Urinary Incontinence in a Disabled Population

Urinary incontinence (UI), the involuntary leakage of urine, has been studied in the aging, able bodied population.  Very little research on UI and disability has been done.  However, one study indicated that the same treatment that works for persons without disabilities may possibly work for people with a disability. 

The study was done on patients who had spinal cord injuries, strokes, brain injuries, multiple sclerosis (MS), musculoskeletal disabilities and other neurological disorders.  A thorough history and exam were done.  All other possible contributing factors had to be ruled out before the continence program was initiated.  Urinary tract infection, diabetes, urinary retention, and prostate cancer, were some of the possible contributing diagnoses that had to be ruled out.

Participants were then taught how to do pelvic muscle exercises (Kegels).  A machine was used to give the patient feedback as to whether or not they were doing these exercises correctly.  The exercises and biofeedback were often successful in decreasing UI without any additional treatment.  If symptoms persisted in spite of exercises, medications were added to treatment.  Additionally, all patients were instructed on the importance of regular bowel movements, decreased caffeine, proper fluid intake, regular trips to the toilet even if the urge to urinate isn't present, and best methods for transferring.

The study found that the same treatment that works for the general population can also work for persons with disabilities.  Interestingly, the program seemed to work best for patients who had dealt with UI for a longer period of time.  Perhaps this was because they were more aware of the impact that UI had on their lives.  Consequently, they were more compliant with the program. 

For further information: "A Behavioral Approach to the Treatment of Urinary Incontinence in a Disabled Population," Fried, G MD; Goetz, G MSN; Potts-Nulty, S MSN; Cioschi, H MSN; Staas, W Jr MD, Archives of Physical Medicine and Rehabilitation.