Prostate and Male Urinary Incontinence

The other night at dinner a friend was telling me that his buddy of over 30 years had to stop wearing khaki pants because he is embarrassed by wet spots caused by urination. I immediately asked him if his friend had a prostate procedure and the answer was yes, which he then followed up with the question - “why?”.

To understand the “why” you have to have a basic understanding of what the prostate is, where it is in the male body, and why a procedure may cause urinary incontinence.

First off, the loss of the ability to control urination by men is commonly caused by surgery or radiation treatments for prostate cancer. It may be a short term issue or can be a lifelong issue. Let’s drill down into the details to understand “why”.

Lets start with the basics of what the prostate is and what is does and how it helps hold urine. Urine is stored in the bladder after it is drained from the kidneys. The bladder holds the urine until there is an urge to urinate. The bladder is a hollow, muscular, balloon-shaped organ. Urine flows out of the bladder and leaves the body through a tube called the urethra. Urination occurs when muscles in the bladder contract and forces urine out of the bladder. While this is happening the muscles that surround the urethra relax an allow the urine to flow out.

Here’s where the prostate comes into the picture - it is a gland that surrounds the urethra.

An enlarged prostate gland can obstruct the urethra and can cause urination retention or other problems with urination.

Removing the prostate through surgery or destroying it through radiation (via external beans or use of radioactive seed implants) disrupts the way the bladder holds urine and can result in urine leakage. Radiation can also decrease the capacity of the bladder and cause spasms that force urine out. Surgery can also damage nerves that help control bladder function.

Surgeons and procedures have changed over the years to attempt to reduce these issues. When removing the prostate they may try to save as much of the area around the bladder and the sphincter muscles around the urethra reducing the damage to the sphincter. Doctor have also improved the process of how they place the radioactive seed implants that destroy the prostate while limiting damage to the bladder.

Any man who is going through surgery or radiation to treat prostate cancer should expect to develop some problems with urinary control. There are new techniques that may help some men only have temporary problems controlling urine, and many may regain full control of their bladder over time.

Treatments options may include (always speak with your doctor for any and all treatment options):

Pelvic floor exercises. Doctors will often start with behavioral techniques that train men to control their ability to hold urine. These exercises are often called “Kegal Exercises”

Supportive Care including behavior modifications. This often includes reduction in fluid intake, reducing/avoiding caffeine, alcohol, or spicy foods, and not drinking before bedtime. Regular and frequent urination and not waiting till the last minute to go may also be encouraged. Losing weight may also help. Medications that also interfere with incontinence may also be reviewed.

Medications may be reviewed as they can increase bladder capacity and decrease urination frequency.

Neuromuscular electrical stimulation is treatment used to retrain and strengthen week urinary muscles and improve bladder control. This treatment involves a probe being inserted into the anus and a current passed through the probe at a level below the pain threshold which causes muscle contraction. The patient is then taught to squeeze the muscles when the current is on. After the contraction the current is switched off.

Artificial sphincter is a patient controlled device mad of tree parts - a pump, a pressure-regulating balloon, and a cuff that encircles the urethra and prevents urine from leaking. Results from an artificial sphincter can cure or greatly improve up-to 70-80% of patients.

Bulbourethral sling is a device used to compress and suspend the urethra. It is made to help achieve ladder control.

Other surgery may also be available on your doctors recommendation to help men hold urine.

If you are experiencing male incontinence there are many products available to avoid embracing leaks through your clothing and also help control odors. Here is a link to our Male Incontinence Products that may help you live a more active and comfortable lifestyle after prostate surgery or radiation treatment.


To follow up on what started this discussion on why prostrate issues impact men and cause incontinence are: enlarged prostate may cause obstruction and flow of urine through the urethra making it difficult to urinate or control when to urinate. Treatments such as radiation and surgery will reduce or eliminate the prostrate, but may result in a reduction in bladder capacity and the inability to control urination and unwanted leakage. Luckily, treatments and surgeries are getting better. Any change in urination or feeling should be discussed with your doctor. Any treatments or changes to existing treatments should be discussed with your doctor.

Caregiving for People New to Incontinence

When dealing with incontinence as an adult, especially if this is a new situation, it is very important to consider the emotional well-being and dignity of the individual. There is no singular cause of adult incontinence and it may be brought on by many situations including child births, disease, injury, certain medications, infection, or other conditions out of the control of the individual. If this is a new situation is is important to speak with a doctor or health care provider to help find the cause and provide advice for proper care. Click here for information about ways to help speak with your doctor about incontinence.

Types and Levels of Incontinence
You should always consider the feelings of the individual dealing with incontinence. They may be embarrassed, angry, confused, in denial, or ignoring symptoms hoping that they will go away. Many times a caregiver will be a family member or somebody close to the individual that is new at dealing with the situation and corresponding conversations. Being a caregiver can be a demanding job dealing with both the physical and psychological issues.

