladder, flow rates, and other factors that may explain someone’s incontinence. The procedure can be used to find out what type of incontinence a person may have. The urodynamic test results help diagnose the cause and nature of a lower urinary tract problem, such as stress incontinence.

Have you had urodynamics for stress incontinence? Post on our forum and share your experience with others.

What Happens During the Test?

There are different types of urodynamic tests, which can vary depending on a person’s health, physical exam and LUTS. The heath provider decides the type of test that is necessary for a person. For precise measurements, imaging equipment can be used to take images of the bladder filling and emptying, pressure monitors record the pressures inside the bladder, and sensors record muscle and nerve activity. A Doctor may also use uroflowmetry, which is the measurement of urine speed and volume. A professional can then see when the flow rate is highest and how long it takes to get there. Special sensors can also be used to measure the electrical activity of the muscles and nerves around the bladder. Doctors may also use a leak point test to measure the impact of pressure on the bladder. An individual may be asked to apply abdominal pressure to the bladder through coughing or shifting position. Methods can be either simple or more invasive, depending on your circumstance.

Is Urodynamics Testing Beneficial?

There is currently evidence that shows it is unsuccessful for improving surgery outcome in those with straightforward stress incontinence. However, the precise information discovered in urodynamics can be highly beneficial. The Royal College of Obstetricians and Gynaecologists in the UK recommends that women undergoing stress incontinence surgery should have urodynamic investigations. Some studies have found that urodynamic study can provide much more information than demonstration of detrusor overactivity alone. Many specialists believe urodynamics adds more precision to evaluation of patients with stress incontinence. Many people do have complex incontinence symptoms or other indications for urodynamic testing.

 

Why is it Controversial?

There is ongoing debate on the role of urodynamics as a diagnostic tool for people with stress incontinence. People often find urodynamic testing uncomfortable or embarrassing. The reliability of urodynamics in diagnosing some forms of incontinence can also lead to false-positive or false-negative results. This may lead to failure to treat the symptoms of incontinence correctly. The results of two large randomised trials show that urodynamics does not improve outcome of incontinence surgery in women with uncomplicated stress urinary incontinence. The importance of urodynamics for all patients prior to surgery is also uncertain.

In late 2018, it was observed that there has been a decline in the use of urodynamic testing for stress incontinence diagnosis. This is thought to be due to the following factors:

  • It is perceived as technically challenging. There is often a lack of staff who are skilled to do this procedure.
  • It has a risk of introducing infection. Urodynamic testing also has a small risk of introducing infection.
  • Patient discomfort. People often find the testing uncomfortable and invasive, and the high number of complaints regarding the procedure may have contributed to the decline.
  • Risk of methodological errors. Some Doctors have refrained from urodynamic testing unless it is absolutely necessary, due to the high risk of methodological errors. The lack of specialist staff exaggerates this problem.
  • Lack of funding. Urodynamics can be complicated and expensive, and a lack of funding has seen it decline.

 

Although subject to controversy, urodynamic testing remains the best method for assessing bladder function and the lower urinary tract. The procedure is successful in identifying abnormal bladder function, in spite of the risks. There is no evidence to suggest it improves surgery outcome for people with simple stress incontinence. However, it is useful for identifying problems in people with complicated stress incontinence and further bladder problems.

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Hello all! My name is Hannah, and I run the New U Clinic in Nottingham, that offers a revolutionary non-invasive treatment for incontinence, using the amazing new BTL Emsella chair. Firstly, I’d like to say a big thank you to the lovely Samantha at Incontinence UK for inviting me to write this guest blog, and giving me the opportunity to talk about such an important issue, what we do, and why I feel so passionately about my work. Secondly, to all of you wonderful ladies out there affected by those little leaks or embarrassing oops! moments, I’d just like to say: don’t give up hope – we can help!

