Functional Urinary Incontinence

What is functional urinary incontinence?

Urinary incontinence is a loss of bladder control. It becomes more common as people get older. Functional incontinence happens when you are unable to reach the bathroom in time to urinate because of physical or mental problems such as:

• arthritis or other problems that make it harder for you to remove your clothing before urinating
• not being able to get to the bathroom quickly because you are using crutches or a walker
• problems with reasoning, such as dementia, which may keep you from realizing that you need to urinate.

The problem may be temporary or permanent.

How does it occur?

Functional incontinence in older people may be caused by:

• stroke
• Parkinson's disease
• Alzheimer's disease
• injury to the brain
• dementia or mental impairment
• severe depression
• chronic heart failure
• diabetes
• medicines that affect mental status, such as sleeping pills, or increase the amount of urine your body makes, such as diuretics (water pills) used to treat high blood pressure
• atrophic vaginitis (thinning and irritation of the vaginal tissues) in older women
• constipation (pressure from large or hard stools)
• decreased physical activity that may come with failing health and aging.

What are the symptoms?

Symptoms include:

• constant leaking of urine
• inability to hold urine long enough to get to the toilet
• a smell of urine on your clothes and in the house.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Samples of blood and urine will be tested. You may be referred to a urologist for further investigation and treatment. (A urologist is a doctor who specializes in disorders of the urinary tract in both men and women and in the reproductive tract of men.)

How is it treated?

The problem that causes functional incontinence can sometimes be corrected. For example, if arthritis makes it harder to remove clothing, it helps to wear clothing that is easy to remove. If medicines cause a problem, your healthcare provider may be able to prescribe different medicine. Constipation may be helped by eating more fiber and getting more exercise.

Other ways to manage incontinency are:

• Bladder training (timed voiding): Bladder training can do a lot to ease the problem. The aim of bladder training is to empty the bladder on schedule, rather than waiting until you feel an urge. For example, you might sit on the toilet 20 to 30 minutes after each meal, at least twice between meals, and before you go to bed. You can adjust the schedule as you learn the frequency that works best. You can even set a timer to remind you when bathroom visits are due.
• Incontinence pads and adult diapers: Disposable incontinence pads or adult diapers can help prevent accidents between bathroom visits. Always change wet pads or diapers. Keep the groin area as clean and dry as possible.
• Urine collecting devices: In some cases a collecting device can be fitted over the penis. The device is called a condom catheter. Catheters can be inserted into the bladder so that it can be mechanically drained on schedule, but this is usually a last resort.

Other practical considerations are:

• Find ways to stay within easy reach of a bathroom.
• Have a night-light and grab bars in the bathroom to help prevent falls when you are in a hurry.
• Don't try to control urinary incontinence by cutting back on fluids. It won't help and may even be harmful.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File urin5354.htm Release 13/2010