Recognize the Emotional Support Needed
Be sure to recognize and support an individual that has made the decision to seek help. Allow them to speak about their concerns and think about how you would want to be treated if the roles were reversed. The ultimate goal is to educate and provide the best possible care and solutions to the issues surrounding incontinence. Be supportive and resourceful and be willing to apply yourself willingly with a positive attitude to protect and maintain a positive relationship. And remember when dealing with adults - they are adults and this is a tough situation for them to be addressing.

Kinds of Wearable Products that are Available
Many people find themselves trying to determine what they need and start by asking all kinds of questions. For example, where should I start and what am I looking for to solve this because there are so many options? What is the difference between a pad and a brief (also known as “adult diapers”). Are there pull-ups for adults so they can dress themselves?

You can start by addressing the level of incontinence. Is is a couple of drops here and there, are there times when the urge to go comes too late to make it to the toilet, or is there a need for a wearable product to ensure there are no “accidents”. Click here for more information on types and levels of incontinence.

Once you have identified the absorbency requirements you can consider the actual types of wearable products to consider for use. Here is a link to the types of products available to wear including information about the differences between pads, briefs/adult diapers, and pull-ups/ protective underwear. Understanding your options, how they work, and the absorbencies they are available in will help you narrow down your selection process.

Other Products Needs for People with Incontinence
Many people new to incontinence care also wonder what other types of products may be needed. It is very important to keep skin clean and healthy.  Keeping skin healthy is more comfortable and much easier to deal with than trying to repair damaged skin or clear up a nasty diaper rash. Here is a link to skin cleansing and skin care products to help keep skin healthy. Avoid skin cleansers with harsh soaps or alcohol to ensure that fragile and sensitive skin is not irritated.

Keeping the environment clean and fresh smelling will benefit both caregiver and patient. Simply covering up smells with perfumes is a temporary solution. Consider biological odor eliminators like those used in hospitals and healthcare environments. These deodorizers attack and neutralize odors to make for a more pleasant environment for all. Also, surface disinfectants for hard nonporous surfaces will help keep your environment clean and healthy.

Disposable gloves for medical care are also a very inexpensive way to keep a barrier between you and urine and or feces. There are many types of gloves including vinyl, nitrile and latex available for caregivers.

Summary
If new or increasing issues with incontinence are occurring see a doctor or healthcare provider. Identify the level of protection needed and the type of wearable incontinence products that best fit your need, keep skin healthy and clean, and maintain a fresh smelling environment pleasant to caregiver and patient.

Diaper Rash caused by Adult Incontinence

Yes, adults can get diaper rash just like children. Diaper rash is often caused by incontinence soiling and the subsequent  rubbing of skin by clothing or incontinence garments. It can also be caused by sweat and clothing rubbing on skin. Any fluid and rubbing by garments can cause an irritation and followed by a rash. Most times these rashes can be identified and treated quickly. If left unattended it may take more effort (and considerable discomfort) to treat.

Adult Diaper Rash (aka diaper dermatitis) is a skin condition caused by skin rubbing against a diaper or pad, and contact with the chemicals in urine and stool. The skin may look red, raw, scalded or burned. It can occur at any age if diapers, protective underwear or pads are used. As stated bore, it is not strictly a child or baby related issue.

It often happens in adults when a rash occurs in the genital area in an area is not cleaned well. Skin irritations can also be caused by products that have perfumes or are allergenic. Fungal or bacterial infections may also cause diaper rash. The skin may appear to be red and swollen with a mild rash or blister and peel in a severe rash. A diaper rash that becomes raw, oozes fluid or bleeds will be harder to treat and advice from a doctor or healthcare professional may be required.

It is very important to deal with diaper rash at the earliest signs of discomfort and the rash appearing. The farther along and more severe the rash the more difficult it is to treat and cure.

The most common causes of diaper rash are:

• Not changing a wet or soiled incontinence product enough. Skin in contact with urine and/or stool becomes irritated.
• Rubbing of the skin by an incontinence pad, diaper or protective underwear product. This may cause irritation in areas including thighs, genitals, buttocks, or belly area.

We hate to mention it, but neglect by a caregiver that does not treat a diaper rash at the time treatment is needed. We hope that this is never the case, but there have been issues where caregivers do not treat a diaper rash because of anger directed at a vulnerable adult.

Sometimes a diaper rash may occur with other skin conditions including psoriasis, atopic dermatitis, or seborrhea. The rash may be red or oozing. A crust may form. There will often times be similar patches of rash on other parts of the body.

Diaper rash is uncomfortable and can lead to worse skin issues and wounds. The earlier they are identified and treated the better. Avoiding getting a rash all together is an even better approach.

Tips for controlling and treating diaper rash:

• Keep the skin dry. Also, make sure that the skin is not in contact with urine or stool.
• Change the adult diaper, protective underwear, or pad every time is is wet or soiled. It is advisable to check the garment every three house during the day. Changes may be needed during the night to prevent or clear up a rash.
• Gently wash the diaper area with warm water and a soft cloth. Rinse well and dry completely. There are many mild no-rinse and rinse skin cleansers available for incontinence perineal skin cleansing to help aid in the cleaning and healing process.
• Do not use soap unless the are is very soiled. Use only a mild soap if soap is needed.
• Do not use wipes or baby wipes that have alcohol or propylene glycol if diaper rash is present. They may burn the skin and spread bacteria. Most adult wipes are formulated without these chemicals to ensure the most comfortable cleaning possible.
• You might want to try using a blow dryer on the warm setting to get the area fully dry (this technique shouldn’t be used on babies or small children.