As I’m sure you know, this is no small issue; incontinence is a life changing problem for over 200 million people worldwide, and sadly one that is rarely talked about. Too embarrassed to speak to doctors or even friends about the problem, most women affected by urinary incontinence simply suffer in silence, with only half of them ever seeking help.

When our pelvic floor muscles aren’t strong enough to sufficiently support the pelvic organs, we are no longer able to control the bladder, and the involuntary loss of urine inevitably follows. The deconditioning of these muscles can be for a number of reasons, from the natural ageing process, to the stress put on the body by childbirth. Consequently, millions of women, of all ages and apparent fitness, are affected and have to live with incontinence.

There are three main types of incontinence. Firstly, there is urge incontinence, which has sufferers relentlessly checking (and running!) for the nearest loo, and living with being exhausted from constantly getting up throughout the night. Secondly, there is stress incontinence, which is characterised by involuntary leaks occurring as a result of everything from coughing, sneezing, lifting, exercising, and laughing. Finally, there is mixed, which results in a combination of the two. Whichever form you experience, the effects on the lives of the women affected by incontinence is no laughing matter.

Whilst there has been a great deal of research on the area, until recently, the help that doctors have been able to offer has been somewhat limited. I’m sure we’ve all heard about kegel exercises, and how they can help build the strength of our pelvic floor – I even heard Lorraine Kelly discussing the ’Pelvic Floor Challenge’ on Women’s Hour yesterday morning. But while it is fantastic to hear more people discussing the subject these days, and beginning to break down the stigma attached to the subject, for many women, all the kegels in the world aren’t going to be enough to put an end to the leaks.

So when I heard about the amazing new Emsella chair, developed by medical technology group BTL, achieving an impressive rate of 95% of treated patients reporting significant improvement in their quality of life, I had to find out more.

The chair uses electromagnetic energy to cause deep pelvic floor muscle stimulation, rebuilding the de-conditioned muscles to support your pelvic organs, and ultimately restoring control of the bladder. In one 28-minute session, the Emsella chair stimulates the equivalent to 11,000 supramaximal kegels, far past the level any person would be able to achieve without the chair, however determined they might be with their exercise regime!

The results have been astounding, with the newly reconditioned muscles giving a significant and lasting restoration of bladder control, to help significantly reduce and even stop urinary incontinence, with many patients reporting a noticeable positive effect even after the first session. What’s more, is that these results are consistently achieved day in, day out, for women of all ages, and with all of the common causes for their incontinence.

Another mayor advantage of treatment for incontinence using the Emsella chair, is that is it quite so easy – whilst many are put off seeking help by the idea of embarrassing and painful procedures, this treatment is completely non-invasive, and is quick, painless, and highly effective. You remain fully clothed, and simply sit on the Emsella chair and read a magazine, whilst the chair does all the work for you!

Needless to say, before long, plans were in action to bring this treatment to my hometown of Nottingham. I have only recently opened the New U Clinic, where I offer this treatment, but already the effects on the lives of the ladies I have treated has been incredible. Every day I hear another heart-breaking story of how a wonderful strong woman has been held back, embarrassed, and had her self-confidence, physical health, social, or intimate life destroyed by incontinence. And every day, I’m able to help another lady take back control, get her life back on track, and face a brighter future without the worries of incontinence!

The Benefits of the Emsella Chair

Thanks again to all of you for taking the time to read this guest blog. I hope you’ve found it interesting and informative, that it will give you the confidence to reach out for help if you need it, and that it will get you talking to your nearest and dearest about these issues without embarrassment – the more we discuss these things, the more the power of the stigma is removed, and the more people will find their ways towards effective treatment. If you, or anyone you know is affected by incontinence, we’d love to hear from you, so please get in touch for a free confidential consultation, or to find out more, see www.stopincontinence.co.uk.

