Functional Urinary Incontinence

What is functional urinary incontinence?

Urinary incontinence is loss of bladder control. It becomes more common as people get older. Functional incontinence occurs when a person is unable to reach the bathroom in time to urinate because of physical or mental problems such as:

arthritis or other problems that delay removal of clothing before urinating
not being able to move fast enough due to using crutches or a walker
problems with reasoning, such as dementia, that may keep people from realizing they need to urinate.

It may be temporary or permanent.

How does it occur?

Functional incontinence in older people may be caused by:

stroke
Parkinson's disease
Alzheimer's disease
injury to the brain
dementia or mental impairment
severe depression
chronic heart failure
diabetes
medicines that increase output of urine, such as diuretics (water pills) used to treat high blood pressure
atrophic vaginitis (thinning and irritation of the vaginal tissues) in older women
constipation (pressure from large or hard stools)
decreased physical activity that may come with failing health and aging.

What are the symptoms?

Symptoms include:

constant leaking of urine
inability to hold urine long enough to get to the toilet
smell of urine on clothes and in the house.

How is it diagnosed?

Your health care provider will take a careful medical history and examine you. Blood and urine samples will be checked for infection or other problems. You may be referred to a urologist for further investigation and treatment.

How is it treated?

The problem that causes functional incontinence can sometimes be corrected. If arthritis makes removing clothing difficult, it helps to wear clothing that is easy to remove. If medicines cause a problem, your health care provider may be able to prescribe different medicine. Constipation may be helped by eating more fiber and getting more exercise.

How can functional urinary incontinence be managed?

Caregivers often express their frustration: "If only he would tell me sooner..." or, "If only she could move more quickly..." The person's problem, however, is not lack of time to get to the bathroom. The problem is that the person cannot control his or her bladder. The best solution is for the caregiver to learn how to manage the problem effectively.

Bladder Training: Bladder training can do a lot to ease the problem. Bladder training is used successfully in many nursing homes to manage incontinence. The aim of bladder training is to empty the bladder on schedule, rather than waiting for the person to feel an urge. For example, someone with this problem might sit on the toilet 20 to 30 minutes after each meal, at least twice between each meal, and before going to bed. You can adjust the schedule as you learn the frequency that works best. You can even set a timer to remind you when bathroom visits are due.

Incontinence pads and adult diapers: Even with bladder training, disposable incontinence pads or adult diapers can help prevent accidents between bathroom visits. Always change wet pads or diapers. Keep the groin area as clean and dry as possible.

Urine collecting devices: In some cases a collecting device can be fitted over the penis. Catheters can be inserted into the bladder so that it can be mechanically drained on schedule, but this is usually a last resort.

Other practical considerations:

Arrange for the person to be within easy reach of a bathroom.
Have a night-light and grab bars in the bathroom to help prevent falls.
Don't cut back on fluids. Don't try to control urinary incontinence by cutting back on fluids. It won't help and may even be harmful.

National Association for Continence
P.O. Box 8310
Spartanburg, SC 29305
800-BLADDER (252-3337)
Web site: http://www.nafc.org
Education, advocacy, and support to the public and health professionals about the causes, prevention, diagnosis, treatment, and management alternatives for incontinence

The Simon Foundation for Continence
P.O. Box 835
Wilmette, IL 60091
800-23SIMON (237-4666)
Web site: http://www.simonfoundation.org
Information on incontinence in books, on tape, and via newsletter

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File URI5354F.HTM Release 9.0/2006