If possible, leaving diapers, protective underwear or pads off for a time may promote air circulation that keeps skin dry and promotes comfort and healing.

Protect the the healthy skin near the rash with protective lotions or creams. Be careful not to apply creams to broken skin unless directed as it may slow the healing process. Use of a lotion, cream or ointment that is formulated for sensitive skin and free of harmful perfumes and allergens. Also, a moisture barrier cream or lotion will help keep moisture out allowing skin to comfortable heal. Be sure to be gentle when applying any lotion or cream to sensitive skin.

Use a disposable incontinence product with absorbent gelling material (super absorbent microbeads) as these will pull moisture away from the skin.

Showering or bathing multiple times throughout the day and gently drying the area may help. Reapply lotions, creams, or ointments after drying.

Do you have any suggestions on dealing with adult diaper rash that might benefit others? If so, please leave detailed comments on this post. Thank you!

Please note you should consult with your doctor or healthcare professional with any diaper rash or skin care issue to ensure you are taking the proper steps to treat the issue. The information provided is of a general nature and should not be considered not medical advice. 

Why Does Urine Smell?

Urine is the body’s liquid waste that is primarily composed of water, salt, and chemicals called urea and uric acid. The kidneys produce it when filtering toxins and other bad substances from your blood.
The smell of urine is directly related to the volume and concentration of a variety of substances excreted by the kidneys. Normal urine contains a lot of water and has little to no odor. Urine that is highly concentrated with little water may have a strong smell of ammonia. This may cause addition stress and an unpleasant environment for people with urinary incontinence, family members and caregivers.

Many individuals dealing with urinary incontinence get dehydrated trying to reduce their consumption of liquids to reduce the volume of urine. Dehydration makes urine very concentrated resulting in a strong smell of ammonia.

Other influences on the smell of urine include foods eaten and medications (including vitamins and other supplements) that are being taken.

Odors in urine may also indicate a medical condition or disease including, but not necessarily limited to issues such as bladder infection, cystitis (bladder inflammation), congenital heart disease in adults, diabetic ketoacidosis (high levels of blood acids called keytones), gastointestinal-bladder fistula (abnormal connection between intestoines and the bladder), maple syrup urine disease (rare genetic disease that cases difficulty breaking down specific amino acids), metabolic disorder (a problem with the way your body converts the foods you eat into energy), type II diabeties (uncontrolled), and urinary tract infect (UTI). Causes shown here are commonly associated with this symptom. Work with your doctor or health care provider for an accurate diagnosis. Click here for helpful information on how to speak with your doctor or healthcare profession about incontinence. 

Many disposable incontinence products such as pads, adult diapers and protective underwear incorporate odor controlling features to help maintain a pleasant environment. These features include superabsorbent microbeads that absorb liquids and hold in smell. Many also have features that help inhibit bacterial growth with helps reduce odors and help maintain healthy skin.

Keeping incontinence products changed regularly and keeping skin in incontinence areas clean will also help manage offensive urine related odors.

There are also many odor reducing household sprays and room deodorizers that do more than simply cover up offensive odors. They attack the cause of biological odors rather than simply trying to overpower an offensive smell with a flowery or pleasant smell. Covering odors with another odor only lasts as long as the new odor stays stronger than the offensive odor. Biological odor eliminators for rooms will actually absorb and neutralize bad odors and prevent them from building up. Click here to go to room deodorizers to find one that is right for you.

Bladder Supports - Pessary Devices for Female Incontinence

A “pessary” is a device that is placed into the vagina to support the uterus or bladder and rectum. It is a firm ring that presses against the wall of the vagina and urethra to help decrease urine leakage. The size and type should be fitted to meet your individual needs and anatomy. A pessary is most commonly used to treat the prolapse of the uterus. It is also used for the treatment of stress urinary incontinence (SUI).

Poise Impressa Bladder Supports are non-absorbent bladder support products that are inserted into the vagina like a tampon that stops urinary stress incontinence in women before it happens. It gently lifts and gives support to the urethra (the tube above the vagina that leads urine out of the bladder. The support it adds helps prevent urine from leaking out.

There are many types of incontinence, and the Impressa Bladder Support is designed specifically for urinary stress incontinence (USI). USI is the type of incontinence that occurs when an unexpected leak of urine occurs when a women coughs, laughs, dances, sneezes or exercised.

Impressa Bladder Supports are disposable. They are thrown out in the trash after use. They are available in three sizes. There is also a sizing kit that included two Impressa Bladder Supports of each size to help you determine the correct size if you are unsure. 

Incontinence Does Not Discrimate

Incontinence is a health issue that does not discriminate. It can effect young and old, rich or poor, and men or women. For example - Kate Winslet is a 40 year old woman and Oscar winning movie star that has recently publicly discussed the very private issue of her issues incontinence. Her incontinence came about as result of child bearing that has resulted in weakening of the muscles that support the bladder.