Hannah
New U Clinic, Nottingham
01773 764289
hannah@newu.uk.com

Are you a Women experiencing Stress Incontinence? You can still enjoy your frequent run! Read our Guide to Running with Stress Incontinence

As Dementia progresses, some individuals can find it harder to use the toilet and experience accidents or incidents. Choosing the right product is a vital part of looking after someone with Dementia and incontinence.                                                          (more…)

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Read what others have said

Many people suffering from incontinence have already shared their experience. Why not discovering what they have talked about?

Do you have a question?

Our continence nurses and members of the community might have the answer! You can ask a question anonymously. (This FREE service is anonymous - you don't have to disclose your name)

Want to share your story?

People suffering from incontinence can learn from your personal experience (This FREE service is anonymous - you don't have to disclose your name)

Read what others have said

Many people suffering from incontinence have already shared their experience. Why not discovering what they have talked about?

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Incontinence pants are the preferable choice for many users. In contrast to pads, they can be worn like normal underwear and are less bulky than some nappies and pads.

Incontinence pants are available in both washable and disposable designs. With various brands to choose from, the market offers a diverse range of pants to choose from. If incontinence pants are your chosen design, it is important to know which design is suitable for your severity level and lifestyle.

Do you Use Incontinence Pants? Post on our Forum and Post a Product Recommendation

Washable Incontinence Pants

Washable pants are available in a range of different designs, and are less absorbent than disposable pants.

Pros

Cost-effective. Washable pants last a long time, as they can be re-washed numerous times. This makes them a cost effective, durable solution.

Discreet. Washable incontinence pants are thinner, meaning they are often more discreet and undetectable.

Feel like Normal Underwear. This is a key advantage of washable pants. Washable pants have no bulk and are designed to feel just like your normal pants. This can help to “normalize” products for some people, causing discretion and increasing confidence.

Feature Anatomically Shaped Options. You can find washable pants in many designs specially for men and women. For example, there are men’s incontinence shorts and women’s knickers available in the market.

Maximum Comfort. Washable pants are often smaller and provide a close fit, making them more comfortable than a heavier product. Designed from materials similar to normal underwear, their soft feel on the skin ensures maximum comfort.

 

Cons

Less Absorbent than Disposable Pants. Washable incontinence pants are designed for people with lighter incontinence, and hold much less absorbency capacity than disposable pants. They are therefore unsuitable for faecal incontinence pants.

Money can be Spent on Washing. Washable pants are very cost effective. However, they do increase the amount of washing you have to do regularly

Disposable Incontinence Pants

Disposable incontinence pants are traditional pull up incontinence pants. They have much higher absorbency than washable pants.

 

Pros

Higher Absorbency. Disposable pants are designed for heavier incontinence, which makes them a more reliable option for those who need them.

Ideal for Faecal and Urinary Incontinence. Unlike washable pants, disposable pants are suitable for managing both faecal and urinary incontinence.

Can be thrown away and replaced. You don’t need to worry about washing disposable pants, as they can easily be disposed of and replaced.

Advanced odour control systems. As these pants are highly absorbent, they often have more advanced

 

Cons

Less cost effective. Disposable pants don’t last as long as washable pants and are replaced often. This makes them a less cost-effective option.

Feel less discreet. Disposable pants have less of a “normal underwear” feel, and often feel bulkier and more noticeable.

Aren’t available in different styles. Disposable pants are not available in as many designs as washable pants.

 

Which Option Should You Choose?

If you have light incontinence, washable pants are the recommended option. They are also highly durable and can be washed numerous times. If you are looking primarily for comfort, washable products are recommended.

For those with heavier urinary or faecal incontinence, disposable pull up pants are a more suitable option.

Generally, the more economical and discreet option are the washable pants. However, if higher absorbency is needed, we recommend using the pull up pants.

 

Do you have Bowel Incontinence? Read our Guide to Choosing Bowel Incontinence Products

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man with neurogenic bladder

This Thursday 11th April marks Parkinson’s Awareness Day. Parkinson’s is a neurological condition, which like many others, can cause neurogenic Bladder.

 

What is Neurogenic Bladder?

