Urinary incontinence can happen to people of all ages but is more common in older people1, with more than 50% of people aged 65 years and older experiencing at least some level of urinary incontinence2. To gain a better understanding of urinary incontinence, it is important to understand the different types of incontinence your patients could be experiencing. This will better prepare you for the supplies and/or treatment your patients may need.
|Leakage of small amounts of urine during physical movement (coughing, sneezing, exercising, etc.)||Pads and liners|
|Leakage of large amounts of urine at unexpected times, including during sleep||Adult briefs & diapers
|Urinary frequency and urgency, with or without urge incontinence||Adult diapers & briefs
|Untimely urination due to physical disability, external obstacles or problems in thinking/communicating that prevent the patient from reaching a toilet||Adult briefs & diapers
|Unexpected leakage of small amounts of urine due to a full bladder||Pads and liners
|Usually occurrence of stress and urge incontinence together||Adult briefs & diapers
|Leakage that occurs temporarily due to a situation that will pass (infection, taking a new medication, colds with coughing, etc.)||Pads and liners|
If coughing, laughing, sneezing or other movements that put pressure on the bladder causes the patient to leak urine, s/he may have stress incontinence. Physical changes resulting from pregnancy, childbirth and menopause often cause stress incontinence. Common in women, this type of incontinence increases following menopause and, in many cases, can be treated. Incontinence pads and liners can be great solutions for these kinds of leaks.
If the patient loses urine for no apparent reason after suddenly feeling the need or urge to urinate, s/he may have urge incontinence. A common cause of urge incontinence is inappropriate bladder contractions. Abnormal nerve signals might be the cause of these bladder spasms.
Urge incontinence can mean that the patient’s bladder empties during sleep, after drinking a small amount of water or when they touch water or hear it running (as when washing dishes or hearing someone else taking a shower). Certain fluids and medications, such as diuretics, or emotional states, such as anxiety, can worsen this condition. Some medical conditions, such as hyperthyroidism and uncontrolled diabetes, can also lead to or worsen urge incontinence. Involuntary actions of bladder muscles can occur because of damage to the nerves of the bladder, to the nervous system (spinal cord and brain), or to the muscles themselves. Multiple sclerosis, Parkinson’s disease, Alzheimer’s disease, stroke and injury – including injury that occurs during surgery – all can harm bladder nerves or muscles.
If leaks occur at night, incontinence underpads, or commonly known as chuck (chux) pads, are helpful. Additionally, briefs and diapers and incontinence underwear are also solutions for urge incontinence leaks.
Overactive bladder occurs when abnormal nerves send signals to the bladder at the wrong time, causing its muscles to squeeze without warning. Voiding up to seven times a day is normal for many women, but women with overactive bladder may find that they must urinate even more frequently.
Specifically, the symptoms of overactive bladder include:
- Urinary frequency – bothersome urination eight or more times a day or two or more times at night
- Urinary urgency – the sudden, strong need to urinate immediately
- Urge incontinence – leakage or gushing of urine that follows a sudden, strong urge
- Nocturia – awaking at night to urinate
There are several incontinence products that can help protect against leaks, such as underpads (chuck pads) for nighttime or sitting, or briefs and diapers and disposable underwear for large surges of urine.
People with medical problems that interfere with thinking, moving or communicating may have trouble reaching a toilet. Alzheimer’s disease, for example, can interfere with a patient’s mental capacity, making it difficult plan a timely trip to a restroom. A person in a wheelchair may have a hard time getting to a toilet in time. Functional incontinence is the result of these physical and medical conditions. Conditions such as arthritis often develop with age and account for some of the incontinence of elderly women in nursing homes.
There are several incontinence products that can help protect against functional leaks, such as underpads (chux pads) for nighttime or sitting, or briefs and diapers and disposable underwear for large surges of urine. Catheters can also be an option.
Overflow incontinence happens when the bladder doesn’t empty properly, causing it to spill over. Weak bladder muscles or a blocked urethra can cause this type of incontinence. Nerve damage from diabetes or other diseases can also lead to weak bladder muscles; tumors and urinary stones can block the urethra. Overflow incontinence is rare in women. Pads and liners, as well as underpads (chucks pads), can help protect against these kinds of leaks.
Stress and urge incontinence often occur together in women. Combinations of incontinence – and this combination in particular – are sometimes referred to as mixed incontinence. Most women don’t have pure stress or urge incontinence, and many studies show that mixed incontinence is the most common type of urine loss in women.3
Transient incontinence is a temporary version of incontinence. Medications, urinary tract infections, mental impairment, surgery and restricted mobility can all trigger transient incontinence. Severe constipation can cause transient incontinence when the impacted stool pushes against the urinary tract and obstructs outflow. A cold can also trigger incontinence, usually resolving once the coughing spells cease.
For temporary incontinence, a wide variety of products can help protect against leaks, depending on the duration of incontinence and amount of leaks. Pads and liners are typically used for temporary incontinence.
From incontinence level and absorption to activity and mobility level, there are a variety of factors to consider when choosing incontinence supplies for your patients.
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3: U.S. Department of Health and Human Services, National Institute of Diabetes and Digestive and Kidney Diseases
Be advised that the information contained herein is intended to serve as a useful reference for informational purposes only and is not complete clinical information. This information is intended for use only by competent healthcare professionals exercising judgment in providing care. McKesson cannot be help responsible for the continued currency of or for any errors or omissions in the information.