Urinary incontinence is an involuntary leaking of urine, which can occur when any of the normal functions of the bladder are disrupted. There are three major categories of urinary incontinence, which are classified according to etiology: stress incontinence (SI), also referred to as genuine stress incontinence; detrusor instability (DI), also referred to as urge incontinence (UI); and overflow incontinence. In addition, many patients, especially women who have given birth to one or more children, and older women are diagnosed with mixed incontinence, such as a combination of stress incontinence and urge incontinence.
The primary etiological factor producing SI is the incomplete transmission of abdominal pressure to the proximal urethra due to displacement from its intra-abdominal position. SI is classified as a failure to store urine. In this type of urinary dysfunction, leakage occurs during times of abdominal pressure or xe2x80x9cstressxe2x80x9d such as coughing, sneezing, laughing, bending or lifting heavy objects. The frequency and severity of such urine loss can increase as the muscles and tissues, particularly those near the urethro-vaginal myofascial area, grow weaker. It has also been recognized that the urinary sphincter muscle, which is located at the upper end of the urethra, adjacent to the bladder, works well at sealing off the passing of urine from the bladder to the urethra when it has a generally round or circular cross-sectional configuration. Support of the proximal urethra elevates it above the pelvic floor and subjects it to increases in intra-abdominal pressure, thus allowing compression and maintenance of continence. However, when this passageway becomes distorted into an elliptical or oval cross-sectional configuration, the sphincter muscle can not close properly, therefore, the tendency for involuntary urine loss increases. SI can be caused by damage to the proximal urethra through trauma, radiation, sacral spinal cord lesions, prior surgeries, estrogen deficiency, or a congenital weakness. Neuromuscular damage from pregnancy, childbirth, and pelvic surgery is a common cause of SI. SI may also occur in men who have undergone prostatectomy, since the procedure may damage the proximal urethra.
The most common type of urge incontinence (UI) in elderly individuals is detrusor instability (DI) or xe2x80x9curgexe2x80x9d incontinence. DI is urinary leakage due to spontaneous and uninhibited detrusor contractions occurring before the bladder is completely full. Accompanying these contractions is an extremely strong need to urinate (urgency) and in some case complaints of frequency or nocturia. Another term often used is overactive bladder, which includes a cluster of symptoms; urgency, frequency, nocturia and in some cases DI. Most of the time the cause of DI is idiopathic, unless there is a presence of neurological dysfunction such as associated with stroke, cerebral tumors, Parkinson""s diseases, multiple sclerosis, or Alzheimer""s disease. However, a tumor, stone, foreign body, urinary tract infection or even prior surgical procedures to reduce incontinence can also cause this condition.
Overflow incontinence is the involuntary loss of urine associated with an over-distended bladder. This condition results in frequent to constant dribbling of urine in the absence of detrusor contractions. Symptoms may resemble those seen in SI or DI. In men, overflow incontinence may be due to an outlet obstruction, hypocontracted detrusor muscle, or a neurological disorder such as a spinal cord injury or multiple sclerosis. Although rarely seen in women, overflow incontinence is most commonly due to prior genitourinary surgery or pelvic organ prolapse. Individuals with overflow incontinence will typically retain large amounts of urine within the bladder after voiding. In this case, the ability to store urine is intact but bladder emptying is impaired.
Although urinary incontinence affects individuals of all ages, the majority of people are elderly and women. Among non-institutionalized people over 60 years of aged, the prevalence of UI ranges from 15 to 35 percent with women having twice the prevalence of men. Among institutionalized people, this number jumps significantly, as it is often the primary reason why individuals move to institutions. Urinary incontinence is also prevalent in the younger population affecting 10 to 30 percent of women and 1.5 to 5 percent of men.
Unfortunately, the social stigma and embarrassment associated with urinary incontinence contribute greatly to the distress, depression, isolation, and social withdrawal experienced by some affected individuals. Local complications such as skin breakdown, leading to bedsores and infection can also occur. In addition to the social and physical complications, the financial costs are enormous. UI is the second-leading cause of nursing home admissions and accounts for a large percentage of these health care costs. The annual costs of caring for both ambulatory and institutionalized persons with incontinence, including indirect costs (e.g. the treatment of injuries resulting from falls and complications such as skin breakdown), is estimated at several billion dollars.
Accordingly, there is a need for improved ways for individuals to manage their incontinence without embarrassment and with dignity and discreteness so that they may continue to lead active lives and enjoy a high quality of life. Specifically, because there are many mechanisms to maintain continence, involving the bladder, urethra, spinal cord and brain, it follows that a single tactic is often not enough to eliminate the possibility of involuntarily urine loss and soiling of one""s clothing. Since no one single drug, device, or absorbent article can completely assure an individual of the impossibility of the embarrassment of an incontinent episode, a need exists to use anti-incontinence agents and absorbent articles in combination. A further need exists to provide the convenience of an incontinence prevention system to reduce the frequency of incontinent episodes and to protect a users"" clothing from urine that is lost in one package. A combination of an anti-incontinence agent and an absorbent article provides individuals with a discreet, convenient and sanitary approach to manage their incontinence without the need for institutionalization or undue involvement by a medical professional.
Briefly, this invention relates to a combination for managing the involuntary loss of bladder control along with a method of using and manufacturing the combination. The combination includes an anti-incontinent agent capable of reducing urinary loss and an absorbent article capable of absorbing urine that is lost from the body. The anti-incontinent agent is enclosed in a first wrapper and the absorbent article is positioned adjacent to the wrapped anti-incontinent agent. A pouch encloses the wrapped anti-incontinent agent and the absorbent article to keep both items sanitary. A combination of a disposable absorbent article and information related to an anti-incontinent agent is also disclosed.
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