Neurogenic bladder is bladder dysfunction caused by neurologic damage. This damage can be due to internal or external trauma, disease or injury. Diseases commonly associated with Neurogenic Bladder include:

 

  • Parkinson’s Disease. Parkinson’s Disease occurs due to loss of nerve cells in part of the brain called the Substantia Nigra. Due to this, a reduction in a chemical called dopamine occurs. This chemical has a key role in regulating body movement.
  • Multiple Sclerosis. MS is actually one of the most common causes of disability in younger adults. It is an autoimmune disorder that affects the brain and spinal cord, causing symptoms such as problems with vision, arm or leg movement, sensation and balance.
  • Diabetes. Diabetes causes your blood glucose levels to be too high. High blood sugar can cause an increase in the amount of urine produced. If blood sugar levels are not under control, this can cause nerve damage.

  • Cerebral Palsy. Cerebral palsy is a permanent movement disorder that causes poor coordination, stiff muscles, weak muscles and tremors. It can also cause problems with vision, sensation, speaking, swallowing and hearing.
  • Spina Bifida. Spina bifida is a fault in the spinal cord development in which there is a gap or split in the spine.
  • Sacral Agenesis. Sacral agenesis is a congenital disorder in which there is abnormal fetal development of the lower spine.
  • Dementia causes long-term and gradual decrease in the ability to think and remember. It causes a greater decline in mental functioning than expected in usual aging.

Neurogenic bladder is also commonly caused by infection of the brain or spinal cord, heavy metal poisoning, Stroke, spinal cord injury or pelvic surgery.

Are you looking after someone with Dementia and Incontinence? Read how you can Provide Exceptional Care 

Why do Neurological Disorders Impact Bladder Control?

Most of us don’t give much thought to how our nervous system affects the urinary system. However, our nervous system actually plays a big part in regulating the storage of urine in the bladder and bladder coordination. Our nerves and muscles work together for your bladder to hold urine until you are ready to empty it. Nerve messages go back and forth between the brain and the muscles controlling bladder emptying. Damage to the nervous system can cause problems that affect the lower urinary tract, which includes the bladder, the urethra and the sphincters. This damage therefore means these muscles lose the ability to hold or release urine at the right time.

 

Depending on the damage done to your nerves, you can actually either have underactive or overactive bladder. Overactive bladder symptoms include urinating frequently in small amounts and experiencing loss of bladder control. It can also mean having a strong urge to urinate and having problems emptying the bladder fully. An underactive bladder, on the other hand, can cause an inability to feel when the bladder is full and the bladder filling above normal capacity. People often also experience urinary retention, which is the inability to empty the bladder.

What can be Done to Treat Neurogenic Bladder?

Catheterisation is often provided for people with a Neurogenic Bladder. These are thin tubes that are inserted through the urethra into the bladder to drain urine.

In some cases, surgery is the best option. Bladder augmentation is a common surgery method, where intestines are removed and attached to the bladder wall. This increases the bladder’s ability to store urine. Another method is injecting Botox into the bladder or urinary sphincters.

Doctors may also recommend various lifestyle changes, such as avoiding bladder irritants. It is recommended that you cut out coffee, spicy foods and citrus fruits. Your Doctor may recommend a healthy diet plan for you Being overweight can also worsen incontinence, so it is advised that you maintain a healthy weight.

If you need more tips on managing a neurogenic bladder, you can read our living with incontinence section

What Can You Do for Parkinson’s Awareness Day?

Parkinson’s Awareness Day was created to increase understanding of Parkinson’s as a serious condition. Many people with Parkinson’s do not feel understood or feel like they aren’t taken seriously. You can host your own World Parkinson’s Day Event and approach your local media with a story, or even place Parkinson’s UK’s artwork at your local bus stop. You can visit Parkinson’s UK for artwork and campaign material to download.

