Advanced Practice Consultant – Wound Ostomy & Continence
RN BSc(hons) MClScWH CETN(C)
Date: Jul 22, 2015
Bladder leakage (urinary incontinence)
Elderly bladder leakage is a common issue that arises as people age. The good news is that there are ways to lessen the impact of bladder leakage and there are products to keep the worry of urinary incontinence from affecting a person’s quality of life.
As a caregiver, it’s good to be informed about bladder leakage so that if the person you are caring for experiences incontinence, you’ll know how to help. Also, nothing makes a taboo topic easier to discuss than being armed with all of the information, so we’re here to help!
Understanding bladder function:
The bladder is a small muscle in the lower abdomen. It expands like a balloon as urine fills it from the kidneys. Unlike a balloon, there is no pressure, it just expands until it has reached its capacity.
Nothing makes a taboo topic easier to discuss than being armed with all of the information.
Normal bladder capacity is about two cups, but, for seniors it is often less. For someone to void (pass urine) they must relax the sphincter (ring of muscle) or valve at the base of the bladder and contract the bladder. We feel like we have to void when our bladder starts contracting, but we don’t void right away because we are able to keep the sphincter tight. When we go to the bathroom and relax the sphincter and the bladder contracts, we pass urine.
Why are people incontinent of urine?
- The bladder does not contract well and doesn’t empty completely.
- The sphincter or the pelvic floor muscle is weak and it is harder to hold the urine in.
- The bladder and sphincter do not work together and the person is either incontinent of urine or unable to void.
- Some medications make it harder to empty the bladder so there is always some urine present, and the need to void often.
- Bladder infections may cause a person to leak.
- There are several illnesses that can contribute to incontinence such as MS, Parkinson’s disease, stroke, and dementia, to name a few.
What can you do to help regain bladder control?
- Be sure to drink at least eight glasses of water a day. Some people reduce their fluids to try not to leak. The bladder does not like concentrated urine so it tries to get rid of it. This means frequent trips to the bathroom with not much passed each time.
- Limit the amount of caffeine. Coffee, tea, colas, chocolate and some other soft drinks have caffeine in them. The bladder does not like the caffeine and it tries to get rid of it. Also, the caffeine acts as a diuretic so it makes more urine and a need to void more often.
- Limit the amount of citrus juices as these also irritate the bladder.
- Make sure bowels are moved every day or every other day.
- Empty the bladder every 2-4 hours as soon as the urge is felt; it shouldn’t be put off.
- Learn to do Kegel exercises.
Products to help manage the bladder leakage.
- Use disposable incontinence products that are made to hold urine. Sanitary pads are not designed for urine leakage and will not hold it. There are several brands of products, so ask for samples rather than buy a whole package. The better products have material inside the pad that absorbs the urine and turns it into a gel. These bladder leakage products help prevent leakage and odour from urine.
Below are links to the websites of some of the main brands of incontinence products in Canada. You will be able to see some of the products that are available and each site has some helpful resources too.
- Men can wear condom catheters if needed. These are applied in a similar way to a condom, but allow for a catheter bag to be attached for collecting urine drainage.
There are several types and makes of condom catheters and so it is important to discuss the best options with a health care professional and to ensure a correct fit. The following are examples of some condom catheters that are available, the first link also has a video that demonstrates how that particular one is applied.
- Reusable bladder leakage products including pads and pants can be purchased from a home health store.
- A catheter is a last resort (unless it is an intermittent catheter used for urine retention).
The Canadian Continence Foundation can also provide some great information and resources on their website.
Speak to your Doctor about seeing a Nurse Continence Advisor (NCA) or Enterostomal Therapy Nurse (ETN) for a thorough assessment to help determine the cause of your bladder leakage, and suggest the best course of action to help manage incontinence.