URINARY INCONTINENCE IN THE ELDERLY
When elderly people become incontinent of urine, this is usually assumed to be permanent. Such pessimism, however, is unjustified since about 80-90 percent of these cases can be cured, the Annals of Internal Medicine (104:429) points out. Even the incontinence that follows a stroke can, in many instances, be overcome.
Before anything can be done, though, the patient must be seen by a physician who has special training (usually a geriatrician or urologist) to have the cause of the incontinence correctly determined. Some cases, of course, are “surgical” and can be cured with an operation for such things as prostate enlargement or a uterus that has slipped down out of place. For patients not needing surgery, treatment with an appropriate medicine, biofeedback, or habit training cures over 70 percent.
Older people whose incontinence is caused by muscular weakness can do a lot to help themselves with exercises that tone up the muscles of the pelvic floor. The exercises involved tightening and relaxing the muscles repeatedly for 15 minutes three times every day, the U.S. Pharmacist (12#8:92) reports. By stopping and starting the flow of urine, victims of incontinence can learn to identify those muscles that need to be strengthened. The same muscles control the passage of stools. Identical exercises, incidentally, are employed by women after childbirth to tone up muscles that support the uterus. To do any good, these exercises need to be performed three times every day for at least three months. Victims of incontinence should be aware of the fact that both constipation and alcohol can interfere with the function of the pelvic floor muscles. They should also avoid drinking coffee, tea and grapefruit juice, all of which can suddenly increase the need to pass more urine. Cranberry juice is a useful substitute.
In addition, they should routinely empty the bladder before and after every meal and at bedtime, even if they feel no need to do so. They should always respond promptly to the urge to urinate, and must never ignore it. In a few cases, surgical repair may be required, especially if the bladder has become displaced by repeated childbirth or by removal of the prostate.
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