RISK FACTORS FOR URINARY INCONTINENCE

A number of risk factors for incontinence may increase a person’s chances of having urinary incontinence.

These include the following:

• Some illnesses affect the way the bladder works or interfere with a person’s ability to think. Examples of such conditions are stroke, diabetes, multiple sclerosis, Parkinson’s disease, and Alzheimer’s disease.
• Age. As a person ages, bladder muscles may weaken. In elderly men, enlargement of the prostate gland can lead to incontinence. The lack of estrogen experienced by women who have gone through menopause may make them more prone to incontinence.
• Some medications can cause incontinence or make it worse. Medications taken to rid the body of excess fluid may make a person need to go to the bathroom more often or with sudden urgency. Others taken for mental illnesses sometimes cause incontinence. Caffeine, found in coffee, tea, colas, chocolate, and some weight loss products, can make incontinence worse.
• Weakened bladder muscles and weakened muscles that surround the bladder make a person more likely to be incontinent. Obesity, injury, pregnancy, and childbirth are some of the conditions that can cause this weakness.
• Certain types of infections, such as kidney or bladder infections, increase the risk of incontinence.
• Sometimes people are incontinent because they cannot get to a bathroom fast enough. People with difficulty walking may not be able to get to the bathroom in time.

GETTING A HISTORY

Anyone who wants to know the risk factors of incontinence should have a thorough examination by a doctor who is very knowledgeable about incontinence.

Some types of doctors who may be able to help people with bladder problems include:

Urologist: a doctor who specializes in problems of the urinary system

Gynecologist: a doctor who specializes in women’s health

Obstetrician: a doctor who specializes in childbirth

Family practice and internists: doctors who help patients with many different kinds of problems, including bladder problems

Some nurses and other healthcare workers also specialize in providing care to clients with incontinence. These professionals have special training and/or experience in working with clients who are incontinent. They are also very knowledgeable about the causes and treatment options for incontinence.

A healthcare professional will need a thorough history of a person’s bladder problems. You may be asked to provide any of the following information about the person in your care as part of an overall assessment about the the risk factors of incontinence: (For our purposes, we’ll assume the person is female.)

• When does the incontinence occur? During the day? At night?
• What is the person doing when she is incontinent? Coughing, laughing, exercising, or sneezing?
• How often does she pass water each day?
• How many times does she wake up at night to go to the bathroom?
• Does she feel an urgent need to rush to the bathroom?
• Does she have difficulty starting to make the urine flow?
• After going to the bathroom, does she feel as if her bladder is empty?
• Does she have to strain or push to start urine flowing?
• Does she feel pain or a burning sensation when passing water?
• Does her urine smell unpleasant?
• Is the urine an unusual color? Is there blood in it?
• How many times a day does she experience incontinence?
• When did the incontinence first start? How long has it been going on?
• How much urine comes out when she is incontinent? A few drops? A great deal?
• How many cups of fluid does she drink each day?
• What kinds of liquids does she drink? Do the liquids have a lot of caffeine in them?
• What medication is she taking? This includes prescription drugs, medications bought over-the-counter, vitamins, herbal supplements, and weight loss products.
• Does she have trouble walking? Is it hard to get to a bathroom? Is undressing difficult?

The answers to these and other questions, along with physical examination results, should help to identify the type of incontinence the person is experiencing and its cause.