Incontinence can strike at any age and for many reasons. If you are experiencing incontinence, even just a few drips, it is a good idea to consult your doctor as they may have advice, treatment and life changes that can help reduce or eliminate the condition.

People experiencing incontinence may change their lifestyle due to being afraid of leaks or accidents. Luckily there are many products available that can help control leaks and accidents. Not only will these products help you keep the condition discreet, they will also help maintain skin health and overall comfort.

Disposable products for use with incontinence include:

Pads, Liners, & Underwear Inserts - available in a wide range of sizes and absorbencies. Designed to fit right in existing underwear and many times individually packaged for easy transport and use. These products are designed to absorb urine and keep it away from the skin and control odors. Many people will try to use feminine hygiene pads for this purpose, but these items are not designed for use with urine and will not be as effective or provide the same type of leakage and odor control. Pads are also available specifically for men.

Protective Underwear - these are disposable underwear that are designed to pull on and off like regular underwear. Most have side panels that area easily torn/split making clean and comfortable removal possible. Protective Underwear are available in a variety of sizes and absorbencies to allow the wearer to go about their lives with minimal impact. And since they pull on and off individuals can easily change themselves for even more privacy.

Adult Diapers - adult diapers are also commonly referred to as “briefs” in the manufacturing industry. This often causes confusion between them and protective underwear. An adult diaper is a garment that folds around the waist and up through the crotch area and secures with tabs made of tape or a hook and loop (think Velcro) type of fastener on the side. These products are great for use by caregivers for a number of reasons including ease of assisted changing for bedridden wearers.

Science and technology have come a long way in designing thinner and more absorbent materials allowing these disposable incontinence products to be thinner yet highly absorbent.

There are many people from all walks of life and ages dealing with incontinence. It is a very common issue and should be discussed with your doctor. Here is a helpful link to a previous article on how to discuss incontinence with your doctor.  There are many disposable incontinence products on the market to help maintain dignity and discretion.

Why it is important to get enough fluids if you have urinary incontinence

Urinary incontinence can be inconvenient, uncomfortable and embarrassing for both the patient and family and friends. Often times people will reduce the amount of fluid intake to help control incontinence leakage. It might seem logival to prevent accidents, but it doesn't.

When a person does not get enough fluids it can actually cause urine odor to increase and get stronger. I was recently speaking with my friend about her mothers "unspoken about issue" and she was commenting on the strong smell like ammonia that was always present. She was worried that it was fecal or bowel incontinence and didn't realize that that was a strong and offensive urine related odor. We discussed two factors: 

1. Choosing the right incontinence protection item is important. My friend was fairly certain her mother was using a feminine hygiene pad rather than an incontinence garment.
2. She didn't think that her mother was drinking much other than her morning cups of coffee and as little as possible the rest of the day. 

Both of these factors were probably contributing to the odor and probably not helping. Also, the reduction in fluid intake was not helping control the incontinence leakage.

Generally speaking, drinking plenty of water in small amounts during the day can actually help leakage and improve bladder control as well as help reduce odors. 8 ounces with meals, sipping water between meals, and limiting liquids a couple of hours before bedtime can help. Avoiding or reducing caffeinated beverages, citric juices and carbonated beverages can also help. 

All of this is general information to help ensure a person is getting enough fluids and not avoiding it to reduce urinary incontinence. My mothers friend, as well as anybody reading this that is experiencing urinary incontinence, should talk to their doctor or healthcare provider. Information like this is very generally and should never be construed as medical advice. Click here to go to a previous article regarding how to speak with your doctor or healthcare provider about incontinence.

There are many actions and steps individuals dealing with urinary incontinence can improve their situation.

How to Increase Incontinence Product Capacity with Booster Pads

Booster pads are an excellent option for use with an existing adult diaper or protective underwear when additional leak protection and absorbency is needed. This may be due to the large volume of urine or to help a person stay drier between changes. 

Booster pads are a unique type of product included in the pads, shields and liners category of products. They insert into the existing garment like a pad. They feature the same type of construction as most incontinence protection items, however they do not have a moisture proof backing or lining. This allows the booster pad to fill to its capacity and then pass any additional fluids on to the diaper or protective underwear. Think of it like adding another level of absorbency protection that fills up and then passes liquids to the next incontinence garment when full. 

This solution adds another cost and product used for the care of the individual, but it will also increase the wearability and time between changes of other garments therefore reducing the frequency of changing of those items. With the added absorbency they may also reduce the need to change lines, bed sheets and underpads saving additional time, effort and costs for the caregiver. 

Booster pads are available in different shapes, sizes and leak protection levels. This allows the user to use a product that is both customized and comfortable for their needs.They are available in rectangular shaped pads or hourglass shaped pads. They may be contoured for even a more perfect fit. Some pads also feature side gathers to more efficiently prevent leakage and ensure liquids are drawn into the core of the pad. 

Booster pads are available in sizes and shapes to accommodate all sizes of users.