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Surgery is a common method of treating prostate cancer that hasn't spread outside the prostate gland. Radical Prostatectomy is the most common type, and involves the surgeon removing the entire prostate gland.

 

Types of Radical Prostatectomy

The type of radical prostatectomy performed can vary and depends on the hospital. Keyhole surgery, minimally invasive surgery, involves making five or six cuts to remove the prostate. Robot-assisted surgery means the surgeon uses three robotic arms controlled from a computer. During open surgery, a single cut is made in the stomach.

Unfortunately, incontinence is a common side effect of Prostate Surgery. However, incontinence experienced by men is often only light and temporary. But exactly how long do you have incontinence after Prostate Surgery?

 

Incontinence after Prostate Surgery: What to Expect

You can rest assured that the incontinence you experience after prostate surgery isn’t likely to involve complete bladder emptying. Rather, the short-term incontinence experienced by most is more of a slight drip or leak. This happens most often during strenuous activity or when pressure is placed on the bladder.

There is no standard amount of time that is expected of incontinence. However, patients who experienced normal continence prior to surgery should regain function within 12-13 months of their surgery. There is never an 100% guarantee of this rule, however surgeons work their hardest to cut this time down. Luckily, with the advanced techniques available today, the majority of people should only expect short term side effects.

man with prostate cancer with doctor

Are you managing incontinence after Prostate Surgery?

Post a question on our forum to receive expert advice

forum incontinence

It’s rare that men experience long term incontinence after prostate cancer treatment. As a general rule, if your incontinence symptoms last over a year, you should contact a Doctor. There are a number of procedures that exist to restore continence if you do find yourself with long term incontinence.

 

Why Does Incontinence Occur after Prostate Surgery?

The prostate gland actually sits at the base of the bladder. The urethra runs through the center of the prostate gland. Where the bladder and urethra join, there is a ring of muscles called the bladder neck sphincter. These muscles are vital for our bladder control in staying continent. The bladder neck sphincter closes to prevent urine leaking out, but opens to allow urine to pass. Temporary incontinence occurs due to distress to the bladder neck sphincter during the surgery.

Have you had a Robotic Prostatectomy? Read all about Managing Incontinence Post Surgery

Choosing an Incontinence Product

Choosing an incontinence product depends on the severity of your incontinence and your mobility. If you only have the occasional light leak, a low absorbency “light” product is ideal. Typically, small incontinence pads are the most ideal for light incontinence. For more moderate leaks, a larger pad or pant product is recommended. For heavy to severe incontinence, an all in one pad is ideal. However, it is very rare that people have heavy incontinence after Prostate Surgery.

If you have low mobility or are immobile, a pad is your better option. Pants are harder to put on and take off than simple pads, as they require a full product change.

Recommended Incontinence Pads for Men

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Buy Attends for Men

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£6.19 to £16.29

Buy TENA Men

  • Available in 3 absorbencies
  • Maximum security and discretion
  • Confio Air
  • For light to heavy incontinence

 £5.44

Buy iD for Men

  • For light to moderate incontinence
  • Cotton feel
  • Enhanced comfort and security

£2.19 to £4.84

Read our Guide to the Top 10 Incontinence Pads for Men for Product Inspiration

Recommended Incontinence Pants for Men

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Buy TENA Pants Discreet

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  • Not bulky
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From £7.35

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  • Close body fit
  • Easily removable and flexible
  • For light to moderate urinary and faecal incontinence
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  • Cotton-like fabric
  • Elasticated legs
  • For men with moderate incontinence
  • Breathable textile backing

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Looking for Men’s Incontinence Pants? Read our Guide to Choosing the Best Male Incontinence Pants

Incontinence is a huge issue for many people with debilitating brain conditions. The relationship between Vascular Dementia and Bowel Incontinence is a common problem that is barely spoken of.

