One in five diabetics 'have overactive bladder'
More than one-fifth of people with type-2 diabetes may also have an overactive bladder, according to a study by scientists in Taiwan.
Overactive bladder syndrome is a common condition that is thought to affect about one in six adults, according to Patient.co.uk.
In most cases the condition is characterised by an urgent need to go to the toilet; however, studies suggest that about one-third of people with an overactive bladder have episodes of urge incontinence, where urine leaks before they can reach the toilet. Researchers at the Chang Gung Memorial Hospital in Taiwan carried out a study involving 1,359 people with type-2 diabetes in order to determine the prevalence of overactive bladder syndrome.
Presenting their findings at the American Urological Association annual meeting, they revealed that 22.5 per cent of participants had an overactive bladder, according to a report by Renal and Urology News.
More than one in ten people with type-2 diabetes revealed that they had overactive bladder syndrome with urinary incontinence.
In addition, the study revealed that the prevalence of overactive bladder syndrome was more than twice as high among over-50s and among those who had diabetes for more than ten years. The study authors concluded: “These findings can help guide collaboration between urologists and diabetologists to work toward developing screening for and early treatment of urologic complications in higher risk patients.”
MPs report underlines importance of incontinence care
An all-party group of MPs has published a new report on the commissioning of incontinence care in the NHS. Around six million men, women and children in the UK are affected by incontinence, and the report is designed to support GP consortia in their commissioning of care.
According to MPs, an integrated continence service can help to reduce catheterisations, pressure ulcers, hospitalisation, care home admissions and reliance on incontinence products. Baroness Greengross, who chairs the All-Party Parliamentary Group for Continence Care, said: “Continence problems can affect any member of the population, young or old. “Patients should be able to expect and receive prompt assessment and care to enable them to carry on living full and active lives.”
Health minister Paul Burstow welcomed the report and emphasised that people with incontinence should not have to suffer in silence.
He said: “Incontinence can so often be a hidden problem that affects so many people of all age groups. “We all have a responsibility to ensure greater awareness that there are services that can help.”
Inhaled COPD drugs linked to urine retention
Men who take inhaled anti-cholinergic drugs to treat chronic obstructive pulmonary disease (COPD) may be more likely to suffer from urine retention, scientists have found. Urine retention occurs when a person is unable to empty their bladder.
Symptoms include the frequent or urgent need to urinate, using the toilet several times a night, and urinary incontinence due to overflow. Canadian scientists analysed data on 565,073 people, aged 66 or older, with COPD – a collection of lung conditions including chronic bronchitis and emphysema. They found that 9,432 men and 1,806 women developed acute urine retention, and the risk was greatest among individuals who had just started using anti-cholinergic therapies.
Writing in the Archives of Internal Medicine, the study authors concluded: “Use of short and long-acting inhaled anti-cholinergic medications is associated with an increased risk of acute urine retention in men with COPD. “Physicians should highlight for patients the possible connection between urinary symptoms and inhaled respiratory medication use to ensure that changes in urinary flow (i.e. incomplete voiding, urinary incontinence and decreased urinary flow) are reported.”
Study sheds light on causes of pelvic organ prolapse
US scientists have discovered the cause of pelvic organ prolapse – a condition that affects many women over the age of 50 and can lead to stool and urinary incontinence.
Dr Ann Word, professor of obstetrics and gynaecology at UT Southwestern Medical Centre, found that the condition is caused by a combination of a loss of elasticity and a breakdown of proteins in the vaginal wall. She revealed: “We found that the protein fibulin-5, which until now simply has been known to be important in generating elastic fibres, actually blocks the enzymes that degrade proteins that support the vaginal wall structure.
“The elastic fibres do play a role, but it’s also the enzymes that degrade the matrix that break down both collagen and elastin over time.” Dr Word’s findings, which are published in the Journal of Clinical Investigation, may pave the way for the development of new therapies that target these enzymes and help to tackle the problem. Figures suggest that about half of women who have had children are affected by pelvic organ prolapse, in which the womb, bladder or vagina protrude from the body.
National project may help manage postnatal incontinence
A national project has been launched that should be of benefit to women who have recently given birth.
Led by the University of Stirling, the National Postnatal Care Redesign Project aims to reduce the number of women who receive poor postnatal care.
According to Dr Helen Cheyne, from the university’s School of Nursing, Midwifery and Health, about 30 per cent of women develop urinary incontinence after giving birth, while many more suffer from depression. Yet the expert said that the needs of many new mothers are not being met.”Midwives in the UK have a statutory duty to provide care to women after childbirth for a minimum of ten days,” Dr Cheyne revealed.”However, competing priorities, the more complex health needs of women and increases in interventions during labour and birth have resulted in a system which does not meet the needs of women.”
The project will gather information from across the UK and use it to inform best practice. Elizabeth Duff, senior policy advisor at parenting charity NCT, welcomed the project. She told the BBC: ‘Women and their families are being let down by current postnatal care and improvement is urgently needed.”
