Urinary incontinence is an embarrassing health concern for the elderly

72- year old male patient has persistently complained of uncontrollable loss of urine for the past one week. When examined by physicians, it was found out that the old man had weakened bladder sphincters that could not control the urine outlet at the right time.The doctor then described the elderly man illness as the urinary incontinence. It should be understood that as a human being grow older, the body begin to change and often embarrassing problems could arise especially in men. One of such problems is urinary incontinence. This condition is normally hidden by the elderly. This is because many sufferers of the involuntary urine flow feel too embarrassed to approach anyone for help and some health providers do not take into account to ask their patients if they are having trouble with incontinence. It is very devastating to an individual’s quality of life. With this condition, People tend to lose simple pleasures like meeting friends due to the fear of having an embarrassing situation or the awkward appearance of undergarments used to help protect from the leakage.This problem is common to old men and women above the age of 65 years. For women it might occur a bit earlier in life and women are more likely to suffer from urinary incontinence than men. This is because childbirth can stretch the pelvic floor muscles that hold the neck of the bladder in place making it much more likely for urine to leak out. This occurs when pressure is placed on the abdominal cavity for instance when coughing, laughing, or sneezing. Women are also more prone to incontinence due to the thinning of the vaginal tissues and muscles which can happen after menopause. These also support the neck of the bladder and when weakened, make it easier for urine to accidentally be expelled. Like most conditions, there are several types of urinary incontinence that occur for various reasons. Functional incontinence is brought about when someone simply is not able to reach the bathroom. In such circumstances, we find elders who are bed-bound or wheelchair-bound, but this type of incontinence can also include those who are not able to reach the restroom due to mental reasons as seen in some patients with Alzheimer’s disease. Stress incontinence is when abdominal pressure causes urine to be forced out. Women are much more likely to suffer from this type than men due to childbirth and menopause as mentioned before. Urge incontinence is the overall most common type in both men and women. This is caused by uncontrollable contractions of the big muscle known as the detrusor muscle that surrounds the bladder. This makes patients feel the need to urinate frequently even if the bladder is not full. It also gives them a very urgent feeling to urinate.Another type of an involuntary urinary flow is the over flow urinary incontinence. This is when there are large volumes of urine left in the bladder after urination. This is usually caused by some type of obstruction in the urethra. This type of incontinence is more common in males than females due to the enlargement of the prostate gland.However it is important to understand that some people might suffer from a combination of two or more of the previously mentioned types of incontinence. ManagementTo treat functional incontinence non-drug methods such as habit training are used. This is done by getting the patient in the habit of going to the bathroom on a set schedule. Other procedures such as environmental adjustments like raised toilet seats or widened bathroom entrances can be made depending on the patient’s specific needs. Undergarments and pads can also be used to deal with this type of incontinence. They are very effective but also embarrassing because they are bulky and can be seen under clothes, and they do nothing to suppress the odor if they happen to be soiled. Stress incontinence is also treated with primarily non-drug measures in the elderly. This is because there are no approved medications to treat this condition. The common medicine on market is the Pseudoephedrine and Midodrine drugs, but both cause increased blood pressure and increased heart rate that can worsen cardiac arrhythmias, all of which can be especially dangerous in the elderly. Treatments for incontinence problems include surgical procedures to re-tighten the pelvic floor muscles that helps support the neck of the bladder. Devices such as pessaries are also used; they are soft plastic rings that are inserted into the vagina to press on the pelvic floor and again, help support the neck of the bladder. Kegel exercises can be done to strengthen the pelvic floor muscles. This involves continuously contracting the muscle that is used when you stop urinating mid-stream. For this to be effective the muscle must be contracted many times like 20 to 40 a day and the patient must continue to do this indefinitely. Topical estrogen products like Premarin vaginal cream and Estring can be used to help with vaginal atrophy brought on by menopause and may also help lessen stress incontinence. The main treatment for urge incontinence is drug therapy. All of the medications used to treat this condition essentially do the same thing; they decrease stimulation by the part of the nervous system that triggers the detrusor muscle of the bladder to contract, and this usually alleviates the frequent urges for the patient. However the problem with drugs used in treatment of urge incontinence has side effects such as blurry vision, constipation, dry mouth, and confusion.