When functioning properly the body relies on combining nervous control with structural design, to make passing urine a subtle subconscious action.
This control can be affected by health problems such as multiple sclerosis, Alzheimer’s disease, Parkinson’s disease and pelvic surgery.
Urinary incontinence is more common in Women because childbirth remains one of the main risk factors.
A possible cause of urinary incontinence is if you have a episiotomy during childbirth (a cut made in the tissues of the birth canal to allow easier passage of the baby). This is quite a controversial issue and the most recent evidence seems to suggest that episiotomies don’t significantly increase the risk.
As well as childbirth, the menopause, with its loss of female hormones, is also a common cause of urinary incontinence. The hormone Oestrogen is essential for helping the tissues keep their strength and elasticity. So when levels of Oestrogen fall, the delicate body tissues become dry and thin, and muscles more lax.
Although urinary incontinence becomes more common with age, it’s not inevitable.
Here at Allanda we can provide you with the right incontinence protection whatever the cause.
We read with interest an article by Liz Szabo in US Today last month.
This supports the widely held believe that Incontinence is far more common than reported and can be treated at any age.
The article focuses on the range of treatments and also on the experiences of Lee Greenwood, a real estate agent, who wet herself while showing a home. This was to be the first of many accidents. “I had to do something about it,” says Greenwood, 59, from Pennsylvania. “I was not going to be a recluse.”
Though Greenwood’s problem is common — 20% to 30% of women have it — her attitude is not. Fewer than half of women with incontinence seek treatment, says University of Pennsylvania nurse practitioner Diane Newman, who treated Greenwood. Some women are afraid to ask, she says, and others don’t realize treatments are available. “These patients are devastated,” Newman says. “It’s still such a hidden condition.”
Greenwood tried a variety of strategies for 1½ years — including pills to ease bladder spasms, a special diet and even antidepressants. Nothing worked.
While surgery is effective for up to 90% of women, Newman says, it can be painful and increases the risk of side effects, such as bleeding. Some patients who have surgery develop new bladder problems, such as the need to urinate frequently, Newman says.
The most promising non-surgical approach — physical therapy called pelvic floor exercises — can cure half of women with stress incontinence, in which urine leaks during activities such as sneezing or coughing, the report shows.
Through the training, also called Kegel exercises, patients strengthen muscles around the urethra that control urination, says Jean Wyman, report co-author and a nursing professor at the University of Minnesota. Unlike medication, the exercises have no harmful side effects and often can be taught by women’s primary care providers, she says.
But isolating tiny internal muscles isn’t easy for everyone, Wyman says. Only about half of women can do the exercises correctly on their own. The rest need additional help from physical therapists or nurses, Wyman says.
Pelvic exercises also can prevent incontinence, says Robert Kane, a co-author of the March report and geriatrician and epidemiologist at the University of Minnesota School of Public Health.
The report considers also considers other ways to treat incontinence.
In a study called the Diabetes Prevention Program, overweight women who exercised and lost at least 7% of their weight reduced their risk of stress incontinence by 15% after a follow-up of three years, according to the NIH paper, published in Annals of Internal Medicine. Women who quit smoking are also less likely to leak, partly because they cough less, which reduces strain on their pelvic floor, Newman says.
And certain medications can also can help. But all medications aren’t alike. While estrogen patches and gels alleviate incontinence, the report notes that hormone pills make it worse. Kane says doctors aren’t sure why.
Greenwood finally solved her problem three months after Newman taught her to use electrical stimulation at home. Greenwood still uses the system, in which an internal sensor contracts the pelvic floor muscles for her, half an hour a day. Although the technique worked for her, the NIH report notes there’s no evidence that it benefits women in general.
Greenwood says she no longer lives in fear of accidents. She still uses a patch, which provides Detrol through the skin, and wears pads as insurance. She also does regular pelvic floor exercises.
Wyman says women shouldn’t be afraid to seek help — even if they’ve suffered for years.
“At any age”, Wyman says, “it’s never too late.”
Ivan Lewis, Care Services Minister has announced a flagship 24-hour telephone helpline for carers is going to be introduced in England next year.
However the £2.7 million helpline will not be available to Wales, Scotland or N. Ireland due to a lack of information about entitlements in the devolved administrations.
The carers helpline is being introduced as part of the Government’s Carer Strategy. Ivan Lewis, said people would ‘not be turned away’ because of their nationality, but if they were asking detailed questions about services in Scotland, Northern Ireland or Wales then ‘at the moment the helpline will not have the capacity to give the information they need’.
The work and pensions select committee have challenged the ministers on whether they would raise carer’s allowance, following worries over the government’s failure to raise the amount of £50.55 a week in the government’s carer strategy.
Minister of disabled people, Anne McGuire said that a promised review of carers’ benefits would look at how the allowance “fitted” with other working age benefits.
Researchers at the University of Virginia Department of Urology and Walter Reed Army Medical Center have found that a brain chemical called serotonin, which malfunctions in people with depression, may also be linked to urge incontinence from an overactive bladder.
That means antidepressant drugs used to block serotonin absorption in the brain may also help patients manage urge incontinence. Unlike stress incontinence, which is when bladder muscles weaken through ageing, physical stress such as coughing, or neurological disorders, urge incontinence can be inherited and often begins in childhood.
Nurses who talk with their patients about incontinence should also be on the lookout for symptoms of depression and vice-versa.
