Urinary incontinence in older people is a rather unpleasant phenomenon that causes a lot of discomfort. In the presence of such a condition, involuntary release of urine from the urinary canal is observed. This phenomenon is especially common in older people who are constantly in bed for health reasons. Urinary incontinence is diagnosed more often in women over 50 years of age than in men. This is due to the peculiarities of the anatomical structure of the organs of the urinary and reproductive systems.

It is also possible to cure men using both conservative and surgical techniques. The latter are resorted to extremely rarely, as they are fraught with the progression of complications in “aged” people. Treatment with medications for urinary incontinence in older women and men is not always aimed only at stabilizing the functioning of the urinary system. It is also important to normalize the functioning of other systems and organs. Therefore, therapy is selected strictly on an individual basis, and after a full diagnosis and clarification of the cause of such a pathological condition. Urinary incontinence in the elderly can cause progression of urinary tract infections, inflammatory or ulcerative skin lesions in the perineal area, depression and social isolation.

Etiological factors

Urinary incontinence can be caused by many factors. Age-related changes in the organs of the urinary system play a major role in the progression of this condition:

• decreased bladder volume;
• decreased physiological ability of the bladder to contract;
• reduction in the length of the urethra;
• the presence of a certain amount of urine in the bladder (residual urine). The reason for this is uncontrolled contraction of the detrusor.

Secondary causes of disease progression:

• vaginitis;
• loss of consciousness caused by the presence of neurological pathologies, as well as other ailments;
• atrophic urethritis;
• consumption of certain groups of pharmaceutical drugs;
• the occurrence of various infectious processes in the human body;
• increase in diuresis. This condition usually manifests itself against the background of diabetes mellitus, due to metabolic disorders. Also, the reason for the increase in the amount of urine excreted may be physiological - a person consumes a large amount of liquid per day;
• decreased activity due to injuries of varying severity or due to the presence of pathologies of the articular joints (arthritis);
• congestive heart failure.

In old age, it can occur against the background of severe prostate adenoma.

Varieties

The main types of urinary incontinence are as follows:

• functional. This type manifests itself in people in the absence of their usual conditions for excreting urine, as well as in the presence of mental or physical disorders;
• stressful. If this type is present, urine is involuntarily released during strong laughter, coughing, or during physical exercise, during which the level of intra-abdominal pressure increases;
• excess. Occurs against the background of functional insufficiency of the external and internal sphincters of the bladder;
• incentive. Progresses due to impaired innervation of the bladder.

Symptoms

People suffering from this disease experience very strong discomfort, not only physiologically, but also psychologically. Most often they complain about:

• sudden strong urge to urinate;
• imperative urge to urinate;
• feeling after passing urine that the bladder has not emptied enough;
• Often the urge to urinate occurs at night. This medical condition has its own term – nocturia;
• women often complain that they have the feeling that there is some kind of foreign body in the vagina;
• excretion of urine with little physical activity;
• the frequency of visits to the toilet increases.

Video: urinary incontinence after 50 years

Therapeutic measures

There is no medicine for urinary incontinence in older women and men, the use of which immediately normalizes the process of urine output. Therapy should only be comprehensive, and aimed at normalizing the functioning of not only the organs of the urinary system, but also other organs, the pathologies of which could serve as a “trigger” for urine incontinence.

• Doctors usually prescribe the following for older women and men:
• combination anticholinergics;
• smooth muscle relaxants;
• calcium channel blockers.

Medicines for urinary incontinence in older men and women are used only in combination with exercises that will help strengthen the muscles of the pelvic floor and abdominal wall, as well as diet therapy. It is important to normalize your diet, as well as regulate the amount of fluid consumed.

In view of the fact that there are now special tablets for urinary incontinence in elderly men and women, therapy for this pathology can be carried out not only in a hospital setting, but also at home. It is only important to strictly adhere to the doctor’s recommendations, as well as to properly care for the patient who has developed such an unpleasant disease (especially if he is bedridden).

Folk remedies for urinary incontinence in the elderly:

• plantain seed powder;
• dry herb medicinal sage;
• millennium grass.

