How can people lead an active life and participate in everyday activities carefree despite incontinence? This is what many people who suffer from incontinence symptoms ask themselves. From possibly only occasional bladder weakness to severe urinary incontinence or even fecal incontinence, there are varying degrees. Some of these are associated with considerable restrictions on quality of life.
Whether it is just a drop of urine leaking into one's underwear during a fit of hearty laughter - women in particular are often affected by what is known as urge incontinence - or the bowel emptying uncontrollably - incontinence describes the body's inability to consciously hold back urine or stool. A distinction is made between urinary and fecal incontinence. Both forms can result from various physical or psychological causes.
Incontinence is an especially humiliating condition, but those affected are not entirely helpless in dealing with it. In many cases of urinary incontinence in particular, relief can be achieved through physical therapy or medication. In some cases, surgery can help - for example, when fistulas or an enlarged prostate cause the problem. Thanks to modern aids, it is also possible to continue living a dignified life even with some severe forms of incontinence.
The online shop of Medicalcorner24® offers an extensive range of incontinence products for different levels of severity. In addition to incontinence products for everyday needs, such as pull-up pants or incontinence briefs, we also offer supplies for treatment in hospitals, nursing homes, or home care.
In this article, we would like to discuss the various forms of urinary or fecal incontinence, describe their causes, effects, and possible therapeutic approaches. In this context, we will introduce you to the numerous incontinence products from our range, which you can purchase online at affordable prices.
If you suffer from a form of incontinence, we advise you to see a doctor. This is the only way to determine the exact causes and initiate appropriate countermeasures. In many cases, therapy can provide relief or eliminate the problem. The sooner you confide in an expert, the better. Ultimately, the psychological effects of such an illness should not be underestimated either. Incontinence patients are not alone - let us help you.
Here you will find an overview of the topics covered in this article. With a mouse click, you can jump directly to the section that interests you most.
Medical evaluation of the respective type of incontinence is very important
Different forms of incontinence and their causes
Surgical procedures in the abdominal area can sometimes cause incontinence. In women, during pregnancy or as a result of surgery, the vagina or uterus may become prolapsed. Urinary incontinence is often the result.
The side effects of various medications or alcohol consumption can also worsen existing incontinence. This is the case, for example, with some antidepressants or neuroleptics. Below, we describe various types of incontinence, their causes, and tried-and-tested treatment approaches.
Different types of urinary incontinence
Urinary incontinence occurs when the bladder is no longer able to store urine reliably and empty itself in a controlled manner. Normally, the bladder fills until we feel that it is “time” to go to the toilet. Healthy people can then urinate when they choose. During this process, the sphincter muscle, which had kept the bladder closed until then, relaxes, while the previously relaxed bladder muscle contracts and presses on the bladder.
The pelvic floor muscles also play an important role, as they contract or relax together with the sphincter muscle. Urinary incontinence is often caused by injured or weakened pelvic floor muscles.
Stress incontinence
With this form of urinary incontinence, urine is released involuntarily as soon as the bladder is subjected to a certain amount of pressure. It is also known as stress incontinence. Often, a hearty laugh or cough is enough for those affected to lose at least a few drops of urine. Carrying heavy objects can also contribute to involuntary urine leakage. Women are affected by stress incontinence significantly more often than men.
Weakening or injuries to the pelvic floor muscles are often responsible for incontinence. In men, pelvic floor injuries resulting from prostate surgery may be the cause. The pelvic floor muscles can also be damaged by falls, mechanical impact, or excessive weight loads. Being overweight is therefore one of the most important risk factors for most forms of urinary incontinence. Furthermore, the cause of stress incontinence may lie in irritation and damage to the nerves.
Urge incontinence
This form of incontinence gets its name from the almost constant urge to urinate from which those affected suffer. It is also known as urge incontinence (urge = English for “urge”). In urge incontinence, the bladder sends the signal to empty itself when it is barely filled. The feeling of needing to urinate becomes overwhelming. Those affected can rarely go about their daily lives carefree, as the urge may begin while shopping or taking a walk in the park. Longer trips are hardly feasible - unless there is always a toilet nearby.
Urge incontinence can have psychological causes and often occurs in connection with a weak pelvic floor. Here, too, women are affected more frequently - the weak “little girl’s bladder” is a real cliché. If that is the only cause, the chances of successful treatment through pelvic floor exercises are good.
However, nerve damage or neurological diseases such as Alzheimer’s disease, multiple sclerosis, or Parkinson’s disease can also cause urge incontinence. It can also occur in connection with heart attacks, strokes, or diabetes mellitus. In addition, bladder stones or bladder infections can irritate the bladder to the point that an almost uncontrollable urge occurs.