Non-invasive test for bladder outlet obstruction launched
Men with bladder voiding disorders may benefit from a new, non-invasive diagnostic test which has been launched by urinary incontinence experts SRS Medical.
Poor urine flow may be caused by low bladder contractility, or it may be the result of bladder outlet obstruction due to an enlarged prostate. These obstructions can usually be treated, but complications may include bladder stones, kidney failure and urinary incontinence. SRS Medical has now unveiled its latest diagnostic system, the CT3000Plus Complete Urodynamics system, which can provide an accurate, non-invasive assessment of poor urine flow. The test enables bladder pressure to be measured and also features an electronic leak-point detector.
Kevin Connolly, chief executive officer of SRS Medical, commented: “Many men who have been reluctant to undergo the catheterisation necessary for conventional urodynamics can now be tested quickly and comfortably. We are proud to be part of such a significant advance in diagnostic technology.”
The product was launched at the annual conference of the American Urological Association and should be of interest to clinicians working in the field of urinary incontinence.
Patients welcome new incontinence policy
A new policy on eligibility for incontinence pads has been welcomed by patients in Nottinghamshire. The county’s primary care trust (PCT) used to ask patients to bring in their soiled incontinence pads for weighing in order to determine whether they qualified for a prescription. But pressure from disgruntled patients has led the PCT to change its criteria. Janet Poulson, whose 84-year-old mother had refused to return to her local clinic in Kirkby-in-Ashfield because of its policy, told the Eastwood & Kimberley News that she was pleased about the u-turn. She said: “It’s great they’ve changed it (the policy). It will be a lot better for everybody. It was terrible we had to go through all that. I will take my mum back down there now.” Andrew Kenworthy, chief executive of Nottinghamshire PCT, confirmed: “We have reviewed the policy and have now changed the way that eligibility is assessed for the prescription of incontinence pads.” The PCT had previous stated that its policy was introduced in response to budget cuts and people abusing the system of handing out products for incontinence – a condition that affects more than 50 million people in the developed world.
Behavioural therapy may treat Parkinson's disease-related incontinence
Older adults with Parkinson’s disease who suffer from urinary incontinence may benefit from exercise-based behavioural therapy, experts say. A research team at Emory University and the US Department of Veterans Affairs studied a group of Parkinson’s disease patients, all of whom were at least 50 years of age. Participants enrolled in the study between October 2008 and October 2009 and completed behavioural therapy sessions at a rate of five visits over an eight-week period.
They were helped to identify, contract and relax their pelvic floor muscles, and given guidance on fluid management.
The researchers found that patients who received therapy benefited from a reduction in the frequency of urinary incontinence and improvements in their quality of life. Lead investigator Dr Camille Vaughan, whose findings are published in Neurology journal, said: “This study demonstrates feasibility and efficacy of pelvic floor muscle exercise-based behavioural therapy to treat urinary incontinence in older adults with Parkinson’s. “These results are promising and should be evaluated in randomised controlled trials.”
Parkinson’s is a long-term neurological condition that affects the coordination of body movements, such as walking, talking and writing.
Revolutionary pelvic toning device available on NHS
Women with stress incontinence should consider talking to their doctor about a pioneering device that could improve their condition.
The PelvicToner is designed to exercise the pelvic floor muscles, which often weaken after childbirth and during the menopause.
As a result of this muscle weakening, many women experience stress incontinence, where urine leaks when the bladder is under pressure, such as when they cough or laugh.
Now, women can benefit from the spring-loaded PelvicToner device, which has been clinically proven to treat the condition and has been approved for use on the NHS. Professor Marcus Drake, a researcher at the British Urology Institute who led a two-year trial of the product, said: “Continence service provision is patchy and this sort of product empowers women, gives them better privacy and the prospect of not wasting their time. “In our study the PelvicToner aided women to identify their pelvic floor confidently.”
New mums can obtain the device free of charge as long as they have a maternity exemption certificate, while women who pay for their prescriptions can get it for just £7.40.
Behavioural therapy may treat Parkinson's disease-related incontinence
Older adults with Parkinson’s disease who suffer from urinary incontinence may benefit from exercise-based behavioural therapy, experts say.
A research team at Emory University and the US Department of Veterans Affairs studied a group of Parkinson’s disease patients, all of whom were at least 50 years of age. Participants enrolled in the study between October 2008 and October 2009 and completed behavioural therapy sessions at a rate of five visits over an eight-week period. They were helped to identify, contract and relax their pelvic floor muscles, and given guidance on fluid management.
The researchers found that patients who received therapy benefited from a reduction in the frequency of urinary incontinence and improvements in their quality of life. Lead investigator Dr Camille Vaughan, whose findings are published in Neurology journal, said: “This study demonstrates feasibility and efficacy of pelvic floor muscle exercise-based behavioural therapy to treat urinary incontinence in older adults with Parkinson’s. “These results are promising and should be evaluated in randomised controlled trials.”
Parkinson’s is a long-term neurological condition that affects the coordination of body movements, such as walking, talking and writing.