Folk remedies for therapy can only be used after consultation with your doctor. Otherwise, uncontrolled use can cause the progression of various complications.

During treatment, it is important to maintain the patient’s hygiene, especially if he cannot do this himself. Pads for the elderly with urinary incontinence will help keep the skin of the perineum dry and prevent the formation of ulcers and wounds on it. It is important to replace these products in a timely manner (on average, replacement is done once every two hours). They are selected for each patient strictly individually. Briefs for the elderly are also often used for urinary incontinence.

A person should be washed 4-6 times a day, after which it is recommended to treat the skin of the perineum with glycerin. It is also necessary to encourage the elderly person to empty their bladder every three hours.

Video: How to treat urinary incontinence

Most older women are familiar with the characteristic symptoms of incontinence - urination that cannot be controlled by willpower. About 80% of patients who have entered menopause suffer from urinary disorders. Not all representatives of the fair sex seek help from a doctor, aggravating the situation and provoking the development of complications.

Classification of urinary incontinence:

• False. This is involuntary urination caused by congenital or acquired defects of the urethra, bladder or ureter (for example, total urethral epispadias, the result of trauma - urinary fistula or ectopic ureteral orifice).
• True (not related to the presence of gross defects).

Causes and factors provoking development

Urinary incontinence in old age is a frequently diagnosed female ailment. The causes of senile urinary incontinence lie not only in age-related changes in the body. There are several types of urination disorders, each of which has a specific basis:

1. Stress incontinence. Symptoms of this pathology can be noticed during physical activity, as well as when sneezing and laughing. In older people, the problem occurs in 30–40% of cases;
2. Imperative or urgent incontinence. Manifestations of this type of disease are familiar to 15–20% of people. The disorder is a consequence of increased bladder tone. Pathology is negatively affected by external irritating factors, for example, the sounds of pouring water, cold air temperature, drinking strong drinks, etc.;
3. Involuntary loss of urine of a temporary nature (transient).

If an older person experiences symptoms of such a disorder from time to time, it is advisable to get tested. This is necessary to identify an infectious and inflammatory lesion affecting the bladder or urethra - urethra. In older women, urinary urgency can also be associated with inflammation of the vagina and is usually accompanied by a burning sensation.

The consequence of past diseases of the genitourinary system can be enuresis - urinary incontinence, which manifests itself during sleep. Severe emotional shocks and some pathologies of the central nervous system also lead to a disorder of excretory function: Parkinson's disease, stroke.

Women who have entered menopause may experience the disease due to a decrease in the amount of estrogens - female sex hormones produced by the ovaries. Hormonal imbalance provokes atrophic changes in the cervix and urethral tissue.

Involuntary release of urine may be a consequence of a mechanical obstruction to its normal outflow. Tumors and stones localized in the bladder or urethra can cause an imbalance in urinary function

Some habits and risk factors contribute to the development of the disease:

1. Regular consumption of carbonated and caffeinated drinks.
2. Insufficient amount of coarse fiber food in the diet and, as a result, frequent constipation.
3. Hormonal changes in the body associated with menopause.
4. Hereditary predisposition.
5. Participation in certain sports.
6. Chronic inflammatory process in the pelvis.
7. Smoking and accompanying cough.
8. Decreased overall muscle tone.
9. Gynecological operations.
10. Rapid, protracted or traumatic labor.
11. Upper respiratory tract diseases.

Therapeutic course

Incontinence is especially difficult to control in very old people. In old age, all body systems weaken, and the protective function of the immune system decreases. Aging does not bypass the bladder either: the tone of its muscles weakens, and the walls of the organ thicken, losing their ability to stretch.

For treatment of age-related urinary incontinence in women to be effective, it is necessary to visit a doctor and undergo the necessary tests

Hormonal deficiency leads to a decrease in the tone of the bladder, so the organ loses its ability to hold a normal amount of urine. Urinary disorders in older women can occur due to prolapse and sagging of the urethra, since a lack of female sex hormones can also affect the urethra. To eliminate a delicate problem, the doctor selects special medications that help restore estrogen levels.

