Exploring what makes us incontinent - The Simon Foundat...

The Simon Foundation for Continence

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Exploring what makes us incontinent

BarrySimpson profile image
3 Replies

Have you ever tried to find out why you are incontinent? I believe that incontinence is not always taken as seriously as it should be by the medical profession: see for example 'No diaper hospitals in the US' on this site. I wonder whether there might be some of us that are curable but are being left with 'something we can live with'.

I have been doubly incontinent since an accident causing spinal injury at cervical vertebrae 4 and 5 (between my shoulder blades) resulted in paralysis below that position. In my case my anal and urethral sphincter muscles are held closed except with manual intervention such as a urethral catheter or bowel evacuation. These sphincter muscles are controlled by the pudendal nerve, which issues from the spinal cord between sacral vertebrae 2,3 and 4 near the base of the spine. I am incontinent because instructions from my brain to open or close my anal and urethral sphincter muscles are not reaching my pudendal nerve because of my spinal injury between my shoulder blades. After spending seven months in a specialist spinal injury hospital, I was left with the impression that no-one had a clue how to repair nerve injuries: so I remain incontinent and paralysed with severe spasticity below my shoulder blades.

The situation might be more hopeful for others. Many, perhaps most, of those posting here seem to have the opposite problem - anal, or more commonly, urethral sphincters which they can not close, causing dribbles, or which they can not control to open and close when appropriate. Maybe damage to the pudendal nerve could be responsible?

Another cause of incontinence might be damage to the anal and urethral sphincter muscles themselves rather then the nerves controlling them. The anus is perhaps more likely to be injured than the urethra. In my bowel evacuations, the nurses are very careful to lubricate their fingers before inserting them and usually insert only one finger.

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BarrySimpson profile image
BarrySimpson
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incon1982 profile image
incon1982Administrator

Patients and patient advocates need to ask their healthcare providers WHY. What is the cause? And old age isn't an answer. Treating symptoms without a thorough understanding of why they are happening doesn't help. Treatments and management methods need to be based on a true understanding/diagnosis of why the incontinence is happening. And yes, that could mean a cure for some, or a lessening of incontinence episodes for some, and for those where there is no fix, at least we can figure out the best way to manage things. That's my two cents on that.

BarrySimpson profile image
BarrySimpson in reply to incon1982

What aroused my suspicion that incontinence gets low priority was firstly my stay in a specialist spinal injuries hospital during the first half of 2013 where there really was no preparation for when patients left to go home. Then during the first half of 2016 I had nearly 2 dozen catheter blockages. Only one nurse used the phrase 'something they can live with' but other health professionals left me with the same impression. Medical practitioners seem to be content to leave incontinence, including catheter blockages, to the nurses while nurses spend a lot of time unblocking or replacing them without anyone trying to prevent them.

livingwithacatheter.com/cat...

BarrySimpson profile image
BarrySimpson in reply to BarrySimpson

prevent/livingwithacatheter.com/cat...

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