The website Continencenurse.net have just published ten facts that every nurse should know about Incontinence, these are based around recent research and in some cases challenge long held beliefs. We thought some of these may be useful to patients and nurses who visit this site:
1. Incontinence is not a normal outcome of ageing.
The inability to control urine is one of the most unpleasant and distressing problems from which a person can suffer, often causing isolation, depression and physiological problems. Urinary incontinence is NOT part of the normal aging process but it IS a sign of an underlying problem that requires careful assessment.
2. Patients are more likely to discuss incontinence problems, symptoms and treatments with a nurse than with a doctor.
The widespread stigma around patients around incontinence places a greater burden on nurses to introduce the topic of bladder control. Nurses understand the best ways to initiate a dialogue with patients, put them at ease, and encourage them to talk about symptoms, related issues and lifestyle changes. They can offer significant help to their patients in overcoming their reluctance to discuss bladder control problems — after all, in a recent poll, nurses were named the health care professionals most trusted by the public.
3. Incontinence can often be cured or improved with simple lifestyle changes.
Many people with symptoms of urinary incontinence (UI) or overactive bladder (OAB, symptoms of which include urinary urgency, frequency and frequent trips to the bathroom at night) find their symptoms improve as a response to changes in their behaviour, environment, or lifestyle. New skills, habits, and strategies for preventing UI and lifestyle changes, such as smoking cessation, weight reduction, dietary and fluid intake changes, bowel regulation, bladder retraining, and pelvic floor muscle exercises are all included.
4. Kegel exercises work and should be encouraged for men and women.
Also known as pelvic floor exercises, Kegels can significantly improve various types of incontinence in men and women. It is important for people to know about Kegel exercises because they are a type of simple, inexpensive, self-care that really works. Up to 80% of the incontinent population can benefit from Kegel exercises.
One of the main causes of Women’s urinary incontinence is hormones. Before menopause, a healthy dose of estrogen keeps the lining of the bladder healthy and strengthens the pelvic muscles by stimulating blood flow to this area.
But without the oestrogen brought on by menopause, your pelvic muscles may become less strong and lose the power to keep the opening of your bladder sealed. This then causes unwanted leaks particularly when coughing or lifting for example (this is known as stress incontinence).
This type of incontinence can be prevented by pelvic floor exercises. Strengthen your bladder muscles by squeezing and holding your pelvic muscles, as though you are trying to avoid urination, and then relax them. Repeat three sets of fifteen of these every day.
Another way of helping to avoid incontinence is to drink extra water, then delaying urination for five to fifteen minutes which will boost your bladder strength.
The advent of super-comfortable nappies are causing problems with increased incontinence the Daily Mail reports, though thats not the only problem. “It’s the attitude of parents which is also to blame” says paediatric nurse June Rogers, who works as a specialist adviser on child incontinence in Manchester.
She adds: ‘I don’t know if you could say parents are lazy, but toilet training certainly isn’t a priority for a lot of them.’
As a result, increasingly older children are now effectively incontinent-This means primary school teachers are being expected to deal with growing numbers of nappy-wearing children starting full-time school. Today, every new reception class of 30 will have more of these youngsters, and in some areas it is almost the norm. Ann Nash, a teacher in Bradford and a spokeswoman for the Association of Teachers and Lecturers, said she had recently heard of three children from the same family who arrived at school still in nappies. ‘The oldest of them was seven – and by then the incontinence problem is fairly well set in.
The use of smaller sized pull-up underwear being promoted as training products has made it a lot worse, but the biggest problem is that some parents are increasingly aware that the disability discrimination law, introduced in 2005, means schools can’t legally reject pupils because they are incontinent, so they don’t bother to train them.
The Government Carer Strategy published last week appears to have listened to what carers need, so lets hope the goals are seen through.
The Strategy will aim to:
- Put £150m towards carers having short breaks.
- £38m will go towards support for carers entering or re-entering the job market.
- £6m for improving support for young carers.
- Other aims include annual health checks for carers to help them stay fit and well.
- Training for GPs to recognise and support carers.
- As well as a personalised support service for carers being offered and targeted training for key professionals to support carers.
Although it’s ambitious, the Government plan by 2018 to have carers recognised as expert partners in care and be able to have a life of their own.
Carers Week 2008 started Monday 9th June and ends Sunday 15th June.
As someone experiencing incontinence, there is a chance you have a carer, and this week is your chance to say ‘Thank You’ to them for all their support and hard work.
The Carers Week National Survey 2008, revealed some interesting facts on the effect caring can have with regards to their health, relationships, career and finances.
Carers Week is in its 14th year and is in partnership with 10 charities including Carers UK, Counsel and Care, Crossroads Caring for Carers, Macmillan Cancer Support, Help the Hospices and 5 others.
Many celebrities have pledged their support for Carers Week 2008, one of them being Tony Robinson, better known as Baldrick in Black Adder and as himself in Time Team:
“Carers are the unsung heroes and heroines of contemporary society, but the contribution they make is far too often ignored. Let’s work together and demand the changes we need in order to make their lives better”.
In February 2007, the Government agreed to renew The National Strategy for Carers to improve their support and this week, the Government will be publishing the Strategy. We will be posting further information about the Strategy in the near future.
Money off vouchers for Superdrug and Carers Week bookmarks are now available direct to carers from the Carers Week website more…