A distinction is made between two types of urge incontinence:
Motor urge incontinence: Usually triggered by neurological diseases, it causes excessively frequent contractions of the bladder regardless of how full it is.
Sensory urge incontinence: The bladder sends false signals to the brain, which then “orders” the contraction of the bladder. Inflammation or cancer often triggers this form of urinary incontinence.
Mixed incontinence
In mixed incontinence, stress incontinence and urge incontinence occur together. Those affected suffer from a strong urge to urinate that they cannot control. Urine is often released involuntarily. Usually, one form of incontinence is more pronounced than the other.
The causes are the same as those of isolated urge or stress incontinence. In women, mixed incontinence is occasionally observed as a result of pregnancy or uterine or vaginal prolapse.
Overflow incontinence
In overflow incontinence, the bladder outlet is severely narrowed or blocked, allowing only a very small amount of urine to flow out. The bladder fills to capacity but cannot be completely emptied. Only when enough pressure has built up do small amounts of urine overcome the blockage and dribble out uncontrollably.
The discomfort caused by a distended bladder, coupled with the fear that something might “go down one’s pants” again, makes life difficult for those affected. Without aids such as adult diapers, participating in everyday life without restrictions would hardly be possible.
Men are most commonly affected by overflow incontinence. An enlarged prostate is often to blame. However, tumors can also narrow the bladder outlet. When an obstruction impedes urine flow, this is referred to as obstructive overflow incontinence.
Functional overflow incontinence occurs when the bladder muscles are too weak to contract and empty the bladder. Here too, urine only starts to flow when the bladder is already very full. Nerve damage - which can occur, for example, as a result of diabetes mellitus - may be the cause. Strong sedatives can also sometimes cause the bladder muscles to relax.
Overflow incontinence
Also known as neurogenic urinary incontinence, this form of incontinence is caused by neurological damage or diseases. Those affected cannot predict when their bladder will empty. Urination can occur at any time - in bursts, reflexively. Men and women are equally affected by reflex incontinence. Two different forms of this condition are distinguished:
Spinal reflex incontinence: Neurological diseases or spinal cord injuries are possible triggers. This form of incontinence can occur with paralysis of the lower limbs.
Supraspinal reflex incontinence: Diseases such as dementia, Parkinson's disease or strokes can damage the brain so severely that reflex incontinence is triggered.
Extraurethral urinary incontinence:
This form of incontinence is either congenital or caused by a fistula. Fistulas are channels that develop in tissue, for example as a result of inflammation. If such a fistula creates a connection between the bladder and the anus (in women, the vagina may also be affected), urine leaks from this opening in the body. Depending on the course of the fistulas through the body, urine may even seep through the skin in some cases.
It is hardly surprising that those affected rarely venture out in public. Fear of accidents and the shame when “it” happens are considerable - the psychological burden is immense. However, in many cases, extraurethral urinary incontinence can be treated surgically. It is therefore strongly advisable to seek medical help.
Different types of fecal incontinence
In fecal incontinence - also called bowel incontinence - those affected lose control over intestinal gas and bowel movements. In mild cases, they suffer from flatulence or the involuntary passage of intestinal mucus and liquid stool components. In severe cases, it is not limited to a "skid mark" in the underwear - solid stool can no longer be retained either.
Fecal incontinence is divided into three degrees of severity:
- First-degree partial incontinence: frequent involuntary passage of intestinal gas. Small amounts of liquid stool are discharged, leaving visible traces in the underwear.
- Second-degree partial incontinence: the symptoms of first-degree incontinence become more severe. In addition, liquid stool is passed involuntarily.
- Total incontinence (third-degree fecal incontinence): control over retaining the bowel contents is completely lost. Even solid stool is passed involuntarily.
Causes of fecal incontinence
Diseases or injuries of the anorectum (the rectum or sphincter) are the most common causes of fecal incontinence. The rectum is the part of the intestine where stool remains until it is expelled. A full rectum creates the urge to have a bowel movement. A healthy person can keep the sphincter closed until reaching the toilet.
The following circumstances can lead to loss of control over the continence functions of the human body:
- Pelvic floor weakness: as with urinary incontinence, fecal incontinence is often caused by weakened pelvic floor muscles. Elderly or long-term bedridden patients are frequently affected.
- Injuries to the anal area: the sphincter or intestinal nerves can be injured in accidents or during surgery. In women, such injuries occasionally occur as a result of childbirth.