This week is brain awareness week. This is a global campaign to increase public awareness of the progress and benefits of brain research. Lectures, panel discussions and lessons are held each year to educate people on the function of the brain. The relationship between the brain and the bowel is discussed frequently. It can be incredibly hard to take care of someone with Vascular Dementia and Bowel Incontinence. Understanding the link can be a key step to accepting and learning about their condition.

What is the Relationship Between the Brain and Bowel Function?

It is the muscles within the rectum and anus that help to control your bowels. The sphincter muscles are responsible for the release of stool. The relationship between the brain and bowel is more important than you may think. Just like how our bladder becomes full and sends signals to the brain to let it know, our digestive system becomes full and sends signals about its fullness to the brain. The brain then sends signals via the nerves to keep the external sphincter closed. These signals begin in the brain and go to the spinal cord and continue to the nerves located in the sacral area of the back. They then go down to the rectum and external sphincter muscles. The brain's signals are important to ensure the muscles only release stool when it is appropriate.

bowel incontinence sphincter muscle

Are you caring for someone with Vascular Dementia and Incontinence? Post on our Forum and Receive Expert Advice.

incontinence forum

What is Vascular Dementia?

Vascular Dementia is caused by reduced blood flow to brain. This often results from a serious of tiny strokes, also known as “infarcts”. These strokes damage and destroy some brain cells. The condition can also be caused by a single stroke, in which the blood supply to part of the brain is suddenly cut off. In addition to this, it can also occur to the narrowing of small blood vessels in the brain. This is also called “Subcortical Vascular Dementia”.

Vascular Dementia affects an estimated 150,000 people in the UK. The condition does gradually get worse over time, although on some occasions it can be slowed down. Vascular Dementia can impair an individual's memory, language and motor skills.

woman worried incontinence

Exploring the Link Between Vascular Dementia and Incontinence

Vascular Dementia thinking changes can range from mild to severe. It is generally only the most severe cases of Vascular Dementia that can cause bowel incontinence. The damage and death of brain cells that control the bowel interrupts the communication between the brain and bowel. Some people with Vascular Dementia therefore develop bowel incontinence.

Faecal incontinence also occurs due to other cognitive complications. These include the following:

  • Feeling disorientated and confused
  • Difficulty with motor skills and balance
  • Slowness of thought
  • Memory and language problems. This can make communication difficult. If someone is relying on another person for care, language problems can mean they do not communicate when the bowel is full

Taking Care of Someone with Vascular Dementia and Bowel Incontinence

Find the Right Product for Them

Maintaining their dignity means providing them with a product that meets their needs. Read our Guide to Choosing Bowel Incontinence Products for guidance on choosing a product.

Recommended Bowel Incontinence Products

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Patience is Key

Being gentle and patient is key when helping someone with bowel incontinence. This is true for both communicating with them and changing products. If you are unsure about changing products, read our guide to Putting on Incontinence Pads and Pants for an Individual.

 

 

Talk with a Doctor

Talk to a Doctor about options that apply to the person you’re caring for. You should also ask about any appropriate medication. Some medications can be helpful for calming the bladder and bowel. Some of these do have side effects that can worsen Dementia, so it is important to get expert advice.

 

Ensure they Have a Healthy Lifestyle

Experts recommend the following tips:

  • Avoid caffeine
  • Do gentle exercise regularly
  • Eat plenty of fiber
  • Limit liquids at night-time
  • Avoid bladder irritant foods such as spicy foods

 

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Incontinence is a word most people say quietly. For most people, it is discussed only with a Doctor, or never at all.

However, the studies that have taken place over the years never fail to shock people. The majority of studies have found that incontinence affects around 300m people worldwide. This equates to about 5% of the population. A huge issue is that due to the lack of talk about it, there may be many more people suffering from incontinence than has been found. To date, it is estimated that around 7 million people in the UK have urinary incontinence (5-10% of the population). The fact that many do not even see a Doctor means this proportion could be even higher. 

The infographic below shows the partition on a population of 50 million people:

incontinence infographic

Image provided by Ontex Healthcare, (September 2018)

Yes, it affects more women. But don’t forget about the men.

