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Continence Management

Leading an active life with
urinary incontinence

Urinary incontinence affects people both physically and psychologically, but there are ways to reduce its impact.

Urinary incontinence describes any accidental or involuntary loss of urine, this can be connected to bladder disorders, the muscle structure of the pelvic floor and for many other contributing factors.
The NHS estimates that between 3 and 6 million people in the UK have some degree of urinary incontinence with as many as 24% of older people affected. Of those older people in institutional care, 30-60% are affected by urinary incontinence.1,2
Despite it being a problem suffered by both men and women of all ages, it is often treated as a ‘taboo’ subject and kept secret by those affected.


Leading an active life

As urinary incontinence can happen suddenly it can be difficult for the people affected to lead an active lifestyle. Some activities make the problem worse while others, by their very nature, take participants beyond easy reach of a toilet. This can result in people withdrawing from social situations. Fortunately, this doesn’t need to be the case.

Before we talk about how the people affected can help themselves, it’s worth remembering why it is so important to manage the condition correctly.

Understanding the effects of continence problems

If urinary incontinence is not managed correctly, or in time, it can lead to long-term health risks such as:

  • Urinary tract infections

    Due to incomplete emptying, bacteria and other germs could multiply in the bladder and migrate further through the ureters to the kidneys, possibly resulting in severe renal disorders and damage.          
  • Skin problems

    Skin can become irritated by constant contact with urine or faeces and can no longer defend itself sufficiently against bacteria. The natural protection of skin is weakened, leading to skin irritation, leading to incontinence-associated dermatitis.
  • Emotional stress

    People often feel ashamed of the disorder and are uncomfortable about discussing it. It can put a strain on everyday life with frequent toilet breaks having to be meticulously planned.

Physical and practical recommendations

An elder man is happily smiling

If you’ve been diagnosed with urinary incontinence, there is a lot you can do yourself to eliminate or reduce these risk factors. To support the natural function of the bladder you can make small alterations to your diet and introduce specific daily exercises:

  • Diet

    Follow a wholesome diet with plenty of easily digestible, high fibre foods such as wholemeal bread, oats, raw fruit and vegetables. Yoghurt and kefir are useful additions to your daily diet as they support your natural intestinal flora. Regulate your digestion by taking enough time for eating and avoiding excessive pushing during defecation.
    Avoid drinking fruit and vegetable juices, black tea, coffee and alcoholic beverages as these lead to increased urination and, therefore, act as irritants to the bladder.
  • Routine

    You can 'accustom' your bladder to empty at fixed times, with specific intervals. Over time it adapts itself exactly to this rhythm and “forgets" the urge between these times. Begin your bladder training by going to the toilet during the day exactly every two hours for two weeks. With support the bladder can be retrained to hold urine and the number of times it is emptied is reduced. Gradually you can increase the intervals between the planned trips to the toilet.
  • Exercise

    Regular exercise is very important and can actually improve symptoms but choose activities that don’t exert great pressure on the abdominal cavity and pelvic floor. Walking, swimming, dancing and cycling are ideal. Yoga can have multiple benefits. As well as helping to reduce anxiety, it focuses on posture and includes exercises to strengthen the pelvic floor muscles.

    From a practical perspective it’s a good idea to make a list of all the situations where you pass urine involuntarily (maybe when sneezing or coughing) and practice pre-emptive behaviours such as tensing the pelvic floor before the triggering moment.

    Similarly, practice regular relaxation techniques such as yoga or meditation and include activities in your daily life that reduce anxiety and bring you pleasure.

Improving day-to-day life

An elder couple is walking at the sea
There are also small changes you can make around your home to make toileting easier. For example, ensure your toilet is easy to access and is the right height for you. Attach handles to the wall next to the toilet if necessary.

Think too about your wardrobe. Whenever possible wear clothes that can be opened quickly: skirts, trousers and dresses with zip or Velcro® are ideal. Choose materials that are permeable to air, absorbent and easy to wash. If relevant, loose fitting clothes make it easier to empty urine bags or change pads.

Selecting the right continence product

As well as making lifestyle changes, an important aspect in managing urinary incontinence is finding the most appropriate, absorbent product. High quality products, worn discreetly in the underwear, allow you a reliable and discrete disposal of urine, protecting your skin and preventing noise and odours.

The choice of product depends on the severity and frequency of your condition and should be adapted to meet your needs.

 

 

 

 

REFERENCES

[1] Irwin, D., Milsom, I. et al. Impact of overactive bladder symptoms on employment, social inteactions and emotional wellbeing in six European countries. British Journal of Urology International: 2005; 97, 96-100

[2] Hunskaar, S., Lose, et al. (2003) Prevalence of Stress Urinary Incontinence in Women in Four European Countries, 2002. ICS: UK