Incontinence

 Incontinence

How can we help you?

Howsme are a team of experts from a variety of professional backgrounds who can give you confidential online information and support.  Whether you have a quick question or need to resolve complex issues howsme has the answers you need.  We look forward to hearing from you.

Incontinence

The definition of incontinence is ‘involuntary loss of urine’ and it is the word involuntary that is the important one as it boils down to losing urine when you don’t want to!  This loss of urine can be tiny drips or large amounts.  it  can be easily managed or extremely difficult and tends to have a big impact on everything you do in life.
 
Urine is collected in the bladder which is an expandable bag held within the pelvis.  (If you are desperate to go for a wee you can feel exactly where it is!!). The bladder holds the urine until you get to the toilet when the urine then passes along a tube called the urethra and out into the toilet.  This process relies upon a balance between intra-abdominal pressure and muscle control, if either of these are disrupted incontinence can result.
 
Different types of incontinence
 
1.      Stress incontinence
2.      Urge incontinence
3.      Overflow incontinence
4.      Functional incontinence
5.      Structural incontinence
6.      Mixed incontinence
7.      Transient incontinence
8.      Childhood incontinence (enuresis)
 

Stress incontinence

This very common form of incontinence is also known as effort incontinence.  It is usually caused by weakness in the pelvic floor muscles. 

These muscles support the urethra and any weakness makes it difficult to hold the urine in the bladder when in intra-abdominal pressure is increased.  When we laugh, cough, sneeze or exercise we increase our intra-abdominal pressure (it feels like you tummy is tensing up). 

This pressure helps to squeeze the urine out of the bladder and the pelvic floor muscles help to prevent it coming out of the bladder until we are at the toilet. 

 
Therefore

Pelvic floor weakness + increased intra-abdominal pressure = incontinence
 
The amounts of urine lost are usually small during laughing or coughing as a result of the inability of the weak pelvic floor muscles to hold the urine in the bladder against the increase in intra-abdominal pressure.
 
Female stress incontinence is usually caused by the physical changes as a result of pregnancy, giving birth and the menopause.

Because the hormone oestrogen can affect the pelvic floor muscles some women find that stress incontinence is worse the week before their period and following the menopause.  
This type of incontinence is treatable.

Urge incontinence

This is when a sudden urge to urinate results in involuntary loss of urine.  A common cause of this is involuntary or inappropriate muscle contractions. 

These muscle contractions result from an infection, inflammation or irritation in the local area or a problem of the central nervous system.  Urge incontinence can also result from overactive nerves that control the bladder (this is sometimes referred to as ‘reflex incontinence’). 

If the nerves that control the bladder are damaged in diseases such as multiple sclerosis, Alzheimer’s disease, Parkinson’s disease or following a stroke; urge incontinence can occur.  It can also happen if a surgical procedure has damaged the nerves to the bladder.

Those suffering with urge incontinence are likely to be incontinent after drinking just a small amount of fluid, upon hearing, seeing or being in contact with water and can be incontinent whilst they are asleep.

Overflow incontinence

Overflow incontinence describes when urine dribbles either constantly or for a while after passing urine.   This is because the bladder is unable to empty or fully empty and is therefore constantly overflowing, hence the name! 

The bladder can remain full either because the bladder muscles themselves are too weak to push all of the urine out or the urethra is partially blocked. 

Multiple sclerosis and some of the effects of diabetes can lead to overflow incontinence because they can affect the bladder muscle.  Tumours and kidney stones can block the urethra preventing the urine from passing out of the bladder.  

Overflow incontinence is rare in women and is usually caused by either fibroids or ovarian tumours.  Sometimes the urethra becomes affected by a vaginal prolapse or the surgery to correct a prolapse and can cause overflow incontinence.

Overflow incontinence is more common in men and is usually caused by benign prostatic hyperplasia (BPH), which can restrict the flow of urine along the urethra.

Functional incontinence

Functional incontinence is when you know you need to go to the toilet but don’t get there for whatever reason. 

There are lots of things that can prevent us getting to the toilet in time and the most common is having limited mobility. 

As well as moving, people with functional incontinence may have problems indicating to others that they need to go to the toilet or they may have problems actually knowing what to do. 

Functional incontinence is more common among people suffering from Alzheimer’s disease, dementia, people who are confused or have poor mobility, eyesight or struggle to use their hands. 

Mental health issues such as depression, anxiety, phobias and anger can lead to functional incontinence if the sufferer doesn’t want or can’t visit the toilet. 

People with functional incontinence tend to lose large amounts of urine.  Because of the causes this type of incontinence is often associated with the elderly.

Structural incontinence

Occasionally children are born with structural differences within the pelvis leading to structural incontinence.  a common structural problem is ectopic ureter.

Mixed incontinence

Mixed incontinence describes a condition of having stress and urge incontinence together.   Mixed incontinence is quite common in women.

Transient incontinence

Transient incontinence describes incontinence that occurs as a result of a temporary state.  For example some medications, severe constipation or temporary limited mobility may cause incontinence.  As soon as the cause is removed the incontinence stops.

Childhood incontinence (enuresis)

This is completely normal in very young children.

 
How to clean urine / how to clean urine stains.

How to clean urine if the stain is still wet.

Start by blotting up as much of the urine as possible with some adsorbent material. Then dampen the area with water or a solution to dilute the remaining urine and blot out excess liquid again, repeat if necessary until the stain or odour is insignificant.

Let the area dry out completely in a well-ventilated area and if possible in direct sunlight. Sunlight is very effective at removing urine odour but be cautious as sunlight can also fade colours.

Solutions to clean urine or remove stains. 

Hydrogen peroxide is also used to clean urine or remove urine stains. Some people use white vinegar, ammonia or soap flakes as all these have been effective and have successfully problem solved the issue of, how to clean urine or remove urine stains. However do not use ammonia on silk or wool.

Liquid detergent or soda water can be effective when cleaning urine stains and some believe using a little alcohol rubbed into the area will clean the urine.

Methods of how to clean urine and remove urine stains.

Methods of how to clean urine and remove urine stains vary depending on the material that has been damaged. Equally important as cleaning the urine or removing the urine stain is to make sure that the odour is completely neutralized.

Dissolve one tablespoon of baking soda to one cup of warm water, put this into a spray bottle and spray the effected area. Baking powder has the ability to neutralize most odours.

Remember if you are to purchase a product to clean urine or remove urine stains read the label to make sure that it contains enzymes that will remove the smell, not mask it with another powerful scent.

This product might be a little more costly but worth the extra for a superior result.

Updated: 15th September 2009