URINARY INCONTINENCE IN WOMEN OVER 50: TREATMENT

If you have one or more of the problems listed in DIAPPERS, be sure to tell your doctor about all of them, as well as when you first noticed them. All of the conditions are treatable. For instance, if you are taking a “P”—a pharmaceutical such as a diuretic or other medication that is responsible for your incontinence, your doctor will suggest that you switch to another brand. And sometimes more than one of the causes of DIAPPERS can contribute to the problem. Here’s the treatment:

D (Delirium caused by pneumonia): Once the pneumonia is treated, the incontinence will disappear. Very often, urinary incontinence in an elderly woman is the first sign of pneumonia, a stroke, or an irregular heartbeat.

(Infection of the urinary tract): For a urinary tract infection, a urine sample and culture are always the first step toward treatment. The most common cause of a urinary tract infection is E. coli bacteria, which will respond to the antibiotic Bactrim or Noroxin taken twice a day for one week.

A (Atrophic vaginitis, prolapsed uterus, dropped bladder): To treat atrophic vaginitis, your doctor may prescribe a vaginal Premarin cream. To treat a prolapsed uterus or a dropped bladder, your doctor may want to use a pessary, a ring that is inserted into the vagina; this will raise the bladder and support the pelvic wall, adjusting the angle of the bladder so as to help you retain control. Reconstructive surgery to lift the bladder or vaginal Premarin cream may also be used.

P (Pharmaceuticals): A patient who takes a high dose of the laxative called Lasix only once a day may benefit if she takes a half dose in the morning and the other half in the afternoon or evening. If you plan to be away from home for the day, you should not take the medication until you are back home.

P (Psychological problems): People who become depressed often find that they lose interest in maintaining their personal hygiene. A mild antidepressant such as Zoloft, taken at night, can be helpful.

E (Excessive fluid intake): Many people believe they must drink eight glasses of water a day in order to maintain good health. While this is true for most people, in an older woman, the high water intake combined with a dropped bladder will make it almost impossible for her to hold her urine, especially if she also takes diuretics. With the help of your doctor, cut back on the amount of water you drink and the diuretics. A pessary can also help.

R (Restricted ability to get to the bathroom): If activity is restricted, you should get a commode and keep it near the bed.

S (Stool impaction): Using FiberCon or Metamucil on a regular basis and increasing the amount of exercise you get will help relieve stool impaction.

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