SATURDAY, OCTOBER 3RD, 2020.-
A new blog post "Health and Prevention" addresses urinary incontinence from the age of 65, and presents six ways to maintain quality of life
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Urinary incontinence (IU) in the adult population affects about 20-25% of people over the age of 65, according to data from the Spanish Society of Geriatrics and Gerontology (SEGG), although the most striking fact, in their opinion, is that only a third of the incontinents consult with their doctor for this problem.
"UI is part of and is one of the so-called 'big geriatric syndromes'. It is the cause and origin of physical, mental disability, and also causes a significant deterioration in the quality of life of the elderly," says the scientific society, while celebrating treatment and it is possible to recover the degree of urinary continence in 30-40% of patients, reducing the severity of the same by around 40-50% of cases.
Classically, incontinence was defined as 'the involuntary loss of urine that conditions a hygienic and social problem', although SEGG stresses that, the International Incontinence Society proposed a conceptual modification, considering it as any urine leak that causes discomfort in the patient.
In this sense, the geriatrician of the Hospital Quirónsalud Zaragoza Nieves Fernández Letamendi, draws attention to that third of patients who do not comment anything to the doctor, because she is ashamed to present 'escapes' of urine. "There are also older people who believe they have no treatment, and they think it's normal and inevitable given age or, in the case of women, they also consider it inherent in childbirth," she says.
Thus, the geriatrician agrees with SEGG that urinary incontinence has a "significant impact on the quality of life of the patient higher than all levels" and stresses that, "on a physical level it is responsible for a greater number of falls (when running or getting up to urinate at night), urinary tract infections, or increased risk of pressure ulcers and overinfection of them , in addition to causing a restriction on physical activities".
Psychologically, the expert emphasizes that "UI can cause loss of self-esteem, anxiety, stress, as well as depression in the patient over 65; while, at the social level, it can promote isolation, limiting its social relations", highlights the specialist of Quirónsalud Zaragoza, a center that has the seal 'Safe Protocol against Covid-19', issued by Applus+, after certifying that it complies with all the protocols and measures necessary to minimize the risk of contagion in its facilities.
In order to determine that the patient has urinary incontinence, the geriatrician argues that, first, a comprehensive geriatric assessment is necessary, which will allow to guide the type of incontinence that occurs and the possible causes.
"After that, treatment will be raised in an integral and individualized way, combining various therapeutic options. The objectives to be achieved will be, improve the quality of life and, if possible, regain continence", explains the expert of the Hospital Quirónsalud Zaragoza, who details the following measures in these 6 recommendations:
1.- Hygienic-dietary measures: Avoid exciting substances (alcoholic beverages, coffee, tea, citrus) and reduce the intake of liquids from the afternoon. Correct constipation. Stay as active physically as possible and wear comfortable clothing with simple opening and closing systems (elastics, velcros, for example), that allow you to undress quickly when you notice the micional desire.
2.- Environmental intervention: Reduce architectural barriers to access the toilet as easily as possible; if necessary, handles and/or elevators are even recommended to facilitate the use of it; in case of disability, have easy access to a urinal or sanitary bottle/wedge to urinate when needed.
3.- Palliative or comfort measures: In addition to other treatments, absorbents may be recommended to offer comfort and well-being, minimizing the impact of this problem. If used, we will recommend the care needed to keep skin integrity in contact.
4.- In addition to the above, we may also recommend and explain in the consultation behavior modification techniques, which seek to restore the bladder emptying pattern, being considered highly effective in the management of incontinence.
5.- If non-pharmacological measures are not sufficient, in some cases, drug prescribing may be helpful. However, its effectiveness will depend on the type of incontinence and will be evaluated in consultation to employ each other, depending on the cause and assessing possible interactions with other drugs that are taken and possible side effects, which can sometimes worsen some chronic diseases common in the elderly.
6.- Depending on the results of the geriatric assessment, and in the cases in which it is indicated after it, it can be referred to Physiotherapy units or urology or gynecology services, if it is subsidiary of improvement with surgical treatment.
Finally, the geriatrician of the Hospital Quirónsalud Zaragoza insists on the importance of the specialized assessment by the Geriatra, and that it is not stopped, since "we geriatrics value the over 65s in all its dimensions, and we can help improve incontinence, which causes so much discomfort on many occasions and that can become very invalidating in the day to day of our patients".