Relaxing agents and laser treatment techniques, which do not require hospitalization or a rehabilitation period, help to cope with the pathology. Laser correction is carried out within half an hour, helps strengthen the collagen of the vaginal tissue and quickly eliminate the symptoms of the disease.

Treatment of chronic diseases requires regular use of pills, which often cause symptoms of incontinence. This side effect is observed with antihistamines, diuretics and sedatives. Severe urinary dysfunction may disappear after discontinuation of inappropriate medications.
If pathogenic microflora contributes to the development of incontinence, antibiotic therapy is indicated.

Set of exercises

There are special exercises designed to solve a sensitive problem. We should not forget that gymnastics must be done regularly, otherwise the long-awaited relief may not come.

Female urinary incontinence is corrected by alternately contracting and relaxing the muscles that support normal urination. This technique is called Kegel gymnastics. By performing the exercises daily, the first results can be seen within a month. The duration of the full course is about 6 months.

Herbal treatment

Many women, faced with the first symptoms of the disease, try to treat incontinence on their own. Traditional medicine recipes complement physiotherapy and drug treatment well, but it is not recommended to use them without the consent of the attending physician and until the causes of the pathology are clarified.

A decoction of lingonberry leaves and St. John's wort helps to eliminate the urinary disorder that occurs during menopause. To prepare it you will need 2 tbsp. l. berries and lingonberry leaves and 2 tbsp. l. dried St. John's wort. The resulting mixture is poured with 3 glasses of water and boiled for 10 minutes. The herbal decoction is filtered and drunk 3 times a day before meals.

Lingonberry leaves are rich in phytoncides - active substances that have a detrimental effect on microorganisms that cause bladder diseases

Surgical methods

In some cases, medications do not bring the expected effect and the woman’s quality of life continues to decline. If this happens, it is necessary to pay attention to other methods of treating the disease, for example, modern surgical methods (fixation of the pelvic floor using synthetic materials, elimination of anatomical defects, etc.).

Relaxation of the bladder sphincter, resulting from the formation of stones, cannot be treated conservatively. The tablets will not restore normal excretory function until the tumors are removed.

How to prevent illness and prevent complications from developing

To prevent the symptoms of pathology from affecting the normal rhythm of life, older women should carefully monitor the condition of the body. Preventive recommendations will help you avoid problems with urinary function:

1. The bladder should be emptied completely and promptly, even if there is no urgent need to go to the restroom.
2. Products containing large amounts of sugar do not have the best effect on the functioning of the excretory system. Tomatoes, citrus fruits and milk have a similar effect.

Alcohol has an irritating effect on the bladder, so drinks containing alcohol should be excluded from the menu

1. Heavy lifting and strenuous physical labor should be avoided.
2. You cannot limit the amount of fluid you drink. Some women drink very little water, hoping that this measure will help avoid frequent urge to go to the toilet. However, dehydration will have the opposite effect - the urine will become concentrated, which means increased irritation of the bladder. The likelihood of developing a bacterial infection will also increase. If incontinence symptoms occur primarily during sleep (enuresis), you can reduce the amount of fluid you drink at night.
3. Hygiene products (soap, toilet paper, bath fillers) should not be colored or strongly scented.
4. The pressure exerted on the urinary system is often associated with the acquisition of excess pounds by a woman. Having lost excess weight, patients often report significant relief.

Summary

Any type of urinary incontinence requires proper treatment. The causes of the pathology are varied, so you cannot choose a therapeutic course on your own. Only a specialist can prescribe medications or recommend surgery after collecting a complete history of the disease.

Up to 60% of people who have crossed the 75-year-old threshold suffer from senile enuresis. Pathology is observed equally in people of both sexes. In this article, we will look at the main causes and treatments for urinary incontinence in older women.

Urinary incontinence refers to the involuntary release of urine from the urethra.

Table 2. Main types of urinary incontinence in an elderly woman.

Type of enuresis	Description
	Involuntary urination is caused by pressure on the abdominal wall. “Trouble” occurs against the background of lifting heavy objects, laughing, sneezing or coughing.
	A small amount of urine is released immediately after the urge to urinate. Usually a few drops of urine are released. Less often, emptying the bladder is complete.
	The person cannot control urinary retention. The process of urination occurs both during the day and at night.