For example, the Tranquility TopLiner Super-Plus Contour Booster Pad that measures 32” x 14” is designed specifically for large sized bariatric use and can absorb up to 27.5 ounces of fluids before reaching capacity. It is contoured to ensure maximum comfort and protection.

On the other end of the product needs spectrum is the very popular Dignity Stackables Barrier Free Pads that will hold about 8-10 ounces of liquid. These pads are rectangular shaped pads that measure 3.5 inches x 12 inches and provide a light incontinence protection level for those that may need just a little more protection and don’t want the added build of a larger more absorbent pad. These pads are also used as primary incontinence pads worn in underwear for people with very light incontinence leakage. 

Booster Pads may be an excellent option for you if added absorbency would help maintain skin health, comfort and reduce caregiving needs including changes and/or costs. If you would like to see more about our line of booster pads click here to go to our page with all the Booster Pad options available to you. 

Male Incontinence Causes

Male incontinence may occur for many reasons. Essentially, incontinence is when there is an accidental leakage of urine and may happen when the sphincter is too weak, the bladder muscles contract too strongly or the bladder is too full.

The male urinary tract consists of the kidneys that produce urine, the urinary bladder that stores urine, and the urethra tube that leads urine from the bladder through the prostate and out the penis. The urinary sphincter is a ring of muscle around the urethra that controls the flow of urine. Nerve signals tell the sphincter to stay squeezed shut to prevent. The nerves and the muscles work together to prevent urinary leakage.

Incontinence in men may result from a number of issues ranging from conditions such as constipation, infections, and prostrate issues. Prostate issues and treatments are a major cause of urinary incontinence in men. Any disease, condition, or injury that damages nerves can lead to male urinary incontinence.

The prostate gland is a male gland about the size and shape of a walnut. It surrounds the urethra just blow the bladder where it adds fluid to semen before ejaculation. It commonly becomes enlarged as a man ages. This condition is called benign prostatic hyperplasia or BPH.  As the prostate enlarges it may squeeze the urethra, which affects the flow of the urinary stream. 

Prostate Treatment Related Incontinence Issues:

• Short-term incontinence caused by prostrate surgery. This may go away with time. In some cases this may last up to a year.
• Stress Incontinence – often a result after prostate removal (radical prostatectomy) or radiation being used as treatment for prostate cancer. Improvements in surgical techniques are helping make this type of incontinence less common.
• Some treatments for an enlarged prostrate can cause incontinence. These treatments are for conditions such as benign prostate hyperplasia (BPH).

There are also many causes of Urge Incontinence. These conditions include:

• Urinary tract infection (UTI)
• Constipation
• Painful infection of the prostate gland known as Prostatitis
• Multiple Sclerosis, Parkinson’s disease or stroke
• Kidney or bladder stones
• Blockage from prostate cancer or benign prostatic hyperplasia (BPH)

Overflow Incontinence in men may be caused blockage of the urethra from BPH or prostate cancer. 

Other causes may include:

• Stricture – narrowing of the urethra
• Medicines such as antihistamines and decongestants
• Diabetes, multiple sclerosis or other nerve conditions

Many people, men included, may have more than one type of incontinence and each type may have an additional cause. There are many products available that are designed specifically for use with Male Incontinence. Click here to see all products specifically designed for men that are dealing with incontinence.

Drugs that Contribute to Urinary Incontinence

Urinary incontinence is often the result of medicines being taken for other health issues. These medicines may cause incontinence or worsen existing incontinence. If you suspect you are experiencing incontinence or worsening incontinence it is very important to consult your physician to determine next steps. Never stop taking medicine without consulting your doctor.

When considering medication induced incontinence be sure to think of both prescription medicines and any over-the-counter medicines you may be taking. 

Here are some common drugs that may worsen or cause urinary incontinence:

High Blood Pressure Medicines

These drugs include alpha-adrenergic antagonists or alpha-blockers including Cardura, Minipress, Hytrin, doxazosin mesylate, prazosin hydrochloride and terazosin hydrochloride. These drugs work by dilating blood vessels to reduce blood pressure. In doing this they may also relax the bladder along with the blood vessels. 

They are some times prescribed to men to help with urinary problems such as enlarged prostate, benign prostatic hyperplasia (BPH). Alpha-blockers help relax the muscles in the bladder neck which allows urine to flow more easily and improving symptoms of BPH.

These drugs may lead to stress incontinence, which is leakage that occurs during strain such as sneezing, laughing, coughing, or physical exercise.

Antidepressant Drugs 

Antidepressant drugs may worsen incontinence in some people. These drugs include Nopramin, Cogentin, Haldol, Risperdal, Elavin, Prolixin (fluphenazine), Hadol (haloperidol), nortripramine, amitriptyline, desipramine, benztropine, halperidol, and risperidone.

These drugs can impair the ability of the bladder to contract resulting in an inability to empty (or void) the bladder completely. This may lead to overflow incontinence. Some antidepressant drugs may decrease your awareness of the need to go to the bathroom until it is too late to get to the toilet.

