What is Functional Incontinence?
Urinary incontinence is a medical condition affecting millions of Americans and most of which are women. Functional incontinence is one of the types of incontinence in which the person is usually aware of his/her need to urinate and is able to understand the urge to urinate, BUT is not able to reach the bathroom in time due to other problems and there is involuntary leakage of urine. The cause is not that the patient is unaware of the need to urinate, the cause is any physical or mental problem due to which the patient is not able to get to the bathroom in time. The leakage can be minor from a few drops to complete emptying of the bladder. People having functional incontinence have trouble getting to the toilet and in using the toilet when needed. Treatment for functional incontinence comprises of treating the underlying condition.
Causes of Functional Incontinence
- Functional incontinence occurs due to numerous causes. The common cause is any problem, which prevents a person from moving quickly to get to the toilet or there is some problem which causes delay in removing the clothing to use the toilet, or difficulty in transferring from a wheelchair to a toilet.
- As mentioned above, functional incontinence occurs when the patient is not able to make it to the toilet in time due to some mental or physical impairment, such as severe arthritis. In such conditions, the patient is not able to unbutton their pants fast enough to make it to the restroom in time.
- Other important causes of functional incontinence include dementia, confusion, poor vision, impaired dexterity/mobility or the lack of will to use the toilet due to depression.
- Elderly individuals are more commonly affected with functional incontinence, as they tend to have other medical issues, which cause functional incontinence.
- A patient having Alzheimer's disease may forget the way to the bathroom or may not be able to plan properly to reach a bathroom in time resulting in involuntary leakage of urine.
- Patients suffering from musculoskeletal problems, such as arthritis or back pain may have trouble unbuttoning their clothes etc. and this causes delay in reaching the toilet and thus leads to a leak.
- Neurological problems, such as multiple sclerosis or Parkinson's disease, exacerbates the problem, as the patient finds it difficult to reach the toilet in time because of these conditions resulting in incontinence.
- The toilets or the restroom may not be easily accessible or there may be difficulty in reaching the toilet, such as during the night, the patient has a poor vision and there is no proper lighting on the way to the toilet.
- Functional incontinence is common among people with disabilities may find it difficult to reach the bathroom in time.
- With mental disabilities, such as dementia and its other forms or Alzheimer's disease, patient may not be able to communicate or think properly or they are not able to plan trips to the toilet in time. Such patients may also not be able to recognize the need to use the toilet or are not able to find the bathroom by themselves.
- Functional incontinence is also common among people suffering from severe depression, as they can lose all the desire to look after themselves, and this includes using the restroom.
- Certain medications can also cause functional incontinence. If a person has taken sedatives which result in grogginess, then that person may not be able to recognize the need to use the bathroom until it's too late.
Symptoms of Functional Incontinence
Functional incontinence is not a disease in itself, but a symptom of some other medical (physical/mental) problems. Other than the leakage of urine, patient can have symptoms of the medical problem which they are having. Arthritis causes joint pain. Parkinson's causes tremors. Depression makes a person gloomy and lethargic. Similarly, associated symptoms of functional incontinence will depend on the underlying problem causing it in the first place.
Investigations for Functional Incontinence
There are different types of incontinence. Functional incontinence is diagnosed when the patient has other medical conditions which make making the decision or the trip of getting to the toilet difficult. Furthermore, medical history and physical exam along with other investigations help in confirming the diagnosis of functional incontinence, as well as its underlying cause.
Testing also helps in diagnosing other types of incontinence, which can be caused by the same disease, such as multiple sclerosis as well as Parkinson's can cause both functional as well as urge incontinence, as damage to the nerves cause difficulty in holding control of urine.
Treatment of Functional Incontinence
Treatment for functional incontinence comprises of treating the underlying cause of functional incontinence. It could be anything, a physical or a mental problem, causing functional incontinence. These underlying problems could directly cause the functional incontinence or may contribute to functional incontinence. If a patient is suffering from depression which is making him/her not bothering to go to restroom, then treatment for depression should be initiated so patient is able to care for himself/herself. If the patient is not able to reach the toilet quickly enough due to joint pain from arthritis then starting treatment for arthritis helps with tackling the problem of functional incontinence, as the patient will be able to go to the toilet as quickly as possible.
If the patient has poor vision, then treatment should be sought for that and also the path to the toilet should be kept well lit without any obstacles, so that the patient is able to reach the toilet on time.
Similarly, treatment is tailored according to the different medical conditions which are responsible for functional incontinence.