Continence Program

Sharp Continence Program can help.

One in 12 adults in the U.S. experience some degree of incontinence, 80 percent of them women. People affected by strokes, traumatic brain injury, multiple sclerosis and spinal cord injury have a neurological component involving the brain and spinal cord, which can cause urinary and bowel incontinence. Other factors include changes in pelvic floor musculature due to altered hormonal levels, trauma, birthing and behavioral issues. Urinary tract infection, severe constipation, hydration issues, diet, chemical factors, medication and environmental changes can also contribute to incontinence.

The types of incontinence include:

• Functional: Loss of urine due to issues of mobility and/or difficulty managing clothing
• Iatrogenic: Loss of bowel or bladder control due to other factors (i.e., medication, surgeries)
• Mixed: Stress and urge incontinence occurring together
• Overflow/Reflex: Leak of urine due to overflow of bladder with retention
• Stress: Leakage when you cough, sneeze, laugh or do physical activity
• Total: Loss of urine with no conscious desire to void
• Urge: Sudden urgency with loss of control either with urine or stool

Sharp's Continence Program
The Continence Program at Sharp assesses and treats the whole patient with incontinence problems. A thorough bladder history includes the assessment of alterations in habits, use of medications (prescribed and over-the-counter), implementation of a bladder and bowel diary and monitoring of physical activity that causes leakage. Information gathered to understand the possible causes of incontinence may include medical and surgical history, behavior style, stress activity scale, cognition, environmental barriers and functional ability. Urodynamic studies can also be performed to assess bladder and sphincter function in order to aid in identification of the neurological components of incontinence.

The Continence Program offers instruction on intermittent catheterization, skin care, infection monitoring and prevention of incontinence. Program participants meet with a continence therapist for 8 to 12 weeks with a home care program developed to meet each individual's needs.

The therapeutic treatments of the program include:

• Biofeedback
• Bladder retraining
• Dietary modification
• Pelvic floor muscle exercises
• Relaxation and breathing techniques

Find a Physical Therapy Doctor
To find a Sharp-affiliated doctor, search for a San Diego physical therapy doctor or call 1-800-82-SHARP (1-800-827-4277), Monday through Friday, 8 am to 6 pm.

For More Rehabilitation Information
To learn more about the Continence Program at Sharp, please call Rehabilitation Services at 858-939-6947. To find general information about rehabilitation, visit Rehabilitation in Adult Health or read the Rehabilitation News archive.

References
AHCPA, Urinary Incontinence in Adult, Clinical Practice Guideline. US Department of Health and Human Services, March 1996.

Doughty, Dorothy B., Urinary and Fecal Incontinence Nursing Management, Mosby, 1991.

Jeter, Kathryn, Nursing for Continence, W.B. Saunders Co., 1990.