Diuretics

Diuretics are also known as water pills. They work in the kidneys to reduce blood pressure by flushing excess water and salt out of the body. Essentially, they cause the body to produce more urine. This translates to more trips to the toilet and possible worsening of incontinence. 

These drugs include any medicine prescribed as a diuretic including Bumex, Lasix (Furosemide), Aldactone, bumetanide, Hyrdodiuril (Hydrochlorothiazide HCTZ), Maxzide (HCTZ - triameterene), spironolactone, furosemide, theophyline and hydrochlorothalizide (and other “thalazides” which are common medications for hypertension).

Sleeping Pills 

Sleeping pills may create a problem for those with incontinence at night because the user don’t or can’t wake up when their bladder is full. These drugs include any sedative or sleeping aid that relaxes muscles and make you sleeping including Ativan (lorazepam), Valium (diazepam), Lunesta, Ambien, Librium (chlordiazepoxide), diazepam, flurazepam, lorazepam, eszopiclone and zolpidem. 

These drugs slow reflexes which may result in not recognizing the signal that it is time to go. They may put you in such a deep sleep that you miss the body alert to get up and use the toilet. Bed wetting effects approximately 10% of people with incontinence. 

Hormone Therapy Drugs

Hormone therapy including oral estrogen-only or combination estrogen and progesterone pills may cause or worsen urinary incontinence. At one time it was thought that these medicines helped incontinence symptoms, but they are now known to trigger or worsen both stress and urge incontinence. 

Decongestants and Antihistamines

These drugs may contain pseudoephederine which may tighten the urinary sphincter causing urinary retention. These drugs include Sudafed, Contac, Benadryl pseudoephedrine, and diphenhydramine.

For women this is frequently followed by sudden overflow incontinence. However, men who have leakage after prostate surgery may be using these drugs to temporarily clamp down on the bladder muscles to help prevent bladder leakage. 

Narcotics and Painkillers

These drugs are opium based painkillers that may interfere with the bladder’s ability to contract fully. This can lead to urine retention and overflow incontinence. They may also cause constipation and studies show that constipation desensitizes the bladder and worsens urge incontinence. These drugs include any opium-based pain medicine including OxyContin, MS-Contin, Oramorph, Percocet, Demerol, codeine, morphine and oxycodone.

Understanding that these types of drugs may cause or worsen incontinence is a key to opening a dialog with your doctor. Under the doctors supervision changes to drugs, behavior or physical activity amy help improve your condition. Being prepared for this conversation will help the dialog be open and beneficial as it is often uncomfortable. Keep in mind the following when speaking with your doctor:

• How long ago/ when did the incontinence begin?
• Did you have incontinence before taking these medicines? Was there a change? 
• What drugs are you taking (prescription and over-the-counter) and when did you start taking them? 

Please realize that there are many drugs that may not have been included on this list that may cause or contribute to urinary incontinence. It is very important to speak with your doctor about all medications you take in order for them to identify best options for your optimal care. 

What is Incontinence?

Incontinence is the involuntary loss of bladder and/or bowel control. Loss of bladder control is also known as urinary incontinence and loss of bowel control is also known as fecal incontinence. It is a common problem the effects both men and women of all ages. 

There are many causes of incontinence including surgery, child birth, menopause, birth defect, injuries to areas such as pelvic area or spine, disease, infection, certain medications, and chronic conditions such as asthma, diabetes or arthritis. Certain beverages including alcohol or caffeinated drinks may also contribute. In this article we will focus on urinary incontinence.

Urinary incontinence is almost always a result from an underlying medical condition. Incontinence can occur when any part of the urinary system malfunctions or is compromised. Urinary incontinence can range in severity from drops or small leaks to complete loss of bladder control. This system includes the kidneys, ureters, bladder, sphincter and urethra. In the normal situation the bladder will store urine until it is time to urinate or void the bladder. Urinary incontinence can happen when any part of the urinary system is not functioning correctly.

Voiding or void is a medical term often used to describe the process of urination i.e. voiding the bladder. Some individuals may not be able to void completely which can also cause problems such as bladder infection. This is often found with people that have certain diseases or spinal cord injuries. 

The types of urinary incontinence are - stress incontinence, urge incontinence, overflow incontinence, & functional incontinence. Here is a brief description of each:

Stress Incontinence - may happen when there is an increase in abdominal pressure from situations such as laughing, exercising, sneezing, or coughing. The urine leaks due to weakened pelvic floor muscles and tissue. This may be caused by childbirth, being overweight or obese (bariatric), having had prostate surgery, and certain medications. 

Urge Incontinence - also known as overactive bladder. This is the incontinence that describes when there is a sudden urgent need to urinate and not having time to get to the bathroom or toilet. This type of incontinence is often caused by damage to the bladder’s nerves, damage to the nervous system or damage to muscles. Conditions such as multiple sclerosis, Parkinson’s disease, diabetes and stroke can affect nerves resulting in urge incontinence. There other other conditions that can lead to urge incontinence such as bladder infections, bladder stones, and use of certain medications. 

