Functional incontinence is very prevalent amongst the elderly who suffer various other disabilities associated with their age. The common problems these age groups suffer are confusion, lack of mobility, poor eyesight, dementia, depression and poor dexterity. All these debilities hinder their quick journey to the bathroom. Even if they manage to reach the bathroom, loss of dexterity will delay the unbuttoning of clothes and similar actions needed to start voiding.

The solution to this problem is two pronged.
– Physiotherapy and exercises to improve the functional deficiencies are instituted. Mostly the effort is to manage the situation to lessen the problem of leaking of urine is to use diapers with enough absorption capacity.
– Another very useful procedure with geriatric patients is to insert a catheter and collect the urine in a bag. The choice is decided by the degree of disability.

Mixed incontinence on the other hand is a condition where the person suffers both stress and urge incontinence at the same time. Treatment includes remedying the causes of stress incontinence such as taking medication like anticholinergics to quieten the bladder.

Certain medical appliances are available for use to help overcome some of these problems.

• The appliances mentioned here are for women. Urethral inserts can be inserted into the urethra after urination and removed before urination. Pessary is a stiff ring worn all day inside the vagina. This raises the bladder and helps to stop leaking.
• Botox injections are given to the bladder muscles to calm them and are common to both genders.
• Implantation of sacral nerve stimulator to stimulate the nerve which helps control urine leak.
• When all therapies fail to give relief, then surgery is a choice. In the ‘Sling’ procedure a mesh is inserted below the bladder which give extra support to urethra. Colposuspension is lifting the bladder to stop leak. This benefits in stress incontinence. Insertion of an artificial valve is at the sphincter is another procedure.
• A high degree of hygiene is required to keep these problems at bay. Incontinence causes the surrounding skin areas to remain damp and encourages fungal and other skin infections and eruptions that can spread to other areas. It can lead to chronic urinary infection too. It is essential to clean the area of urine, keep the skin dry and air the area adequately.