- Prolapse or severe hemorrhoids: a prolapse is a protrusion - that is, the emergence - of the rectum or lower bowel through the anus. Severely irritated or already protruding hemorrhoids may indicate such a development and should always be examined by a doctor.
- Inflammatory diseases: Crohn's disease, for example, is an intestinal disease that causes chronic inflammation, which can lead to permanent nerve damage and fecal incontinence.
- Neurological diseases: multiple sclerosis, Parkinson's disease, or dementia can be associated with fecal incontinence.
- Cancer: If tumors develop in the anorectal area, fecal incontinence may also occur.
- Side effects of medications: some medications have a laxative effect or cause the pelvic floor muscles to relax.
- Constipation: A low-fiber diet combined with insufficient fluid intake promotes the development of constipation. Hardened stool forms a barrier that only liquid feces can seep past. Frequent severe constipation promotes the development of enlarged hemorrhoids and can cause injuries to the intestine.
- Diarrheal diseases: Various illnesses cause uncontrollable diarrhea. This form of fecal incontinence usually disappears on its own. Only if the immune system cannot fight the underlying illness can persistent diarrhea become life-threatening due to the associated loss of fluids. Diarrhea can also occur as a side effect of medication, due to alcohol consumption, or after eating foods that are not tolerated.
Incontinence - treatment and therapy
In many cases, incontinence can be treated. Much depends on the specific form and severity of the condition, as well as the patient's age and overall health. The sooner you see a doctor, the better.
Many people affected feel ashamed of their condition and do not want to confide in a stranger. However, specialists know exactly what to do and can initiate countermeasures as well as prescribe aids such as incontinence briefs or diapers.
Treatment and therapy for urinary incontinence
- Pelvic floor training: Targeted training of the pelvic floor muscles can provide relief in many cases and also serves as a preventive measure. This therapy includes special muscle training, but also draws patients' attention to poor posture and unnecessary strain that should be avoided in everyday life. The pelvic floor is a large muscular area that literally forms the floor of our lower abdomen. Its only weak points are the openings for the rectum, urethra, and vagina. When urine or feces are excreted, the pelvic floor relaxes. At all other times, it supports the internal organs in the pelvic area. The pelvic floor muscles must also withstand some physical strain - for example, when carrying heavy loads.
- Biofeedback training: If neurological disorders are present that limit patients' awareness of their pelvic floor area, biofeedback training can help. A probe is inserted into the rectum or vagina, triggering a signal as soon as the muscles contract. Using these tones or lights, patients can specifically train their pelvic floor muscles.
- Electrotherapy: The pelvic floor muscles can also be stimulated using electrotherapy. Weak electrical impulses are directed into the muscles, allowing them to be trained in a targeted and painless manner.
- Reducing body weight: If the pelvic floor is strained by excess weight, training and dietary programs to reduce weight are also recommended.
- Bladder training and toilet training: Anyone who responds to the first signs of urinary urgency is gradually “programming” their bladder to empty early. Medically supervised bladder training helps strengthen the bladder sphincter and promotes regular bladder emptying without urinary urgency. During toilet training, patients must record when they urinated, how much urine was excreted, and how much they drank. A specialist uses this data to create a daily schedule with set drinking times and bathroom visits.
- Cancer: If tumors develop in the anorectal area, fecal incontinence may also occur.
- Medication treatments: In cases of urge incontinence, antispasmodic medication can provide relief. Incontinence that develops in women due to hormonal changes during menopause can sometimes be treated with hormone therapy.
- Catheter: If reflex incontinence cannot be treated in any other way, those affected depend on catheters to empty the bladder. Catheters are also used for overflow incontinence.
- Surgery: In cases of injuries, malformations, or tumors, incontinence can sometimes be treated with surgery. Extraurethral incontinence caused by fistulas must be treated surgically. An enlarged prostate can also be operated on to cure overflow incontinence. There are also known cases in which a so-called bladder pacemaker has helped patients with urinary incontinence. Damaged urethras can sometimes be repaired with supportive implants. However, surgery should always be the last resort when non-invasive therapies have not been successful.
Treatment and therapy for fecal incontinence
- Training the pelvic floor: Pelvic floor training is also one of the most important preventive measures in cases of fecal incontinence. The training can counteract intestinal weakness, in which bowel movements become less active. Women who suffer from connective tissue weakness as a result of the hormonal changes of menopause also benefit from a trained pelvic floor.
