What to do about urinary incontinence in dementia in the elderly?

Written by Zhang Hui
Neurology
Updated on September 24, 2024
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Dementia in the elderly is a degenerative neurological disease, and there are currently no particularly effective treatments. In the later stages, it is very common for the elderly to experience urinary incontinence. This is mainly because in the later stages, the autonomic nervous system is affected. Damage to the autonomic nerves leads to dysfunction of the sphincter muscles, resulting in urinary incontinence. Currently, there are no particularly good treatments for urinary incontinence caused by dementia, but some common methods are as follows. First, it is important to kindly remind and encourage the elderly to go to the bathroom frequently, asking every one to two hours whether they feel the need to urinate, which can help avoid urinary incontinence. Second, bathrooms must have conspicuous signs that are prominently placed to help the elderly locate the restrooms easily. Third, when necessary, the elderly can be given diapers to wear to avoid embarrassment from wetting their pants. Also, it's crucial to provide psychological comfort to the elderly and avoid causing them excessive psychological burden. Additionally, other causes must be ruled out. If there is a urinary tract infection or some other urinary system disease causing the incontinence, treatment of the primary disease should be undertaken.

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What are the clinical manifestations of urinary incontinence?

The clinical manifestation of urinary incontinence is primarily the involuntary leakage of urine, where the patient lacks the ability to control urination. Diagnosis mainly involves reviewing the patient's medical history and a physical examination, which in most cases is sufficient to understand the type and cause of the incontinence. A urodynamic test is crucial for a definitive diagnosis. The contents of the urodynamic examination include the assessment of bladder and urethral function. If a patient exhibits the aforementioned symptoms, they should visit the urology department of a hospital for formal evaluation and treatment.

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Is it normal to have urinary incontinence with morning sickness during pregnancy?

Morning sickness and urinary incontinence are considered normal phenomena. If severe nausea and vomiting occur after pregnancy, it could increase abdominal pressure, leading to stress urinary incontinence. This condition is thought to be caused by the relaxation of pelvic floor muscles. It is crucial to actively engage in pelvic floor rehabilitation after childbirth to aid the recovery of the pelvic floor, to prevent symptoms like urinary incontinence and leakage when coughing postpartum. The best period for pelvic floor recovery is between 42 days to six months after childbirth. Engaging in pelvic floor rehabilitation during this period is beneficial for recovery. The longer the delay, the slower and more challenging the recovery will be.

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Urinary incontinence pelvic floor muscle exercise method

If you want to improve urinary incontinence through pelvic floor muscle exercises, this method is mainly suitable for mild stress urinary incontinence and is not applicable to all types of urinary incontinence. Therefore, if you want to improve urinary incontinence through pelvic floor muscle exercises, you first need to determine if it is mild stress urinary incontinence before proceeding. Usually, we choose to do anal lift exercises to improve this. The specific exercise method for anal lift exercises is to take a deep breath, lift the anus, hold for about five seconds, then relax, and continuously practice 15 times. Perform 15 times per set, about 20 sets a day, and it needs to be maintained for more than half a year to be effective.

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Can you wear diapers for urinary incontinence?

Urinary incontinence generally requires the use of diapers, as the condition is primarily caused by various pathological changes, leading to the involuntary discharge of urine from the urethra. Due to the easy infiltration of the perineum and around the urethral opening by urine, there might be occurrences of eczema or perineal infections. Wearing diapers can timely absorb the leaked urine, thereby reducing the chances of developing eczema and perineal infections. It is also necessary to actively seek the underlying cause of urinary incontinence and treat it accordingly. Common types of urinary incontinence include persistent, stress-related, overflow, and urge incontinence. By conducting thorough examinations, the specific type of urinary incontinence can be identified, followed by targeted treatment.

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What should be done about postpartum urinary incontinence in women?

Generally, women are prone to urinary incontinence after childbirth. Normally, due to the significant increase in uterine pressure during childbirth, which compresses the bladder, or damage to the anterior vaginal wall, postpartum urinary incontinence can occur. If urinary incontinence is confirmed, it is still necessary to observe temporarily. Postpartum urinary incontinence can generally last three to six months, and the bladder will recover to its pre-pregnancy state. During this period, it is best to wear thicker clothes and trousers, use a pad, and maintain cleanliness of the vulva. If the symptoms of urinary incontinence cannot be alleviated, it is still necessary to perform pelvic floor exercises or undergo symptomatic surgical treatment.