Urinary Incontinence in Elderly Patients: Causes and Solutions

Urinary incontinence

Hello, Doctor...
My father is 80 years old.
He had a vascular obstructive stroke six years ago.
After being discharged, his urinary function was normal.
However, in the past few months, we have noticed that whenever he feels the urge to urinate, he ends up urinating before he can reach the bathroom.

1.
What could be the cause of this?
2.
Recently, it has even become severe to the point where he only feels the urge after he has already urinated.
Is there any medication that can help improve this condition?
3.
Should we consult an endocrinologist or a neurologist?
4.
Can physical therapy help improve this situation? If so, how should it be done?
Thank you for addressing these questions.

frank, 30~39 year old female. Ask Date: 2003/11/19

Dr. Pan Zhenqin reply Urology

Your father's urinary incontinence may be due to several factors, including: 1.
Urgency urinary incontinence caused by benign prostatic hyperplasia, 2.
Coordination issues between the bladder muscles and the urethral sphincter following a stroke or due to age-related degeneration, 3.
Diminished sensation after a stroke or due to age-related degeneration, 4.
Slowed mobility after a stroke, 5.
Chronic incomplete bladder emptying leading to urinary tract infections, 6.
A complex interplay of the above issues.
Medications can help alleviate symptoms but may not completely eliminate them.
It is recommended that you take your father to a urology outpatient clinic for treatment, which should significantly improve his quality of life.
Best wishes for your and your father's health from the Urology Department of Tainan City Hospital!

Reply Date: 2003/11/19

More Info

Urinary incontinence in elderly patients, particularly those with a history of stroke, can be a complex issue influenced by various factors. In your father's case, the onset of urinary incontinence after a period of normal function may be attributed to several potential causes.

1. Causes of Urinary Incontinence: After a stroke, patients can experience changes in bladder control due to neurological damage. This can lead to conditions such as urge incontinence, where the individual feels a sudden, intense urge to urinate and may not make it to the bathroom in time. Additionally, there may be issues related to bladder overactivity, detrusor muscle dysfunction, or even cognitive impairments that affect the ability to recognize the need to urinate.

2. Severity of Symptoms: The fact that your father is experiencing incontinence even after urinating suggests a possible progression of the underlying condition. This could indicate that the neurological pathways responsible for bladder control are further compromised, leading to a lack of awareness of bladder fullness. It is essential to consult a healthcare provider to assess the situation thoroughly.

3. Treatment Options: There are several treatment options available for urinary incontinence. Medications such as anticholinergics can help manage urge incontinence by relaxing the bladder muscle. Other medications, like beta-3 adrenergic agonists, can also be effective. However, the choice of medication should be made by a healthcare professional, considering your father's overall health and any other medications he may be taking.

4. Specialist Consultation: Given your father's history of stroke, it would be advisable to consult a neurologist or a urologist who specializes in urinary disorders. A neurologist can evaluate any neurological factors contributing to the incontinence, while a urologist can assess bladder function and recommend appropriate treatments.

5. Physical Therapy: Pelvic floor physical therapy can be beneficial for some patients with urinary incontinence. This type of therapy focuses on strengthening the pelvic floor muscles, which can help improve bladder control. A physical therapist specializing in pelvic health can provide tailored exercises and strategies to help manage symptoms.

6. Lifestyle Modifications: In addition to medical treatments, certain lifestyle changes can also help manage urinary incontinence. Encouraging your father to maintain a regular bathroom schedule, limit fluid intake before bedtime, and avoid bladder irritants (like caffeine and alcohol) can be beneficial.

7. Monitoring and Follow-Up: Regular follow-up appointments with healthcare providers are crucial to monitor your father's condition and adjust treatment as necessary. Keeping a bladder diary, where you track fluid intake, urination times, and any incontinence episodes, can provide valuable information for healthcare providers.

In summary, urinary incontinence in elderly patients, especially those with a history of stroke, can arise from various causes, including neurological factors. Treatment options include medications, specialist consultations, physical therapy, and lifestyle modifications. It is essential to work closely with healthcare professionals to develop a comprehensive management plan tailored to your father's specific needs.

Similar Q&A

Managing Incontinence After Hip Surgery in Elderly Patients

Hello, Doctor: My relative is over seventy years old and recently underwent hip joint surgery due to a fall. Since then, they have experienced urinary and fecal incontinence. Although we use pads, they often pull them off themselves, causing caregivers frequent distress in cleani...

Dr. Liu Jinyong reply Family Medicine
In response to your question: There are many causes of urinary and fecal incontinence. In elderly individuals, it may be due to factors such as stroke, degenerative arthritis of the lumbar and sacral spine, vertebral compression fractures, nerve compression in the spine, inflamma...

Understanding Urinary Incontinence After Stroke: Causes and Solutions

Hello, Dr. Hsu. My mother is 67 years old and was recently hospitalized due to a minor stroke, where she was found to have hypertension. She is currently on a long-term regimen of antihypertensive medication, and her physical and mental state is unchanged from before. However, af...

Dr. Xu Wencang reply Urology
Hello, in response to your question regarding your mother's symptoms, she is experiencing stress urinary incontinence. Normally, the bladder is supported by the pelvic fascia, but after childbirth, this fascia can become lax, causing the bladder to descend when straining, wh...

Understanding Urinary Discomfort: Causes and Next Steps for Seniors

An elderly female in her 70s has been experiencing discomfort and a feeling of pressure in her urinary area, along with frequent urination and urgency since the end of last year. Although urination is normal, she feels a sense of pressure. Recently, she mentioned that there is al...

Dr. Du Mingyi reply Urology
Medications for overactive bladder may need adjustment, and a follow-up appointment with a urologist may be necessary.

Understanding Urinary and Fecal Incontinence in Older Men

An elderly male in his 60s has recently experienced issues with urinary and fecal incontinence, which he has not encountered before. He feels an urgent need to use the restroom as soon as he has the urge, or he fears he will not make it in time. Which specialist should he consult...

Dr. Ke Fangxu reply Surgery
This phenomenon is often due to insufficient sphincter strength, and a minor stroke could also potentially cause this situation. It is advisable to first consult a neurologist for evaluation. If it is solely a sphincter issue, oral medications combined with Kegel exercises can ge...