Understanding Urinary Incontinence in Adults

Urinary incontinence can be painful, embarrassing, and even debilitating. Whether it is yourself, a member of your family, or even a close friend, this is an issue many will have to deal with.

人们通常认为尿失禁只会影响老年人，但事实上，任何年龄的人都可能受到影响。由于受影响人群的多样性，潜在的病因及其治疗方法也有很大差异。

Care and nursing at home specialists, Helping Hands says, “No two people are going to have exactly the same need”, which is why it’s extremely important the care you or your loved one receive is tailored to the individual.

如果以下列出的症状看起来很熟悉，可能是时候去看医生了。

Causes of Incontinence

Urinary Tract Infections (UTIs)can affect people of all ages and are the most common healthcare-associated infection reported to the National Healthcare Safety Network. According to the World Health Organisation, around 50% of women will report having a UTI in their lifetime.

These infections can occur in any part of the urinary tract from the kidneys to the urethra and are the result of bacterial infections. If left untreated infections of the lower tract can develop into a kidney infection. Irritation in the bladder from infection can result in an intense need to urinate or incontinence.

避免尿路感染的方法是喝足够的水——每天6到8杯水——帮助排出细菌，保持膀胱健康。如果性活动频繁，在性交前后小便以减少感染的机会。注意——虽然蔓越莓汁中有一种有效成分可以防止细菌粘在膀胱壁上，但科克伦的一篇综述显示，这种流行的家庭疗法中含有的蔓越莓汁并不足以起到任何作用。

Interstitial Cystitis, or Painful Bladder Syndrome (PBS)这种疾病最早会影响30多岁的人。伴随着强烈而突然的排尿冲动，它会在排尿时和骨盆区域引起疼痛。

PBS is poorly understood, and may come and go in episodes of varying lengths. Try cutting out caffeine and alcohol, and taking measures to reduce stress. Paracetamol and ibuprofen can help to deal with the pain, and your doctor may prescribe other drugs to help counter the symptoms.

Benign Prostatic Hyperplasia (BPH) is common in men over 40, affecting roughly 20% of the population according to a study in Reviews in Urology (Roehrborn, 2005). The presence of blood in urine is a key indicator, as is a burning sensation when urinating and a frequent need to urinate. When suffering from BPH, men may struggle to fully empty their bladder, meaning the bladder takes less time to fill and they may feel the urge to urinate much more frequently.

Prostate cancer also affects urination in men, with 11.6% of men suffering at some point during their life according to the National Cancer Institute. Prostate cancer causes similar symptoms to BPH, and unfortunately treatment involves surgery, chemotherapy, or radiotherapy.

尿血和尿频可能是膀胱癌的结果。同样，它也可能需要手术、化疗和放疗。要降低患癌症的风险，避免致癌物。Smoking can increase the risk of bladder cancer two to three times.

Take these 4 Steps to keep Healthy

For anyone experiencing symptoms related to urinary incontinence, there are some simple steps you can take to try and keep your bladder healthy.

1. Switch from caffeinated and carbonated beverages to water to keep your urinary tract free from bacteria.
2. Some foods may worsen bladder conditions such as PBS, particularly acidic food. Try and avoid foods which can cause irritation.
3. 水潴留是指液体在身体某些部位积聚的情况，通常是腿部。它经常影响孕妇和老年人，并对膀胱造成压力。为了避免晚上膀胱过度活跃，白天可以四处走动或做其他运动。
4. 盆底(或凯格尔)运动可以用来加强肌肉和增加膀胱控制。这有助于防止尿漏和失禁。一些公司如“帮助之手”提供膀胱再训练和失禁援助服务。

Mental Decline and Incontinence

痴呆症是一种大脑紊乱，会影响沟通和日常活动的表现。Alzheimer’s Diseaseis the most frequent cause of dementia, causing 50-70% of cases according to the Centre for Disease Control. Other common causes include Huntington’s, Parkinson’s, and Creutzfeldt-Jakob Disease.

随着神经元的死亡，这些情况会导致大脑结构的变化。随着病程的进展，会出现排尿困难。尿失禁可能是由于个人无法正确地清洁自己而导致的频繁尿路感染，也可能是由于不良饮食或脱水引起的便秘，或者是药物的副作用。

Alternatively, urinary incontinence may occur because of neurological decline caused by dementia. Mobility can decrease as the disease progresses, making it difficult for a sufferer to reach the toilet on time. Reduced sensation can also prevent the sufferer from knowing when they need to urinate. Mental decline can lead to the individual not knowing where the toilet is, or how to use it when they get there.

How can you help someone with Dementia?

There are some steps you can take to manage the effects of dementia on urinary incontinence:

1. 1. Diet and lifestyle can be used to reduce the effects
   2. Establish routines to avoid accidents
   3. Take the sufferer to the loo after every meal
   4. Ensure they eat at regular times
   5. Avoiding drinking two hours before bed
   6. Easy to remove clothing can help those with limited mobility or their helpers

Further Information

If either you or a loved one are beginning to struggle with reaching the toilet in time, it may be time to look for external aids. Families often take on the care of a relative showing signs of decline, however, round-the-clock care can be exhausting and take up a lot of time.

There are organisations that can offer live-in or occasional care, and can often provide specialist help in dealing with conditions such as dementia. Look for companies regulated by theCare Quality Commission (CQC)and approved by your local social services.