Note: some women have both stress and urge incontinence which may be referred to as “mixed urinary incontinence”

Overflow Incontinence - this type of incontinence that describes when a person is not able to empty their bladder completely and as a result may experience leakage when the bladder is full. This is something that many men experience in the form of frequent dribbling of urine.  Overflow Incontinence is caused by weak bladder muscles, blockage of the urethra cause by situations such as an enlarged prostate, tumors and constipation. 

Functional Incontinence - incontinence caused by physical problems such as arthritis or cognitive problems. The problems such as dementia may prevent a person from getting to the bathroom in time. 

Many more women experience urinary incontinence than men, but it does still effect men. Since there are many possible causes of incontinence it is important to obtain a medical diagnosis to determine possible treatment options. Many times urinary incontinence can be cured or improved so it is important to consult with your doctor. For example, sometimes changes to diet, behavior, or medicines or diet can help improve the situation. Any changes that are made to any of these, especially medicine should be done only under the care and supervision of your doctor. 

In some cases surgical treatment may be performed after receiving a medical evaluation and exhausting nonsurgical treatment options. 

During evaluation and treatment there are many options for products to help manage and maintain comfort, health, dryness and dignity. These products include garnets such as adult diapers, protective pull up underwear and underwear pads and liners. Click on this link of you would like to check out any of the large variety of incontinence products available on our web site. 

Caregiving by Family Members of Incontinent Adults in the US

More and more family members are becoming the primary caregiver of incontinent adults. Taking care of an incontinent adult can be difficult for both patient and caregiver. There are many product decisions, living environments, and paid levels of care available - but the ongoing question is where does one start if they are providing care to an adult that is dealing with some level of incontinence.

This is especially challenging in todays environment in the US in which more multigenerational families are living in the same household. In an article in “The Sensible Resurgence of the Multigenerational Home”* in Bloomberg Businessweek, a Pew Research report released in June 2014 shows a record 57 million Americans, or 18.1 percent of the population lived in a multigenerational households in 2012. Just to give you an idea, that is up from 28 million in 1980. Families may be living in the same home for many reasons - pooling finances, child care, and easy monitoring when aging parents turn frail. 

When considering this information it is also worthy to note that the CDC Vital and Health Statistics “Prevalence of Incontinence Among Older Americans”** report published in June 2014 shows that over 50% of non-institutionalized persons aged 65 and over reported a urinary leakage and /or accidental bowel leakage, 43.8% reported a urinary leakage and 17.3% reported an accidental bowel leakage. Additionally, more than one-held of noninstitutionalized women and more than one quarter of noninstitutioinalized men aged 65 and over reported a urinary leakage. 

The CDC report also showed that in older persons, incontinence is associated with multiple interacting factors, including chronic conditions such as diabetes and stroke, cognitive impairment, and mobility impairment. Bladder incontinence may be caused by conditions such as age-related changes in the lower urinary tract, urinary tract infection and conditions not directly related to genitourinary system, such as diabetes, cancer, stroke, cognitive impairment and mobility impairment. Risk factors for bowel incontinence include chronic diarrhea, inadequate fiber and water intake and chronic constipation, diabetes, stroke, neurological and psychiatric conditions, cognitive impairment and mobility impairment. Use of certain medications and polypharmacy are also associated with incontinence.  

Needs for caregiving continue to increase in the US with the population aging and more multigenerational living arrangements. For many the incontinent adult may be able to still take care of themselves and in others there may be one or more primary caregiver to make sure that the patient is cared for, comfortable, and healthy. 

These two reports should show that if you or someone you love is dealing with incontinence, you are not alone! Making good decisions and not allowing the situation to take over our life is the first step. If you are the caregiver, dealing with it in a matter-of-fact and direct manner showing no embarrassment yourself may help move the discussion along. Many times, a doctor may have already started this conversation and have been the first point of contact to initiate dialog and thus avoiding arguments or embarrassment. The goal of everyone involved should be comfort, discretion and honesty. This will help ensure that all the best decisions are being made and everyone stays comfortable.

If you are searching for information or details on what type of products are available and what is the best incontinence products for your situation here is a quick guide to walk you through the basics of the main incontinence products and how they might best suit your situation:

• Adult Briefs also known as Adult Diapers
• Folded piece of absorbency material that is placed between legs of wearer, drawn up and fastened at the waist.
• Works well for bedridden or individuals with limited mobility as they are easier to put on and take off
• Available in a wide range of waist sizes for adults from 20” to over 100” 
• Available in a wide range of absorbency from light to heavy/overnight 
• Protective Underwear
• Pull up style incontinence undergarment
• Pulls on and off like regular underwear
• Many have ‘“tear away” sides for easy and clean removal
• Perfect for people that have mobility and want to have a level of independence
• Available in a range of absorbencies and styles - with many looking just like regular underwear
• Available in a wide range of waist sizes from 17” to over 80”
• Bladder Control Pads and Underwear Liners also known as pads, shields and liners
• Available in a wide range of sizes, absorbencies and styles
• Available for light (drips and dribbles) to heavy /overnight levels of protection
• Can be worn in regular underwear or in special incontinence garments
• Many designed with adhesives to hold pad in place in underwear
• Available in products with moisture barriers and without depending on your needs
• Available in styles specifically for men or women and also some in unisex design
• Underpads and Bedpads
• Available in disposable or reusable/ washable versions
• Available in a wide ranges of sizes and absorbencies
• Available for use on seating or bed surfaces
• Often used in conjunction with other incontinence products to keep mattresses and linens dry

There are many incontinence products and supplies available for a wide range of incontinence situations to help you and your loved ones live a comfortable, happy and healthy life. The products available today will help people live normally and comfortable as the population ages, health issues emerge and living situations change. 