The incidence of senile enuresis is presented in the diagram.

Risk factors

The main reason for the development of enuresis in the fair sex is relaxation of the urethral muscles.

The walls of the urethra become less elastic. The muscles that hold the bladder in place weaken. Other causes of urinary incontinence are indicated in the tablet.

Table 1. Risk factors.

Factor	Description
	Enuresis can spread from mother to daughter.
	The pathology progresses against the background of the development of adhesions, disruption of the rectum, uterus and urinary system.
	The disease is provoked by an overdose of diuretics, long-term use of antidepressants, sedatives, and alpha-blockers.
	The risk group includes women with degrees 3-4.
	The risk group includes smokers who have been smoking for 30 years or more. A “smoker’s cough” can act as a provocateur.
	Self-control of urination is lost against the background of multiple sclerosis and dementia.

Note! Problems with stool also adversely affect the condition of the urinary system. Incontinence occurs in women suffering from “chronic” constipation.

The diagram shows the diseases against which senile enuresis develops.

Characteristic symptoms

The main symptoms are presented in the table.

Table 3. Symptoms of urinary incontinence in the elderly.

Symptom	Description
	It occurs against the background of even the slightest physical activity.
	Involuntary urination occurs when the bladder is half empty.
	At the same time, involuntary passage of feces may occur.
	A woman tries to leave the house less often because she is afraid of “disgracing herself” in public.
	The desire to go to the toilet is observed against the background of the appearance of sharp sounds, bright light, or noisily flowing water.

Degrees of incontinence

The following degrees of senile enuresis are distinguished:

• drip – up to 50 ml;
• light – 50-100 ml;
• medium – 100-200 ml;
• heavy – 200-300 ml;
• very heavy - from 300 ml.

How can you help?

Treatment of urinary incontinence in older women involves:

• taking medications prescribed by a doctor;
• use of special gaskets;
• doing exercises.

In the most difficult cases, the doctor makes a decision regarding surgical intervention.

Carrying out drug therapy

The following medications are used to treat urinary incontinence in older women:

• antispasmodics;
• antidepressants;
• drugs to increase bladder capacity.

Use of antispasmodics

Drugs in this group help relieve inflammatory processes in the organs of the genitourinary system and increase the time interval between urination processes.

A drug	Description	Price
	M-anticholinergic blocker from the group of tertiary amines. Helps eliminate spasms and reduce smooth muscle tone. The medicine also relaxes the bladder detrusor, reduces spontaneous detrusor contractions, and increases bladder capacity.	732 rubles.
	It has an antispasmodic and myotropic effect.	678 rubles.

The most effective drug in the group of antispasmodics is Spazmex.

Use of antidepressants

Medicines from this drug group are prescribed against the background of stress incontinence. Taking antidepressants helps relax the nervous system.

Table 5. The most effective antidepressants.

Medicine	Description	Price
	The medicine has a powerful antidepressant effect.	487 rubles.
	A tricyclic antidepressant with thymoleptic, antidysuric, antidepressant, and psychostimulating effects.	394 rubles.

Note! Antidepressants should not be taken on their own.

Medications to increase bladder capacity

As the volume of the bladder increases, its ability to hold urine increases.

Medicine	Description	Price
	The medication helps reduce the tone of the smooth muscles of the urinary tract.	359 rubles.
	Blocker of m-cholinergic receptors localized in the bladder.	From 214 rubles.

Drugs whose active ingredient is tolterodine have a powerful effect.

Application of special gaskets

One of the most effective remedies for involuntary urination are urological pads. They differ in the degree of absorption.

Table 7. Pads for older women with urinary incontinence.

Product	Description	Price
	German products. The product has a 3-layer texture. The antibacterial effect is provided by the acidic pH factor. The top layer of the product is made of natural cellulose, which stops the development of an allergic reaction.	Up to 380 rubles.
	Swedish products. These pads are suitable for drip and moderate incontinence. The main advantage is the blocking of unpleasant “aroma”. The pads perfectly absorb moisture, thereby ensuring comfort and dryness.	Up to 400 rubles.
	Hygiene products are made of high-quality absorbent, which has binding properties. The liquid is absorbed evenly and does not cause any discomfort.	120-200 rubles.

