Urinary incontinence self-care

by | Pharmacy Care, Women's Health

General Information

Urinary incontinence, or loss of bladder control, is when urine accidentally leaks from your bladder. The amount of urine that leaks can range from just a few drops up to the entire contents of your bladder.

Urinary incontinence is a common problem. One in 3 women who have had a child and one in 10 men will have some type of incontinence problem during their adult lives.

The muscles that help keep urine in your bladder are the pelvic floor muscles and urethral sphincter. Pelvic floor muscles help hold all your pelvic organs in their correct positions. When they are strong, your urethra and bladder cannot move out of place. This helps keep your urethra closed, so urine cannot leak from your bladder.

The urethral sphincter is a band of muscles around the urethra (the tube that takes urine from your bladder to outside your body). When these muscles are strong, they squeeze tightly and keep urine in your bladder, and relax when you want to pass urine.

Urinary incontinence can cause skin rashes and irritation from urine being in contact with your skin. This can increase your chances of getting a urine infection. It can lead to emotional and social problems if you are not able to continue with your normal daily activities.

Common bladder control problems include stress incontinence, urge incontinence, overflow incontinence and functional incontinence. These are discussed in more detail below.

Stress incontinence

This is when your bladder leaks due to physical pressure, usually from lifting, exercising, coughing, sneezing or laughing. It happens when you have a weak pelvic floor or weak urethral muscles, and is most noticeable with a full bladder. Causes of stress incontinence include pregnancy and childbirth, menopause, constant coughing, lots of heavy lifting, being overweight, straining to empty the bladder or bowel, ageing and a general lack of fitness.

Urge incontinence

This is when there is a sudden, strong urge to pass urine and you cannot stop from leaking urine before you get to the toilet. You may also feel the need to urinate more often, including at night, even though your bladder is not full. This is known as an overactive bladder. It is more common in the older generation and causes include urine infections, stroke, Alzheimer’s disease, Parkinson’s disease, diabetes, certain medications and prostate problems.

Overflow incontinence

This happens when your bladder cannot fully empty itself. This means it becomes too full, causing it to overflow and regularly leak or dribble small amounts of urine. Many people complain of a sense of incomplete emptying and a need to strain to pass urine. Causes include prostate problems, diabetes and certain medicines.

Functional incontinence

This is when you don’t recognise that you need to go to the toilet due to certain health problems such as dementia, poor mobility and dexterity. Toilets may also be inaccessible and may contribute to patients not reaching them in time.

See Your Pharmacist or Medical Professional

It is a good idea to seek help from a health professional if you have bladder control problems.

This is particularly important if:

  • you are experiencing bladder control problems which are interfering with your lifestyle or health
  • you need to get up frequently during the night to go to the toilet
  • you have symptoms of a urine infection, such as pain or discomfort when passing urine, cloudy or bad-smelling urine, a raised temperature or abdominal pain
  • your bladder control problems started after a trauma, such as a fall
  • there is blood in your urine
  • your bladder control problems began after starting a new medicine

Treatment Tips

  • bladder control problems are not a normal or inevitable result of giving birth or of getting older; they can often be cured or managed with correct medicines or products
  • before seeing your doctor keep a ‘bladder diary’ to record when and how much leakage occurs, how often you need to go to the toilet, how much urine you pass and how much fluid you drink
  • drink between 1.5 to 2 L of water per day to avoid dehydration (unless on a fluid restricted diet as advised by your doctor)
  • identify and avoid triggers that make your bladder control problems worse, such as spicy foods, caffeine and alcohol
  • constipation can make bladder control problems worse; see your pharmacist for advice
  • avoid heavy lifting (or use correct techniques)
  • try to keep to a healthy weight and exercise regularly
  • go to the toilet only when you need to
  • pelvic floor muscle exercises can be used to tighten and strengthen pelvic floor muscles to reduce stress incontinence; ask your health professional for advice
  • bladder training can be helpful for urge incontinence, and it involves gradually increasing the time between feeling the need to pass urine and actually going to the toilet. Ask your health professional for advice
  • surgery is sometimes an option for treating urinary incontinence, particularly when other treatments have been unsuccessful
  • the Continence Foundation of Australia runs the National Continence Helpline (1800 330 066)

Treatment Options

Incontinence pads and pants

e.g. MoliCare, MoliMed, MoliForm, TENA, Poise, Depend, Carefree Plus

  • a wide range of disposable incontinence pads and absorbent underpants are available for men and women
  • they come in different absorbencies for different amounts of urine leakage
  • they are designed to minimise contact between urine and skin, and help reduce skin irritation
  • washable, reusable products are also available
  • menstrual pads are not recommended for urine incontinence because their absorptive capacity is low and they become lumpy and leak when sodden.

Barrier products

e.g. silicone barrier creams or barrier films (Egozite range, Silic 15)

  • silicone barrier creams or barrier film products can be applied to the skin to provide a protective layer, preventing urine from irritating the skin

Oral medication

e.g. darifenacin (Enablex), oxybutynin (Ditropan Tablets, Oxybutynin Sandoz, Oxybutynin Winthrop, Oxytrol Transdermal patch patches), propantheline (Pro-Banthine), solifenacin (Vesicare), tolterodine (Detrusitol)

  • these medicines can be prescribed by your GP to help with urge incontinence
  • they are unsuitable for people with some medical conditions
  • they can cause side effects such as dry mouth and blurred vision

e.g. oestrogen therapy (tablets, vaginal creams, pessaries, skin patches)

  • oestrogen therapy may help to manage stress or urge incontinence in women after menopause. However, there are risks as well as benefits, and you should discuss these with your GP

More Information

Availability of medicines

  • GENERAL SALE available through pharmacies and possibly other retail outlets.
  • PHARMACY ONLY available for sale through pharmacies only.
  • PHARMACIST ONLY may only be sold by a pharmacist.
  • PRESCRIPTION ONLY available only with a prescription from your doctor or other health professional.

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