Functional Urinary Incontinence: Causes, Symptoms, and Effective Management Strategies

Neurological disorders, cognitive impairments, and conditions that affect your muscles often come with a range of uncomfortable side effects - one of them being functional incontinence.

If you've ever dealt with urine leaks due to functional incontinence, you'll know first-hand how frustrating it can be. However, it's much easier to deal with your incontinence when you gain a better understanding of why it happens and what can be done about it.

In this article, we'll provide an in-depth look at the causes, symptoms, and effective management strategies related to functional urinary incontinence.

A Closer Look at Functional Urinary Incontinence

Functional incontinence is a type of urinary incontinence where you experience difficulty getting to the bathroom in time to urinate which results in accidental leaks. Although functional incontinence does not occur due to a problem with your bladder or pelvic floor, it can be due to a different underlying medical condition.

The symptoms of functional urinary incontinence

Some of the main symptoms of functional urinary incontinence include:

• Being unable to get to the bathroom in time to pee

• Experiencing urine leaks (these could be small leaks or emptying your entire bladder)

• Wetting the bed (also known as nighttime incontinence)

• Noticing the smell of pee on your clothes or around your home

If you experience any of the above symptoms on a regular basis, you most likely have some type of urinary incontinence. It is best to book an appointment with your general practitioner (GP), so you can help manage this symptom .

Risk factors for functional urinary incontinence

You may be at a higher risk for functional urinary incontinence if you:

• Are over 65 years old

• Do not exercise regularly

• Suffer from a neurological disorder

• Suffer from a cognitive impairment

• Suffer from arthritis or another condition that affects your muscles and joints

• Have family members who have also experienced functional incontinence

The Causes of Functional Urinary Incontinence

While this disability-associated urinary incontinence is typically the result of underlying conditions, there may be other causes and factors involved.

Cognitive disorders

If you have a cognitive impairment, such as dementia or delirium, you may find that you experience involuntary urine leakage. These conditions affect how your brain functions, and you may no longer recognise your need to pee.

In some cases, you may recognise that you need to pee but are unable to find the bathroom or plan a trip to the bathroom because of your cognitive impairment.

Physical disabilities and Arthritis

Decreased mobility because of conditions like arthritis makes it much harder to get to the bathroom in time to pee.

If you have arthritis, you may struggle with mobility and to remove clothing fast enough. If you are wheelchair-bound, you may also struggle to get from your wheelchair to the toilet before your bladder releases urine.

Other physical disabilities like strokes and chronic pain can have the same impact.

Physical barriers

Sometimes it's physical barriers that prevent you from using the toilet - the most common one being limited bathroom facilities or bathrooms that cater to your needs (such as accessible bathrooms for wheelchair users). Other physical barriers include stairs, poor lighting, narrow doorways, and large crowds.

Factors that may Worsen Functional Incontinence

Although by definition functional incontinence is not an issue with the bladder, pelvic floor or bowel itself but with external factors or limitations that prevent toilet access, you may wish to be aware of some factors that may worsen your symptoms.

Weak bladder and pelvic floor muscles

As you age, your bladder and pelvic floor muscles weaken, which often leads to a loss of bladder control. A weak pelvic floor can exacerbate functional incontinence by reducing the ability to delay bladder release, meaning it is even harder to reach the bathroom in time.

Hypertonic pelvic floor

Hypertonic pelvic floor is a common condition that results in your pelvic floor muscles being in an almost constant state of contraction. This can worsen functional incontinence by causing difficulty with fully emptying the bladder and thus increasing frequency and making it more challenging to manage functional incontinence.

Low oestrogen

As women age, their oestrogen levels usually decrease, which can result in thinner bladder lining. Eventually, low oestrogen can also lead to an overactive bladder and urine leaks. This is very common in menopausal women over 50. This can aggravate functional incontinence as it causes urgency or leakage that is harder to manage when you have difficulties with physical or environmental limitations.

7 Effective Management Strategies for Functional Incontinence

Fortunately, there are plenty of effective management strategies and treatment options for functional incontinence, including:

1. Wear incontinence pads and leak-proof underwear

Specialised incontinence products, like incontinence pads and leak-proof underwear, can help you avoid leaks and damage to your clothing. For example, Jude's leak-proof underwear can hold up to eight teaspoons of urine. This can give you the confidence you need to go about your day without any fear of leaks.