Doing exercises

When treating urinary incontinence in old age in women, it is recommended to perform. The main goal of the training is to control the urge to urinate.

Exercise	How to do it?	How many times should I repeat?
	It is recommended to take a horizontal position. Then you need to tense and relax the muscles that are responsible for controlling the urination process. Squeeze the desired muscle and wait 3 seconds. Gradually the interval should be increased to 20 seconds.	10.
	The first exercise is performed at a faster pace.	10.
	The muscles that work when a person feels the urge to empty the bladder become tense.	10.

Note! Training is an additional therapeutic method. It is carried out in parallel with drug therapy. The average course duration is 90 days. All exercises are performed 5 times/24 hours.

"Grandma's" remedies

Treatment of urinary incontinence in elderly women with folk remedies is carried out only under the supervision of a doctor.

Means	How to cook?	How to apply (once/24 hours)?
	20 grams of the main ingredient are mixed with 175 ml of liquid brought to a boil. Infuse for 150 minutes, filter well using gauze cloth.	1. The medicine is drunk in one gulp.
	20 grams of berries are mixed with the same amount of St. John's wort. Then the mixture is boiled in 300 ml of water, cooled, and well filtered.	Every hour from 16:30 until lights out.
	The main component is well crushed, mixed with 180 ml of cooled boiling water, and infused for up to 10 hours.	2.
	30 grams of medicinal herb are combined with 1000 ml of very cool boiling water, boiled for 7 minutes, filtered, divided into 3 equal parts.	3.
	The fruits of the plant are combined with foxglove in proportions of 4 to 1. The product is boiled for 35 minutes, then rosehip branches are added to the saucepan. Next, the medicine is boiled twice more for 30 minutes and filtered well.	2-3.

Surgery

How to cure enuresis if drug therapy fails? The woman is prescribed surgery.

Surgery is usually performed for stress incontinence. In some cases, it is prescribed for urgent enuresis.

Table 10. Types of surgical intervention.

Operation	Description	Success
	The woman is fitted with bioinert slings. Over time, the implant becomes overgrown with the patient's tissues. This promotes the formation of a new muscle frame.	90%
	The muscle tissue in the urogenital area is tightened using sutures, which dissolve after a certain time.	85-90%
	The tissues located around the urethra are attached to the inguinal ligaments using special punctures.	80%

Preventive actions

Prevention of urinary incontinence becomes relevant after 40 years. The instructions look like this:

1. Limit consumption of caffeine-containing drinks. It is advisable to minimize the consumption of both alcoholic beverages and coffee and strong tea. These drinks have a powerful diuretic effect.
2. Stop using tobacco products. Cigarette smoke irritates mucous membranes and adversely affects the immune system.
3. Visit your gynecologist regularly. This will help to promptly detect and treat provoking diseases.
4. Normalize your diet. Avoid foods that contribute to excess weight gain.
5. Learn to cope with the consequences of stress.

Conclusion

If the problem was detected in a timely manner, the condition can be normalized in a short time. Otherwise, the treatment will take a very long time.

More detailed information can be found in the video in this article.

Many older women experience urinary incontinence. There are many drugs available to treat it. A urologist will help you choose the right remedy.

In old age, loss of urinary control is not uncommon. This pathology is quite common, but is observed mainly in the fairer sex. Urinary incontinence in older women and men causes significant discomfort and reduces quality of life. This phenomenon occurs due to fatty degeneration of the bladder, disruption of nerve impulses, and weakening of smooth muscle fibers.

Many people are embarrassed to contact a urologist about such an intimate issue. But only he can recommend drugs that are effective in each specific case, taking into account the cause of the disease and the characteristics of the body.

List of medications

There are many medications that are effective for urinary incontinence in postmenopausal women, older men, and even children. During menopause, estrogen levels decrease, mucous membranes become thinner, and the risk of injury and infection of the genitourinary system increases.

The drugs help relieve spasms, reduce inflammation, block pathological nerve impulses in the pelvic organs, and increase bladder capacity.

