Continence Facts
(information provided by SCA Hygiene Products)
Urinary incontinence
Urinary incontinence is a common symptom
involving an involuntary urinary leakage to such an extent that it becomes a social as
well as a hygienic problem (according to International Continence Society, ICS). The
definition according to the ACA (Association of Continence Advisors) is:
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| Continence is dependent on the function of the bladder
and the urethra. The bladder has the function of a container which collects the urine
under low pressure. If this does not work properly, urine will involuntary leak from the
bladder. This represents one form of incontinence. The bladder should in addition work as a pump, normally controlled by signals initiating voluntary evacuation of the bladder. If these signals cannot be, the bladder empties itself involuntarily. The urethra acts as an infection barrier at the same time as it helps maintain continence (hold the urine). Continence is regulated by muscles and nerves. The area consisting of the lower part of the bladder together with the upper part of the urethra builds the internal sphincter. There is also an area called the external sphincter muscle. These two groups of muscles are part of continence both active continence where we can control it, and passive continence which prevents us from constant leakage. Even if any one of these two groups of sphincter mechanisms malfunction, one can still be continent. |
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| The micturation center is connected to the
lower parts of urethra via the cerebral cortex of the cerebrum. The bladder is filled under low pressure. When the bladder contains approx. 2-3 dl of urine, signals are given via peripheral nerves and the introspective nerves in the spinal marrow to the centers in the brain. This is experienced as the bladder is being filled and results in urinary urge. The reflex to urinate is then initiated from the cerebral cortex, and via the extrovert nerves in the spinal marrow together with the peripher nerves, impulses are given which result in contraction of the bladder muscles and consequently the bladder is emptied. |
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Prevalence
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Stress incontinence among females Mild incontinence is treated with physical therapy, i.e. exercising the pelvic muscles, as well as with drugs. If there is reason to suspect deficient muscle function in the urethra, in cases of stress incontinence, drugs that improve this can be given. Treatment with Oestriol can be a useful complement for post-menopausal women since the urethra and vagina tissue might have become more thin and dry at this stage. More severe incontinence (leakage without physical exertion, for instance when standing up) should be treated surgically. |
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| Stress incontinence among males If leakage appears after prostate surgery due to injury to the urethral sphincter muscle, a positive effect can be achieved by exercising the pelvic muscles. If improvement is not achieved by this, an artificial sphincter muscle can be surgically implanted. |
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| Urge incontinence among females and males Urge incontinence caused by excess irritability of the bladder muscles is primarily treated with bladder exercises aiming to increase the time elapsing between bladder emptying. Other alternatives are pharmacological treatments and electro-stimulation.
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| Overflow incontinence among males An outflow obstruction is usually caused by an enlargement of the bladder due to residual urine. The patient is normally treated with catheter until kidney function and fluid balance is normal and the obstructed outflow is then removed. |
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SCA Hygiene Products
is the world leader in incontinence care products, Visit our international website at www.tena-usa.com.
SCA Hygiene Products may from time to time
substitute packaging and/or adopt Promise and TENA are registered trademarks of SCA HYGIENE PRODUCTS, AB. |
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