Frequently Asked Questions on Adult Incontinence

What is incontinence?

Urinary Incontinence is the involuntary leakage of urine. It is the inability to hold urine in the bladder because voluntary control over the urinary sphincter is either lost or weakened.

What are the common causes of urinary incontinence?

Incontinence can either be temporary and chronic.
  • Temporary incontinence is commonly caused by:
    • Childbirth
    • Limited mobility
    • Medication side-effects
    • Urinary tract infection
  • Chronic incontinence is commonly caused by:
    • Birth defects
    • Bladder muscle weakness
    • Blocked urethra
    • Brain or spinal cord injury
    • Nerve disorders
    • Pelvic floor muscle weakness

What are the different types of incontinence?

  • Stress Incontinence: It is an involuntary loss of small amounts of urine when you cough, laugh, lift or exercise. Stress urinary incontience can be caused by multiple vaginal births, enlarged prostate, pelvic trauma or loss of pelvic muscle tone. We recommend using a Bladder Control Pad or Male Guard
  • Urge Incontinence: It is an inability to control urinating once you feel the need to void. Simply, you may feel the need to urinate but cannot wait to get to the bathroom. It can be caused by Alzheimer's, Parkinsonism, enlarged prostate, spinal cord injuries or urinary tract infections. We recommend using a Bladder Control Pad or Protective Underwear.
  • Reflex Incontinence: This is frequent loss of urine with no warning. This is due to spinal cord injuries, brain tumors or strokes. We recommend using Protective Underwear or Adult Briefs.
  • Overflow Incontinence: Leakage of urine when the bladder is full. For example the person experiences dribbling, frequency, urgency and bladder distention. It is most commonly caused by diseases that cause a blockage of the natural passageway of urine. We recommend using a Bladder Control Pad or Protective Underwear.
  • Functional Incontinence: It is caused by factors outside the urinary tract, such as immobility or cognitive impairment. These individuals would be continent if the external factor were eliminated. We recommend using Protective Underwear or Adult Incontinence Briefs.
  • Mixed Incontinence: It is a combination of forms of incontinence, such as mixed stress and urge incontinence. We recommend using Protective Underwear or Adult Briefs.

What are the levels of incontinence?

  • Light Incontinence: Includes symptoms of stress incontinence and overflow incontinence. Light incontinence usually refers to leaking four fluid ounces of urine or less in one episode.
  • Medium Incontinence: Includes symptoms of overflow incontinence, where the bladder is completely full beyond capacity and four to ten fluid ounces of urine is released as the person has a sudden urge to begin urinating. Medium, also called moderate incontinence, is more fluid loss than light incontinence but not full bladder loss.
  • Heavy Incontinence: Includes total loss of voluntary urination control. Sometimes this means that the person doesn't get the feelings that the bladder needs to be emptied. This might also be constant leakage of urine. Heavy urinary incontinence typically refers to full bladder loss.
  • Overnight Incontinence: Refers to incontinence at night, and usually means full bladder loss at night.
  • Fecal incontinence or bowel incontinence: Fecal incontinence means partial or full loss of bowel control.

How do you evaluate urinary incontinence?

  • Developing a treatment plan will include your urinary pattern.
    • How frequently do you go?
    • How much do you pass?
    • What time of day are you urinating and are you waking at night to go to the bathroom?
    • What are your family history and your physical and cognitive limitations?
  • You can be tested to determine if there are potential urinary problems that are causing your incontinence. This can be determined easily by testing for blood in the urine.
  • You may also be asked to monitor your fluid intake and urine output for a period of time to identify any underlying issues.

What are the different types of disposable incontinence products?

  • Disposable Brief: These are adult dipaers with tape tabs or velcro tabs and are the most absorbent product.
  • Protective Underwear: These are a pull up style diaper but are less absorbent than disposable briefs.
  • Belted Undergarments: They are long pads with a belt that goes around the waist to hold it in place and are for urinary protection.
  • Bladder Control Pads: These are usually peanut shaped and come in different sizes and absorbencies. All have waterproof barriers. Some are just for urinary incontinence and others are for both urinary and bowel incontinence.
  • Light Pads: They are a bladder control pad used by individuals who experience light bladder leaking but who have bladder control.
  • Day Heavy Pads: They are large bladder control pads that are used during the day for both bladder or bowel incontinence.
  • Night Super Pads: They are large pads that are used at night for both bladder or bowel incontinence.
  • Shield and Guards: These are male incontinence products for capturing the dribbles and leakage and protect the skin from chaffing.
  • Bed Pads or Disposable Underpads: They are used to protect the sheets from being soiled.
  • Diaper Boosters: These are rectangular pads that can be used inside of a brief to increase absorbency. They do not have waterproof barriers or adhesive.
  • Liners: They are rectangular pads that can be used in any brief or panty and do have a waterproof barrier and an adhesive strip on the bottom.

Which pads are best for incontinence?

Incontinence pads are available in many absorbency strengths as well as regular or long lengths. Poise Pads range from very light absorbency (2), light absorbency in 3, moderate absorbency is 4, maximum is 5 and ultimate is 6. Poise Pads is made for women. Prevail and Depends Pads makes incontinence pads for men as well. They are shaped to better fit male anatomy and are available in a variety of absorbencies.

When should a brief or disposable underpants be used?

