Posted on Mar 8, 2017 10:05:00 AM by Leslie Wooldridge, GNP-BC, CUNP, BCIA-PMD

Are We Doomed for End-of-Life Incontinence?

Distressed man getting out of bedOften we use the cliché, “What goes around comes around.” Not so with voiding and incontinence. Although at birth the bladder, brain and physical development are not mature enough to perform normal voiding, we are not doomed for a potential end-of-life incontinence. As the body grows and develops, so does continence. 

Many variables can occur that can affect voiding habits for a lifetime.  These may include prolonged bedwetting, inability to void away from home, anxiety and fluid intake. Normal changes related to aging also influence voiding as we get older.

Normal Bladder Capacity  

Normal bladder capacity is 400-600 ml. This can vary greatly depending on the above mentioned variables or co-morbidities. The bladder is a very trainable organ and can be taught to hold more or less than normal. This is where those variables come into play. 

Our Aging Bladders

As we age, so do our bladder. Volume generally decreases. We experience uninhibited bladder contractions that can result in urine leaks if we don’t control them. Contraction of the bladder itself becomes weaker that can cause inadequate emptying.  In men, the prostate enlarges and irritable bladder symptoms or overactive bladder (OAB) can ensue. In women lack of estrogen can also cause bladder urgency, dry vaginal tissues and weakened pelvic floor muscles resulting in incontinence. All of this, coupled with poor lifestyle habits, can cause people to assume that aging results in “normal” incontinence, urgency or frequency but that’s not the case.

Reclaiming Bladder Function

Most of the time, simple behavioral changes can restore bladder function. When not, medications or other therapies may help. Percutaneous tibial nerve stimulation (PTNS) is third line therapy for OAB and is a very helpful adjunct to life changing modifications resulting in less urgency and continence.       

Awareness is key to helping our patients understand healthy bladder habits and successful continence.

Urgent PC is the Proven PTNS

Urgent PC is indicated for the treatment of Overactive Bladder and associated symptoms of urinary urgency, urinary frequency and urge incontinence. Treatment with Urgent PC is contraindicated for patients with pacemakers or implantable defibrillators, patients prone to excessive bleeding, patients with nerve damage that could impact either percutaneous tibial nerve or pelvic floor function or patients who are pregnant or planning to become pregnant during the duration of the treatment. Most patients don't experience side-effects. If side-effects occur, they are typically temporary and include mild pain and skin inflammation at or near the stimulation site. Caution: Federal law (USA) restricts this device to sale by or on the order of a physician. For complete instructions for use, storage, warnings, indications, contraindications, precautions, adverse reactions and disclaimer of warranties, please refer to the insert accompanying each product or online at www.cogentixmedical.com. Urgent PC is a registered trademark of Cogentix Medical © 2017 Cogentix Medical. All rights reserved. 
Leslie Wooldridge, GNP-BC, CUNP, BCIA-PMD
Leslie Saltzstein Wooldridge, GNP-BC, CUNP, BCIA-PMD, is Director of the Adult Bladder Control Center, Mercy Health Partners, Muskegon, Michigan USA. Ms. Wooldridge received a Master of Science degree in nursing administration, critical care nursing and postgraduate certification as a Geriatric Nurse Practitioner from Marquette University, Milwaukee, Wisconsin. In 2015, she was honored with the Women’s Health Foundation Activist Award. She is also the recipient of the 2009 National Association for Continence Rodney J. Appell Continence Champion Award. Ms. Wooldridge has published in multiple refereed journals. She authored the Genitourinary chapter in The Nurse Practitioner in Long Term Care: Guidelines for Clinical Practice (2007). She has lectured throughout the United States on geriatrics, urology and clinical practice.
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