What is urinary incontinence in the elderly?

Written by Wei Zhen Xia
Geriatrics
Updated on December 27, 2024
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For elderly people with urinary incontinence, such as elderly men, the main cause is benign prostatic hyperplasia. Due to the enlargement of the prostate, there is an obstruction at the bladder outlet, which increases the resistance during urination. Urine is not completely expelled and accumulates in large amounts within the bladder. When the pressure reaches a certain level, urinary incontinence occurs. For female patients, the main cause is usually an acute urinary system infection, resulting in localized infections that stimulate the bladder's detrusor muscle, causing it to contract involuntarily and, consequently, leading to urinary incontinence.

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Written by Chen Feng
Urology
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What is the difference between genuine urinary incontinence and pseudo urinary incontinence?

Genuine urinary incontinence generally occurs due to incomplete closure of the urethral sphincter, or due to insufficient urethral closure pressure. As a result, patients will show continuous leakage of urine from the urethra or involuntary urine discharge from the urethra when there is an increase in intra-abdominal pressure, such as during sneezing, coughing, or performing strenuous physical activities. Genuine urinary incontinence includes both continuous and stress urinary incontinence. Pseudo urinary incontinence is generally due to urethral stricture, commonly seen with conditions such as prostatic hyperplasia or urethral stones. The urethral stricture prevents urine from being expelled from the bladder. When the bladder becomes overly full, urine overflows through the urethra, a condition also known as overflow incontinence.

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Written by Chen Feng
Urology
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How to care for incontinence-associated dermatitis

The care for incontinence-associated dermatitis primarily involves keeping the affected skin clean and dry. It is important to avoid skin contact with urine as much as possible. If the skin does come into contact with urine, it should be washed promptly and kept clean and dry. If there is itching or discomfort at the site of the dermatitis, topical corticosteroid ointments may be used to alleviate the itching. Some patients might also develop infections, typically bacterial, which can be managed with antibiotics. For patients with recurrent dermatitis, considering bladder fistulation or other treatment methods might be necessary to prevent skin contact with urine.

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Written by Chen Feng
Urology
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Is minimally invasive sling surgery for urinary incontinence permanent?

Minimally invasive sling surgery is generally suitable for patients with stress urinary incontinence. This surgery is usually not permanent, and its specific name is tension-free urethral suspension. It is used to increase the closure pressure of the urethra. Therefore, when the intra-abdominal pressure increases, the increased urethral closure pressure can prevent urine leakage. This surgery is one of the more common surgeries in clinical practice, but over time, various complications related to the surgery tend to increase. Common surgical complications include difficulty urinating, bladder perforation, and corrosion of the vaginal or urethral sling. Over time, the probability of corrosion gradually increases.

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Written by Wang Shuai
Urology
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What are the symptoms of urinary incontinence?

Urinary incontinence mainly refers to the uncontrolled flow of urine from the urethral opening. There are several types of urinary incontinence, including stress incontinence, urge incontinence, overflow incontinence, tension incontinence, and neurogenic incontinence. Stress incontinence, commonly seen in women who have given birth, mainly refers to the leakage of urine from the urethral opening during actions that increase abdominal pressure, such as coughing, jumping rope, or sneezing. Urge incontinence is commonly seen in acute cases of bladder inflammation, where the inflammation stimulates the bladder, causing the patient to have a strong urge to urinate, thus losing control over urination, with urine flowing out from the urethral opening. Neurogenic incontinence is due to nerve damage, such as after spinal injury, leading to loss of bladder and urinary muscle function, causing urine to continuously flow out from the urethral opening.

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Written by Zhao Li Li
Obstetrics
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Why do lactating women experience urinary incontinence?

Under normal circumstances, postpartum women might experience mild urinary incontinence due to incomplete recovery of pelvic floor muscle function, which is within the normal physiological range. If urinary incontinence persists throughout the entire breastfeeding period, it is considered that there may be an abnormal illness. Due to the stimulating effect on the pelvic muscles during childbirth, it is easy for the pelvic floor muscles to become relaxed. If not properly repaired after childbirth, this can lead to urinary incontinence. Persistent urinary incontinence may affect normal life and work, requiring timely medical consultation and examination. If there are no other ways to improve, surgical repair treatment might be necessary.