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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Written by Wang Shuai
Urology
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Stress urinary incontinence clinical manifestations

The primary clinical manifestation of stress urinary incontinence is the leakage of urine from the urethra when sudden increases in intra-abdominal pressure occur, such as laughing, sneezing, or coughing. This condition is commonly seen in women who have given birth. It is mainly caused by the relaxation of the urethral sphincter and pelvic floor muscles after childbirth. The more childbirths a woman has, the higher the frequency of stress urinary incontinence. For mild symptoms, improvement can be achieved through pelvic floor muscle exercises. If necessary, medications such as Midodrine Hydrochloride tablets can be taken orally. For severe symptoms, surgery is recommended. (Medication should be used under the guidance of a doctor based on specific circumstances.)

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Written by Chen Tian Jing
Colorectal Surgery
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What medicine to take for fecal incontinence?

There are many causes of fecal incontinence, and it is first necessary to further clarify the cause. Most cases of fecal incontinence are mainly due to excessive relaxation of the local anal sphincter or damage to the patient's nervous system, thus requiring oral medication to treat the nervous system. When there is relaxation of the local anal sphincter, simply taking oral medication does not have significant local therapeutic effects. The most effective method is to directly perform a sphincter tightening surgery. After the local sphincter is tightened surgically, it can control the excretion of feces, thereby further alleviating the situation of fecal incontinence. If the patient also has a neurological disorder, it is necessary to actively treat the underlying disease. (The use of medications should be done under the guidance of a doctor.)

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Written by Chen Tian Jing
Colorectal Surgery
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What department should I go to for fecal incontinence?

If there is fecal incontinence, it is first necessary to determine the cause. If the incontinence is due to general neurological symptoms and neuropathy, then it is necessary to register for a neurology department consultation. If it is due to relaxation of the local anal sphincter, then registration with the proctology department is needed. Generally, for local sphincter relaxation causing fecal incontinence, an anal sphincter tightening procedure can be opted for, to provide local symptom relief. Additionally, it is important to also consider coordinating with traditional Chinese medicine enemas, which can enhance the mucosa within the rectum.

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Written by Zhang Lu
Obstetrics
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How to recover from urinary incontinence after natural childbirth

Vaginal delivery refers to childbirth through the vagina, and while it has many benefits, it also has certain drawbacks. The biggest disadvantage is that it can cause damage to a woman's pelvic floor, leading to conditions such as uterine prolapse and bladder prolapse, which manifest as urinary leakage or incontinence. If urinary incontinence occurs after vaginal delivery, it can be addressed through the following methods: First, one can perform Kegel exercises at home. Kegel exercises are a set of movements that contract the muscles of the pelvic floor, which can help alleviate urinary incontinence, though the effect may be weak. Second, for patients with significant urinary leakage or incontinence, it is recommended to seek hospital treatment with machine-assisted therapy, primarily using electrical stimulation of the pelvic floor muscles to promote contraction and improve symptoms of incontinence. Third, if the above methods are ineffective, an evaluation of pelvic floor function should be conducted, and if necessary, pelvic floor repair surgery should be performed.

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Can fecal incontinence be recovered?

If fecal incontinence occurs, the first step is to identify the main cause of the fecal incontinence. If it is caused by relaxation of the anal sphincter and anal canal, then surgery can be performed to tighten this area, specifically through an anal tightening procedure, which can restore control over fecal incontinence. If the patient has other underlying diseases or is elderly and frail, accompanied by changes in the nervous system, the symptoms of fecal incontinence may be alleviated through medication or physical therapy, but complete recovery is unlikely. This is because the recovery of the nervous system requires the integrated regulation of other bodily organs and functions. If there are multiple underlying diseases or if the patient is elderly and frail, especially in the later stages of coma, recovery is difficult.