- Toilet training: can be used as a supportive measure. The time when a bowel movement occurred is recorded. The color of the stool can also provide clues about illnesses and other problems. Based on the recorded data, the treating physician prepares a bowel movement schedule. Toilet training aims to strengthen the sphincter and maintain control over one's bowel movements. A strong pelvic floor makes it easier for the sphincters and rectum to perform their functions.
- Electrotherapy: In some cases, the affected muscles can be stimulated as part of electrotherapy. Implanting a pacemaker may even be considered. It is intended to restore orderly communication between the brain and the pelvic organs and muscles when it has been disrupted. Such therapies must, of course, always be medically evaluated.
- Surgery: An injured sphincter may be repairable through surgery. Some surgeons have even specialized in this area. Implantation of an artificial sphincter is also possible. Surgery may also be considered in the event of a prolapsed colon.
Preventing incontinence - What can you do?
There is a lot you can do to prevent incontinence problems from developing as you age. We have already described how pelvic floor training helps counteract many incontinence problems. But normal, everyday movement can also help. Take plenty of walks, do not remain seated for too long, or do some gymnastics every day.
Yoga also offers many exercises that gently strengthen the pelvic floor. In fact, many exercises you would do during pelvic floor therapy are structured in a very similar way.
Exercise and a balanced diet are important for maintaining a healthy weight. Many forms of incontinence are caused by severe overweight. Avoid carrying or lifting heavy loads incorrectly. This places considerable pressure on the pelvic floor.
Do not eat or drink anything that could irritate the bowel or bladder. Drink enough every day and make sure you eat a high-fiber diet. Dietary fiber, such as that found in whole grains, nuts, fruit, or vegetables, results in greater stool volume, softer stool overall, and faster digestion.
Adequate fluid intake is important so that the dietary fiber - the fibers of plant material - can swell. Stool should be easy to pass without conscious effort.
As a general rule: Talk to your doctor about incontinence. They are qualified and able to assess your individual situation and make a diagnosis. Thanks to medical confidentiality, you can rely on absolute discretion.
There are many ways to treat incontinence and use incontinence aids to continue leading a normal life.
An overview of incontinence supplies and aids
Although incontinence can often be treated, it may take time for the measures to be successful. Fortunately, there is a wide range of high-quality incontinence supplies and incontinence aids that make everyday life easier for those affected. These include, for example, diaper pants and special incontinence underwear.
There are also various aids for caring for people with incontinence who cannot help themselves. These include, for example, incontinence pads and mattress protection against moisture. Such products are also used in inpatient or home care for bedridden patients.
Due to the different anatomy of men and women, many incontinence products are often available in variants for both genders. This condition was a taboo subject among men in particular for a long time. Nowadays, however, numerous incontinence products are specifically offered for men.
A toilet is not always within reach - bladder training helps you hold on longer
Move freely in everyday life - despite incontinence
Incontinence severely restricts mobility in everyday life. This is one of the aspects that affected people suffer from most. Thanks to specially adapted underwear, however, there are now numerous aids available to help people regain their personal freedom.
Incontinence pants and incontinence briefs offer the great advantage that they can be worn under normal everyday clothing. These disposable briefs are so cleverly designed that practically no visible lines show under clothing. Absorbent pads in the briefs absorb moisture and unpleasant odors.
Anyone affected by incontinence can move freely again thanks to incontinence underwear. Knowing that neither a stain on your clothes nor unpleasant odors will get in the way makes it possible to resume social contacts. Sports activities and longer outings are possible again too.
Incontinence briefs for women and men are available in different sizes. Most brands are available in variants with different absorbency levels for different degrees of incontinence. With stress or urge incontinence, often only a few drops end up "in your pants." If fecal incontinence is also present, more absorbent adult diapers are needed.
Incontinence pads and liners
Incontinence pads and incontinence liners are an alternative to adult diapers. These are panty liners or shaped pads that are inserted into underwear in a similar way to a sanitary pad.
Incontinence inserts have adhesive strips that secure them in underwear like a sanitary pad. These aids are recommended for mild bladder weakness through to moderate urinary incontinence.
MoliCare® Pads from Hartmann are an example of incontinence inserts. They are dermatologically tested, have an anatomical shape and reliably neutralize unpleasant odors.
Incontinence pads are also suitable for severe urinary incontinence or fecal incontinence thanks to additional leak-proof elastic cuffs. They can also be worn by bedridden patients. Due to their size, the pads should be worn together with mesh pants or other fixation pants.
Lying and sitting with incontinence - what offers protection?