Older people, as a rule, are diagnosed with a lot of different ailments. And medications used to treat incontinence have side effects, so you should not take them without a doctor’s prescription.

Driptan

This drug from French manufacturers contains 5 mg of the active substance oxybutynin hydrochloride for each tablet. It combines the properties of an M-anticholinergic blocker and a myotropic antispasmodic. The medicine helps relieve tension in the detrusor muscle of the bladder and reduce the frequency of its involuntary contractions.

Driptan is indicated for neurogenic urinary incontinence; it is often used for multiple sclerosis. Another indication is enuresis in children over 5 years of age. The medicine is taken one tablet 3 times a day.

Spazmex are tablets, each containing 30 mg of trospium chloride. It has M-anticholinergic, ganglioblocking and antispasmodic effects. Does not affect central regulatory mechanisms. The drug is taken three times a day or 2 times, depending on the dosage.

The drug is recommended for idiopathic or mixed urinary incontinence of a non-hormonal and inorganic nature, in old people with Parkinson's disease. Spazmex is also prescribed for urinary disorders due to damage to the spinal cord, multiple sclerosis, and after a stroke. It can be included in the complex treatment of cystitis with imperative urges.

Vesicare

Its main active ingredient is solifenacin succinate (at a dose of 10 mg). This medication is considered an M-cholinergic receptor inhibitor. Drugs of this type are used for urge urinary incontinence with the presence of an overactive bladder. Take the medicine 5-10 mg once a day. It is prescribed to patients over 18 years of age.

Betmiga

The drug is based on mirabegton and is a long-acting antispasmodic. Recommended for persons over 18 years of age. Elderly patients are prescribed the same dosage as young people. Unlike many drugs, no dose adjustment is required. The indications for use of this medicine are the same as for Vesicare.

Vitaprost forte

Available in the form of Vitaprost tablets and Vitaprost Forte suppositories. The medicine is based on an extract from the prostate of mature bulls. It is taken orally twice a day, and the suppository is placed at night. Recommended for various manifestations of prostatitis in men, including urinary incontinence in the acute period.

Detrusitol and Urotol

Tolteradine hydrotartrate in Detrusitol helps relieve spastic tension in the bladder walls. The remedy is used for incontinence in women and men, if there is no organic pathology. An analogue of Detrusitol is Urotol, which contains the same amount of active substance (tolteradine).

Pantogam and Pantocalcin

These products contain the calcium salt of hopantenic acid. It has nootropic and anticonvulsant effects. The drugs are recommended for use for various diseases, including urinary incontinence at night and during the day.

Medicine is used for imperative urges to reduce and weaken them. Prescribed from the age of two years. Duration of treatment is up to 6 months.

Imipramine

This drug is considered the strongest tricyclic antidepressant. Its main substance, iminodibenzyl hydrochloride, is capable of blocking the reuptake of neurotransmitters and anticholinergic activity.

The tablets are also used to treat enuresis in children and are sometimes recommended for senile urinary incontinence. Since the drug has multiple side effects, the required dosage is recommended by the doctor on an individual basis.

Any medicine intended to normalize the condition when urinary incontinence is diagnosed in older people has contraindications:

• disruption of the excretory organs (renal and liver failure);
• complete retention of urine outflow;
• intolerance to the main and additional components included in the composition of medicines (including lactose);
• ulcerative colitis, megacolon and intestinal malabsorption;
• closed-angle type of glaucoma;
• tendency to bleed;
• cardiac dysfunction;
• myasthenia gravis.

Persons with polyvalent allergies should be wary of treatment with any of the listed agents. Before starting treatment for urinary incontinence in women, it is advisable to consult with an allergist.

Undesirable effects

Side effects of drugs intended to cure urinary incontinence usually develop when the principles of administration are violated. But sometimes undesirable effects occur even at normal dosages:

• heart rhythm disturbance (tachyarrhythmia);
• the addition of a genitourinary tract infection;
• development of cystitis;
• constipation;
• headaches and dizziness;
• allergic reaction;
• nausea;
• pain in the chest or abdomen.

If you have such symptoms, you should stop taking the medicine. You should consult your doctor to review the dosage or choose a different drug.