As you may expect, incontinence does affect more females than males. Incontinence affects roughly twice as many women as men. Combined faecal incontinence and urinary incontinence affects 10% of women and 5-6% of men in the community, increasing to almost 50% in nursing home residents.

This increase in prevalence is due to common changes in a woman’s health and body, such as pregnancy, hormonal changes, menopause and ageing. In pregnancy, the expanding uterus puts pressure on the bladder. The muscles in the bladder sphincter and the pelvic floor muscles can be overwhelmed by this and become weakened. Increased uterine weight is another huge important factor affecting the frequency of leakages during pregnancy. During childbirth, these muscles are further stretched and weakened, leaving many women suffering from stress incontinence.

 

Are You Experiencing Leakage During Pregnancy? Read our Guide to Pregnancy and Incontinence

Over 10% of men over 65 admit to having urinary incontinence to some degree. Most commonly, male bladder problems are caused by Prostate Cancer, Prostate Surgery, neurological disorders and nerve damage. Many men suffer from benign prostatic hyperplasia, a non-cancerous condition that causes prostate enlargement. Constipation, obesity and bladder infections are other complications that can lead to male incontinence symptoms.

Are You a Man with Incontinence

Post a Question on Our Forum

“I’d Rather Keep It a Secret”

Although we have rough statistics, the fact is that it is hard to estimate how many people have incontinence, as it is barely spoken of. Fewer than half of adults with severe urinary incontinence seek help from healthcare providers. One study found that men would rather admit to sexual impotence than symptoms of incontinence. Women are a little bit more open about the issue, sharing these problems on websites such as “Mumsnet” and “Women’s Health”. However, still only 1 in 5 women claim that they seek help for incontinence issues, the rest keep it a secret. We clearly still do need to spread incontinence awareness for both sexes.

What is the Most Common Type of Incontinence?

Stress incontinence is the most common incontinence type, often brought on by pregnancy, menopause and other problems.

 

Symptoms of stress incontinence are the following:

  • Experiencing leakage when you exercise
  • Experiencing leakage when you cough, laugh or sneeze
  • Leaking when standing up
  • Leaking when lifting something heavy.

Author and runner Rose George shared her experience of stress incontinence an article in the Guardian. She states, “I know it happens from discussing it with my female club mates. I know it happens from running forums online. And I know it happens because it happens to me.”

 

Surprising Fact: More people suffer with bladder problems than with asthma, diabetes or epilepsy!

The Risk Factors For Incontinence Include:

In general, individuals of child bearing age are more likely to have slight incontinence, whereas senior individuals are much more likely to have severe incontinence. The increase in prevalence around the age of 50 is likely to be due to Menopause.

Recommended Heavy Incontinence Products

Buy iD Expert Belt on Incontinence Supermarket

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  • Designed for heavier incontinence

Range from £7.98 to £11.05

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  • Feel like normal underwear
  • Close comfortable fit

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  • For heavier incontinence

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Recommended Light Incontinence Products

Buy iD Expert Light on Allanda

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Range from £1.60 to £2.25

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Range from £3.10 to £6.12

 

Buy Lille Suprem Light on Allanda

  • Small in size for discretion
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Range from £0.99 to £4.35

 

The Impact of Incontinence on the Population

 

Studies find that incontinence influences four important areas:

1. Sexuality

2. Existing partnerships

3. New partnerships

4. The search for professional help

Incontinence is a threat to people’s autonomy and incontinence. This toll on mental health is not only apparent for incontinence sufferers, but also for carers. As authors Cassells and Watt claim in their article, "Carers of people with incontinence have reported sleep deprivation, depression and social isolation". They state “It is a both a caregiver burden and predictor of institutional placement.”

Depression and incontinence is also a large issue on a worldwide scale. In a Canadian study of women with urinary incontinence, more than 15 percent had experienced major depression in the previous year.

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