* Chris Ferrell. The Sensible Resurgence of the Multigenerational Home. Bloomberg Business Week. August 13, 2014

** Gloria Y Schappert S. Bercovitz A, et al. Prevalence of Incontinence Among Older Americans. National Center for Health Statistics. Vital Health Stat 3 (36) 2014

Causes of Female Incontinence

Whether you have been newly diagnosed, having symptoms or been dealing with Urinary Incontinence, there are so many questions needing answers.  But the number one question I’m sure of, is why? 

Urinary incontinence itself, is the accidental release of urine, it can be a short-term problem caused by a urinary tract infection, a medicine, or constipation.  These symptoms get better once treating the problem causing it. 

There are also severe types of Urinary Incontinence, ones that become more of an ongoing issue ranging from a few drops to ounces of leakage:

Stress Incontinence – It’s the most common type of bladder control problem in women.  This occurs in conditions that stretch the pelvic floor muscle (childbirth, weight gain). When these muscles can't support your bladder well, the bladder drops down and pushes against the vagina. Then you can't tighten the muscles that usually close off the urethra. So urine may leak because of the extra pressure on the bladder when you cough, sneeze, laugh, exercise or do other activities.

Urge Incontinence – is caused when the bladder muscle involuntarily contracts and pushes urine out of the bladder. This can happen even when your bladder is holding only a small amount of urine. Some women may have no warning before they accidentally leak urine. Other women may leak urine when they drink water or when they hear or touch running water. Many times doctors don't know what causes this. But sometimes the cause is:

                  

-Irritation of the bladder

-Emotional stress

-Brain conditions such as Parkinson’s disease or stroke

Overactive Bladder - is a kind of urge incontinence. But not everyone with overactive bladders leaks urine.

Overflow – Unexpected leakage of small amounts of urine because of a full bladder.

Mixed – Usually the occurrence of stress and urge incontinence together. It is common for a woman to have symptoms of both types of incontinence.

Whatever the case may be, there are products out there to help you enjoy your quality of life.

What does bariatric mean?

If I had a nickel for every time I was asked what “bariatric” means I would have a bulging pocketful of nickels that makes an awful racket when I walk.  Technically the term “bariatric” deals with the branch of medicine regarding the causes, prevention, and treatment of obesity.  While used to medically describe a patient or situation it has also been pinned to product selection for items and supplies for the comfort and care of larger people.

All that being said, when searching for incontinence products it simply describes the larger sized items for bigger individuals. This would include big briefs, adult diapers, protective pants, and protective underwear.  Generally, these products start above 60 inch and go up to 90 inches and higher.

Bariatric sized incontinence products also address the unique needs of larger people to ensure the proper fit when moving and placement and amount of the materials to wick and absorb fluids. In addition, the products often use materials and have features for additional odor control. Ultimately, the design provides for maximum incontinence protection while utilizing features to help maintain the dignity and comfort of the wearer.

If you are searching for incontinence supplies for somebody with a waist size above 60 inches using the term bariatric should help you quickly narrow down your search. We have put all bariatric specific products in an easy to find category for your shopping convenience. You will also find many standard products in extra-large sizes to accommodate your needs if you are looking for items in the 60-65 inch waist size range.

Incontinence in the US

Incontinence is often misunderstood as a condition that impact only the young and old. In reality it can impact anyone at any age, male or female. Millions of Americans deal with incontinence ranging from light to heavy and levels in between. The numbers continue to go up as the population of baby boomers ages.

One of the most common types of incontinence is "Light" urinary incontinence is commonly known as "Stress Incontinence" or "Urge Incontinence. Both of these conditions are fairly common and there are many discreet products for the individuals protection, comfort and security. Modern urinary incontinence protection products use materials that are extremely absorbent while being thin and provide maximum discretion.

Stress incontinence is when an individual has an intermittent slight leakage of urine that is often an involuntary bladder reaction to laughing, exercising, or lifting.

Urge Incontinence is an uncontrollable and intense urge to urinate. often times faster than the individual can make it to the toilet. There are many common causes such as certain medicines, caffeine, bladder infections, disease, enlarged prostates in men, pregnancy in women, spinal cord injuries (SCI), and urinary tract infections (UTI).

If you are experiencing incontinence now or have been dealing with it for a while you should seek medical advice for a doctor to ensure there are no underlying health issues that should be treated.  If you are looking for products for protection for light incontinence such as pads, liners, briefs, adult diapers, protective underwear, or bed pads then please check out the product selection at www.IncontinenceProductsPlus.com. All products are clearly identified by protection level for your convenience.