Dear Readers,
Eighty-three year old Mr. R. B. resides near Spanish Town, St Catherine. He has written LIFELINE asking for help with his urine problem. He says that as an elderly pensioner, financial restrictions limit the medical care he can afford. Still he is hoping that LIFELINE can assist him. Most times when he goes to pass urine, it comes down before he can pull his pants down. This is making things miserable for him. He closes his letter "yours in need".
Mr R. B. should not just sit at home with this problem but should visit the nearest Government Clinic in St Catherine or should attend the Surgical or Urological Clinics at the Spanish Town Hospital. Help is available for him and perhaps with minimal costs but he, or his family members, will have to seek it on his behalf.
R. B. describes Urinary Incon-tinence which is the uncontrolled leaking of urine and is a very common problem in the elderly. The most common cause of incontinence in older people is due to Detrus or Hyperractivity. The detrusor muscle surrounds the bladder and sometimes this muscle contracts without warning, resulting in urge incontinence and the sudden voiding of urine. Other medical conditions can also lead to incontinence. Bladder stones and tumours can sometimes be the cause and will only be discovered with medical investigations.
Another type of incontinence which is present in older people, especially men, is an overflow. The bladder can become significantly distended in men with large prostate glands. These enlarged glands press on the bladder and restrict the outflow of urine. When this happens, no additional urine can enter the bladder without some urine also running out through the urethra.
Urge incontinence can also occur due to inflammation of the bladder wall resulting in a sudden and uncontrollable urge to pass urine. Often there is no time to get to the bathroom.
Certain medications often used by the elderly can also result in urinary continence. Diuretics (water pills), antidepressants such as Amitryptyline, antipsychotics such as Melleril and Haldol, sedatives like Valium and many antihistamines (which treat Sinusitis and Hay Fever) and Antihypertensive medications, can also give rise to incontinence. A physician's help would be needed to sort this through.
Elderly people often take several medications for different chronic problems.
Medication can help to control Urge Incontinence. Detrol, anticholinergic drugs such as Probanthine antispasmodics for example Oxybutinin and Tricydic antidepressant imipramine (Tofranil) can all be taken to relax the bladder muscle and minimise it. Tofranil is the least expensive drug mentioned and is readily available with a doctor's prescription.
If an enlarged prostate is present in a man with incontinence this should also be treated either medically with drugs such as Hytrin or by surgical removal of the prostate gland.
Finally, a urethral catheter can be inserted into the bladder and changed at monthly intervals. This will keep the bladder relatively empty and prevent the discomfort of repeated wetting of the clothes with urine several times daily. The quality of one's life may even be said to be more important than the quantity, the length of years. R. B. should have his family or neighbours take him to a clinic or hospital soon. His life can be made much more pleasant.
Write LIFELINE
P.O. Box 1731
Kingston 8
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