Additionally, our ultra-thin incontinence pads are perfect for medium leaks and gushes. Not only are they comfortable, but they are also made from plant-based materials.

2. Home Adaptations

An occupational health assessment of your home can be a valuable step in managing functional incontinence. They may help to increase accessibility through grab bars, raised toilet seats or non-slip flooring. Depending on your needs they can also suggest practical solutions such as bedside commodes or assistive devices which can support you to access the toilet safely.

3. Bladder training

Scheduled toileting and bladder re-training are approaches that can help you establish an achievable routine to beat functional incontinence. Scheduling toileting involves setting regular intervals for visits to the bathroom and reducing the risk of accidents by pre-emptying the urgency.

Bladder re-training focuses on increasing the interval of time between emptying your bladder to try and foster more control.

A healthcare professional can guide you on the best approach and also supervise you to ensure it works for you.

4. Treat underlying conditions

As functional incontinence is typically caused by underlying conditions, treating conditions like constipation and urinary tract infections can help alleviate your functional incontinence symptoms. This is why it's so important to understand the root cause of your incontinence.

5. Physiotherapy

This can be helpful for functional incontinence in two ways. Firstly, physiotherapy can help you to strengthen your pelvic floor muscles through target exercises. Secondly, if your functional incontinence is related to mobility physiotherapists can support you to increase mobility, balance and coordination so that you can reach the bathroom in time.

6. Mobility Aids

Mobility aids such as walking frames and canes are often helpful in supporting individuals with functional incontinence by improving their ability to move quickly and safely to the bathroom. They can reduce the risk of falls and boost confidence.

7. Use a urinary catheter

While urinary catheters can be uncomfortable (especially when you first begin using them), your GP may suggest this approach to provide an effective way to empty your bladder.

Pee can either be drained directly into the toilet or a bag outside your body.

Living With Functional Urinary Incontinence

Living with functional urinary incontinence can be challenging, but it doesn't have to be a life sentence. You should try to keep up a positive attitude and perhaps find a community of people - like our like-minded women at Jude - who suffer from the same condition. This will help you feel less alone in your struggles.

Keeping a bladder diary may also help you with keeping track of your symptoms and whether or not they are improving. It may take a while to learn which management techniques work best for you, so be patient with yourself.

FAQs

What are the other types of urinary incontinence?

The other types of urinary incontinence are:

• Stress incontinence - caused by physical actions like coughing, sneezing, laughing, etc.

• Urge incontinence - preceded by an extreme urge to pee.

• Mixed incontinence - a mixture of urge incontinence and stress incontinence

• Overflow incontinence - involuntary urine leakage due to an overly full bladder

Can I prevent functional incontinence symptoms?

Unfortunately, many of the medical conditions that cause functional incontinence are completely unavoidable. However, by adapting your home, using mobility aids or treating the condition causing you a physical disability you can potentially eliminate function incontinence.

When should I see my doctor regarding functional incontinence?

If you're experiencing functional incontinence symptoms, you should make an appointment with your general practitioner as soon as possible. The sooner you get a diagnosis, the sooner you can begin properly managing your symptoms.

How is functional urinary incontinence diagnosed?

You may be asked to keep a bladder diary and undergo a physical examination to determine the cause of your functional incontinence. You'll also be asked about your medical history. From there, your GP should be able to suggest management techniques and treatment or refer you to an occupational therapist .

Who is most likely to suffer from functional urinary incontinence?

Functional incontinence is common among older adults living in nursing homes. These individuals are at a higher risk of having arthritis, muscular sclerosis, and other conditions that are often linked to incontinence. However, functional incontinence can affect people of all ages and backgrounds.

Final Thoughts

Whether you're suffering from functional incontinence, urge incontinence, stress incontinence, or another type of incontinence, urine leakage can affect your entire life. Not only does it cause a variety of physical problems, but it can have a negative impact on your mental health too.

Sadly, many people feel embarrassed to speak about their symptoms - even with their doctor - as there is a lot of shame and stigma surrounding functional incontinence. Here at Jude, we want to smash taboos and shed light on this topic by providing educational resources and specialised incontinence products.

You don't need to be ashamed of your overactive bladder or urinary tract infection. These types of urinary issues are common and are experienced by millions of women around the world. Just know that you are not alone, and effective management strategies are available.