Introduction

The urinary system consists of one pair of kidney, two ureter, one bladder and urethra (tube which carries urine out of the body). The kidney has the ability to excrete or remove the blood waste product from the blood and form urine.

The urine will flow through the ureter and store in the bladder before pass out through the urethra.

As people age, the urinary tract changes in several ways that may make controlling urination more difficult. The maximum volume of urine that the bladder can hold decreases.

Older people may be less able to delay urination after they first sense a need to urinate. The bladder muscles may contract sporadically, apart from any need to urinate. The bladder muscles weaken. As a result, more urine is left in the bladder after urination is finished.

Symptoms and Signs

“Urinary Incontinence” means the loss of control in passing urine. Common in women and as people age. As women age, the urethra (which carries urine out of the body) shortens and its lining becomes thinner. The muscle that controls the passage of urine through the urethra (urinary sphincter) is less- able to close tightly and prevent leakage.

Bladder control could be worse when aggravating factors also occur for examples :

• spinal cord injury,
• neurological disorder Multiple Sclerosis,
• Urinary Tract Infection,
• diabetes,
• cancer of bladder
• drugs ( tranquillizer / hypnotic).

There are several types of urinary incontinence based on its causes and pathology.

Signs of incontinence :

• Urine passed out /leakage when coughing, sneezing or laughing (stress incontinence)
• Frequent urination (more 8 times/day) with small volume . Sometimes, urine passed out before reaching toilet in time (urge incontinence).
• Urine passed out/leakage without urge of urination or not associated with any activity (overflow incontinence).
• Mixture of the above 3 symptoms may occur (mixed incontinence).
• Haematuria which might indicate the present of bladder cancer.

Complications

• Social isolation due to embarrassment.
• Restricted to home especially when accessibility to public toilet is difficult.
• Frequent urination may increase risk of fall.
• Disrupt sleep when frequent urination also occurs at night (nocturia).

Treatment

• See a doctor for assessment and treatment.
• Avoid taking caffeine, coffee, tea and carbonated drink.
• Avoid taking drink after 8 o’clock at night.
• For stress incontinence, practise Kegel’s exercise (pelvic muscle exercise) every day for 6 to 8 weeks to see its effectiveness.
• Use diaper when going outdoors where accessibility to toilet may be difficult.
• Take care of the private part’s cleanliness. Wash and dry it quickly when it is wet.
• Modify house so that toilet is nearby to bedroom or use commode