Functional Incontinence

Overview

What is functional incontinence? Functional incontinence is the involuntary loss of urine due to the inability to reach and use the restroom when the need arises. It often applies to patients with physical barriers, difficulty removing clothing quickly, or difficulty reasoning and recognizing their need for urination. While it is not typically a painful experience, it can have profound implications when left untreated and may persist indefinitely for some individuals, depending on its cause and how it is managed.

This type of urinary incontinence can happen to anyone but is more common to our senior loved ones, especially women. It can be managed by scheduling trips to the toilet or using absorbent aids such as moderate pads and protective underwear, clamps or cuffs in men, and urethral inserts or barriers in women. 

What are the Symptoms of Functional Incontinence?

The primary symptom of functional incontinence is involuntary urine leakage, ranging from just a few drops to complete emptying of the bladder. Other common symptoms include the following:

• Feeling a strong and sudden urge to urinate
• Urine leakage during daily activities
• Bedwetting while sleeping
• Urine leakage without the urge to urinate

If you notice any of these signs, it is prudent to consult your primary care provider to determine the cause and discuss the next and best steps to manage it because it is manageable.

What Causes Functional Incontinence?

Functional incontinence can have various contributing factors, from physical impediments such as musculoskeletal or neurological issues to limited accessibility of restroom facilities. For example, individuals suffering from back pain and arthritis will likely struggle more with mobility to the bathrooms than those without such conditions.

Some of the possible causes of functional incontinence include:

• Psychological issues
• Poor vision
• Muscular or neurological issues like arthritis
• Physical barriers to the restroom, such as furniture
• Cognitive issues like delirium, intellectual disabilities, and dementia
• Weak or overactive bladder muscles
• Blockage resulting from an enlarged prostate in men
• Weak pelvic organs or pelvic floor muscles

How is Functional Incontinence Diagnosed?

Functional incontinence is diagnosed using a combination of physical examination, medical history, and laboratory tests. During the physical exam, a doctor may ask questions about the following:

• Lifestyle and diet
• Your medical history
• Types of medications you take
• Other possible causal factors like fluid intake

The doctor may also recommend urine tests to check for infection or other abnormalities, an ultrasound to examine the bladder's size and contents, and an X-ray to evaluate pelvic muscles or rule out any obstructions in the lower urinary tract.

In addition to these tests, the doctor may ask various questions to determine the severity of your condition to help you manage it better. Some of the questions may include the following:

• How far away from a restroom are you comfortable traveling to avoid incontinence?
• How often do you have accidents, and what amount of urine do you frequently lose?
• What activities are affected by your condition?

In some severe cases, the doctors may order advanced imaging tests such as MRI or CT scans for further investigations. These tests can help identify urinary tract abnormalities, such as tumors or blockages, that could be causing the incontinence. The doctor may also take tissue samples from the bladder or urethra (biopsies) for further testing.

Suppose no underlying cause is found upon completing these diagnostic tests. In that case, doctors may recommend lifestyle changes such as regular exercise or timed voiding schedules to manage your symptoms more effectively. They may also require you to keep track of the following:

• Fluid intake
• Food intake
• Bowel and urinary movements
• When functional incontinence starts becoming an issue of concern

How is Functional Incontinence Treated?

While the treatment of functional incontinence depends on the underlying cause, you can get relief and significantly minimize its episodic occurrences by doing several things, such as:

Bladder Training

It is possible to retrain your bladder and gain control over urinary incontinence with effective bladder training. You can start by visiting the bathroom every two hours, and if you feel an urge before then, stand or sit still while contracting your pelvic muscles to resist it until it subsides. After avoiding the random wetting for about two days, you can gradually extend intervals between trips up to three-four hours at most.

Kegel Exercise

Kegel exercises are the key to strengthening the pelvic floor muscles, which play a crucial role in bladder and bowel control. It helps offset urine leakage and issues with incontinence in both men and women.

Incontinence Products

Panty liners and protective pads can help individuals maintain their comfort and avoid embarrassing situations. You can also use a pessary which is an FDA-approved medical device inserted into the vagina, to support the neck of the bladder to prevent urine leakage, particularly in cases of stress incontinence.

Timed Voiding

By setting a regular schedule for bathroom trips, you may enjoy greater bladder control and fewer inconvenient toilet runs. For people living with dementia in nursing homes, scheduled or prompted voiding can be beneficial. This helps to ensure that they use the restroom at opportune times when their bladders are full.

Functional Incontinence Diagnosis Prevention

Struggling with urinary incontinence can be an uncomfortable and embarrassing experience, but no one should feel alone. Here are a few proactive steps you can take to prevent or manage the condition:

Fluid Adjustment

While it is important to stay hydrated for optimal health, excessive fluid intake – particularly of alcohol and beverages containing caffeine, carbonation, or acidity - can irritate the bladder and increase urinary urgency. Thus, you must maintain moderation when choosing the amount of fluid your body needs.

Create a Toileting Schedule

A toileting schedule is an effective tool in helping to minimize instances of functional incontinence. Caregivers should provide a regular schedule — usually every two hours — for the individual they are caring for, then adjust accordingly based on their records of continence during those periods. This process can help maintain greater control over bladder movements to reduce episodes arising from functional incontinence.

Diet Adjustment

Some foods such as citrus fruits, spicy dishes, and other items such as tomato-based food, sugars, or artificial sweeteners can exacerbate functional incontinence. So it is prudent to reduce or avoid them if you are at risk of developing this disorder.

Limit fluid Intake before Bedtime

Unwanted nighttime leakage can be a nuisance and cause distress. To avoid this issue, it is essential to monitor your fluid intake before bedtime and take one last trip to the bathroom right before turning to bed. You can also use bladder pads for additional protection if necessary.

The Bottom Line

Functional incontinence occurs when a physical or mental impairment prevents a person from making it to the toilet. The main symptom of functional incontinence is urine leakage, but some people may also experience urinary urgency or frequency. Functional incontinence can be caused by things like:

• Psychological issues
• Poor vision
• Muscular or neurological issues like arthritis
• Physical barriers to the restroom, such as furniture
• Cognitive issues like delirium, intellectual disabilities, and dementia
• Weak or overactive bladder muscles
• Blockage resulting from an enlarged prostate in men

If you experience any symptoms of functional incontinence, it is important to talk to your doctor. They will likely ask about your medical history and do a physical exam or other tests to determine the possible cause and recommend the best remedy. You can take various treatments and preventive steps to help improve your quality of life with this disorder.

At Nexwear, our team of experts is always ready to help every step of the way. Check out our online store to get the incontinence products that are right for you.