Those who have overflow or functional incontinence most often need briefs. These can be pull up or have tape/Velcro closure and are easy to remove for changing. They wick away moisture to keep skin protected and most offer odor control features. Depends is a popular brand. Reusable incontinence briefs are available by Salk for men and women. Briefs are available in different sizes. Be sure to use the manufacturer's measuring guide.

What incontinence products are available for nighttime use?

Maximum absorbency briefs should be used at night. A maximum absorbency pad can be added to the brief as well. Try Tena Night Super Maximum Absorbency Pads. Disposable under pads such as Attends Premier Overnight UnderPads or reusable pads such as Becks.

How can I protect my skin from the moisture?

Keeping the skin dry as much as possible. Change pads or briefs as often as needed. McKesson MSA Rinse Free Perineal Wash is balanced to protect the skin. I recommend applying a moisture barrier cream as well, such as 3M Durable Barrier Cream. Barrier creams are available with antifungal agents like Coloplast Baza Moisture Barrier Antifungal Cream.
How can I manage urinary odor with incontinent episodes?
Some bladder control pads or liners are manufactured with “odor-lock” technology. Always Discreet pads for women offer this technology. Other pads such as McKesson Unisex Disposable Liners use a “lock-away core” that reduces the pH of the urine, which decreases odor. Use disposable cleansing wipes such as McKesson’s StayDry Scented soft pack personal wipes with pad changes. It is recommended that incontinent pads be changed as often as needed to keep the skin dry. This will help control odor as well.
How long can a penile clamp be worn?
The penile clamp is to be used for short periods of time, unclamping every 1-2 hours to allow the bladder to empty. It should never be used 24 hours a day, 7 days a week. Long wear time can cause injury, create swelling, scarring of the urethra and breakdown of the skin. If you note swelling or skin changes, call you doctor immediately.
How does incontinence differ in men and women?
Common causes of incontinence in men are typically related to an enlarged prostate (BPH or prostate cancer), prostatitis (inflammation of the prostate) or damage of the nerves or muscles after surgery. Incontinence pads for men are shaped differently and the absorptive core is in the front of the pad. Disposable briefs or under-garments also have absorptive core placed more appropriate to the male anatomy. A condom catheter can be worn as well. This is a catheter that is worn over the penis rather than inserted and can be attached to a leg bag to hold the urine. Common causes of incontinence for women include child birth or prolapse of pelvic organs into the vagina (uterus, bladder, rectum). This occurs as a result of weak pelvic floor muscles. Incontinence pads, disposable briefs or under-garments have the absorptive core that is appropriate for the female anatomy. Other common causes that effect men and women include diseases such as diabetes, Parkinson’s disease, Alzheimer’s or weak bladder muscles.
How long can I keep a pessary in?
A pessary can be left in place for a week. It should be removed and kept out for 1 night a week. Some women will remove it nightly and replace it in the morning. Once removed, it should be cleaned with soap and water and left to air-dry overnight. Always check the pessary for cracks, tears or changes in color. Have sexual activity with the pessary may cause discomfort. It is recommended to remove it prior.
Is overactive bladder the same as urinary incontinence?
An overactive bladder (OAB) causes urgent and frequent urination. OAB can be treated with medication. Your doctor will evaluate your pelvic floor muscles to determine if you have both UI and OAB.
What causes urinary incontinence?
UI can have many causes. A urinary tract infection (UTI) can cause incontinence. Fortunately, taking antibiotics for UTI can solve the problem Taking a diuretic medication (water pill) will increase the need to urinate, sometimes causing UI. Weak pelvic floor muscles. This often occurs after childbirth Chronic constipation can contribute to UI since the same nerves that run along the rectum innervate urinary function as well. Lifestyle factors such as diet. Drinking caffeine or alcohol can irritate the bladder and cause frequent urination, along with spicy foods.
Can medication help?
Medication can help reduce bladder spasms by calming the muscles. Other medications can be injected into the bladder to decrease bladder contractions. Another medication can relax the bladder muscles, allow it to hold more urine.
What are some of the treatments for UI?
Conservative treatments include weight loss, limiting fluid intake each day and avoiding caffeine and alcohol. Physical therapy to strengthen pelvic floor muscles can help and include Kegel exercises and biofeedback.
What are the symptoms of UI?
  • Frequent urination, strong urge to void or pain with voiding.
  • Leakage of urine upon coughing or sneezing (or from any similar movement which puts pressure on the lower abdomen)
  • Waking at night to void, or leaking urine while you sleep
What can I expect when I talk to my doctor?
Your doctor will ask you about your symptoms. Describe what is happening. The doctor will take a detailed history of the problem, including diet. Keep a diary of your symptoms including how often you urinate, how urgent it feels, and how much you void each time.
A pelvic exam should be done to check for prolapse of pelvic organs or any other defect that can contribute to UI. An ultrasound or CT scan can be done along with bladder function tests to evaluate the cause.
How is incontinence diagnosed?
Once you’ve reported symptoms of incontinence, your doctor will take a history and do a physical exam. There will be a urinalysis (urine testing), and possibly other lab tests too. The doctor may also order an X-Ray or urodynamic testing.
How does incontinence relate to age?
Incontinence is not a normal progression of aging. Testing for UI is the same at any age. However, UI is more common in the elderly population.