Whether sitting or lying down, incontinence is just as present as during physical activity. And especially in their own homes, those affected do not want to wear incontinence underwear all the time. In home or inpatient care, it is often more effective to protect not the patient's lower body, but the surface they sleep on with an incontinence protection product. Special pads, underpads and protective covers protect furniture and mattresses in cases of incontinence.
Incontinence pads are primarily used to protect mattresses, beds, or patient transport stretchers. Naturally, they can also be used as a moisture-proof underlay on other seating furniture. Incontinence pads are frequently used in hospitals and nursing homes. The sizes and variants range from small bed pads that cover the area beneath the pelvis to pads that cover entire mattresses as a fitted sheet.
Bed pads consist of highly absorbent cellulose with nonwoven layers that absorb fluids such as urine. They also generally contain odor-neutralizing agents. A polyethylene film or similar material with a slip-resistant outer surface prevents moisture from seeping through. These pads provide reliable incontinence protection - especially against urinary incontinence. They are available in various sizes. There are also various thicknesses, from 4-layer options for mild forms of incontinence to particularly high-performance 12-layer incontinence pads.
For short-term protection, smaller pads can be used. Products such as the Careline incontinence bed pad from Careline impress with their slip resistance, shape retention, and high absorbency. During examinations on a medical examination table, such bed pads can be placed under the patient's pelvis. They can also be used as moisture protection on seating furniture.
To protect armchairs or chairs, waterproof seat pads, such as those manufactured by Behrend, are suitable. These polyester pads are available in various colors. They also have the advantage of looking more like small doilies rather than a medical aid. This provides discreet protection for household furniture.
Disposable protective sheets such as the Vala®Protect special from Hartmann provide very reliable protection for mattresses. These sheets are very tear-resistant and feature side leak protection. They are also soft and supple, so you can sleep on them just as you would on ordinary sheets.
Incontinence Aids – Differences Between Women and Men
The anatomical differences between women and men require different aids for some forms of incontinence.
Condom Catheter for Men – An Alternative to a Catheter
The condom catheter is applied like a conventional condom, but has a tubing connector at the tip. The tube of a leg bag or bed bag can be attached there, allowing urine to be drained into it. Condom catheters are made of silicone and latex and can be worn continuously for up to 24 hours. They provide discreet protection, as the leg bag can be concealed under clothing.
Advantage: External urine collection devices make the use of a catheter (except in cases of overflow incontinence) unnecessary. While a catheter is inserted by a doctor, those affected can easily put on the external urine collection device themselves. Men who suffer from urge or stress incontinence can move around more freely again with this aid.
Pessaries - incontinence aids for female urinary incontinence
Pessaries are usually ring-shaped or oval aids adapted to the shape of the female genitals. They are used to address incontinence problems caused by anatomical changes such as uterine prolapse. Pessaries can be worn together with incontinence briefs. The attending gynecologist decides whether a pessary is appropriate and which shape should be used.
Aids for the inpatient care of patients with incontinence
In addition to incontinence products, which primarily serve to maintain mobility and participation in everyday life, there are also incontinence products that are mainly used in inpatient care or for the home care of bedridden people. These include, for example, sterile catheters together with accessories such as valves and plugs, as well as complete catheter sets. A urinary catheter, for example, is inserted to completely empty the bladder in cases of reflex incontinence or overflow incontinence.
Urine bottles are manufactured in various designs for men or women. The bottles are designed to suit the respective anatomy. They are ideal when the urge to urinate is so strong that those affected can no longer make it to the toilet. This is why ambulances are also equipped with urine bottles. With suitable holders, the urine bottles can be attached within easy reach to the hospital bed.
Coverage of incontinence supplies by the long-term care insurance fund
People in need of care of all care levels are legally entitled to coverage of the costs of aids required for care. The responsible care insurance fund reimburses up to 40.00 euros per month for care aids. These include bed protection pads and other aids such as protective gloves, aprons, or disinfectants, which are useful when caring for relatives with incontinence.
You can submit an application to your health insurance fund for coverage of the costs of care aids. We will be happy to submit the relevant applications for you if you would like to purchase qualified products from our online shop with cost coverage. To do so, we need the name and institutional identification number (IK number) of your care insurance fund. We will then put together an individual product package according to your needs and have this offer approved by the care insurance fund. The fund will then send you a stamped confirmation, and we will deliver your incontinence products.
Please feel free to contact us if you or your relatives need incontinence supplies. We will be happy to advise you on our medical products and delivery service.
Remember to always have the type of incontinence and appropriate countermeasures checked by a doctor. Do not make your own diagnoses. Contact medical professionals at an early stage to give yourself the best chance of successful incontinence treatment.
