Incontinence – Functional

Incontinence (voluntary loss of urine from the bladder) that occurs infrequently (transiet) or failure to comprehend the need to urinate (functional).

FREQUENT SIGNS AND SYMPTOMS

  • Forgetting to urinate.
  • Urinating at inappropriate times or places.
  • Occasional problems in getting from bed to toilet in time.

CAUSES

  • Dementia.
  • Depression.
  • Mobility disorders.

RISK INCREASES WITH

  • Urinary tract infection.
  • Diabetes mellitus.
  • Increasing age.
  • Estrogen deficiency.
  • History of many pregnancies.
  • Spinal cord injury.
  • General debilitated condition.

PREVENTIVE MEASURES

  • Eat a normal, well-balanced diet and exercise regularly to build and maintain muscle strength.
  • Learn and practice Kegel exercises before symptoms of stress incontinence begin.
    Kegel exercise: The purpose is to recognize, control and develop the muscles of the pelvic floor. These are theones used to interrupt urination in mid-stream. The following exercises strengthen these muscles so you can control or relax them completely:
  • To identify which muscles are involved, alternately start and stop urinating when using the toilet.
  • Practice tightening and releasing these muscles while sitting, standing, walking, driving, watching TV or listening to music.
  • Tighten the muscles a small amount at a time, “like an elevator going up to the 10th floor”. Then release very slowly, “one floor at a time”.
  • Tighten the muscles from front to back, including the anus, as in the previous exercise.
  • Practice exercise every morning, afternoon and evening. Start with 5 times each, and gradually work up to 20 or 30 each time.

EXPECTED OUTCOME

If the underlying cause can be determined and treated, incontinence problems can be cured or significantly improved.

POSSIBLE COMPLICATIONS

  • Most likely to continue unless underlying causes can be treated.
  • Urinary tract infections.
  • Social isolation due to concern about embarrassment.

TREATMENT
GENERAL MEASURES

  • Following treatment of the underlying cause, it may be necessary to rely on external devices or super-absorbent pads.
  • Specially trained nurses or therapists will help a patient learn how to cope with the problem, such as scheduled voiding, prompting, and habit training.
  • In some cases, incontinence will require caregiver assistance for management.
  • Absorbent pads or diapers may be worn.
  • Learn and practice Kegel exercises (see instructions in Preventive Measures).

MEDICATION

Medicine usually is not necessary for this disorder, but antibiotics may be present if there is a complicating urinary tract infection.

ACTIVITY

As tolerated by physical condition.

DIET

  • No diet restrictions.
  • Start a weight loss program if overweight is a problem.