Urinary incontinence in women is sometimes dismissed by physicians as a minor inconvenience, according to Dr. Lily Arya, associate professor and chief of urogynecology and reconstructive pelvic surgery with the University of Pennsylvania medical system.
The condition has an effect on 80 percent of women at some point in their life and a significant number of men, too, she said.
If a person is constantly “bathroom mapping” — determining where restrooms are located before setting out on a trip — that’s an indication that he or she should consult a doctor, Arya said.
For women, stress can exacerbate the problem. Once a woman experiences urinary incontinence, it can trigger life-changing behavior.
They may stop exercising out of concern the problem will grow, Arya said. That can lead to weight gain, heart disease and a poor self-image, the Penn Medicine surgeon said.
“You don’t feel so good about yourself,” Arya said. “This is what I call the creep of the bladder condition. A little joke of ‘Oh, I have to cross my legs’ and then the creep goes on and on and the bladder takes over your life.”
Even more vexing, urinary incontinence can put men and women at risk for depression, according to C. Neill Epperson, director of the Penn Center for Women’s Behavioral Wellness.
“It does have a very powerful impact on how people feel about themselves,” Epperson said.
As such, short-term mental health counseling — about eight sessions — may help reduce or eliminate the problem, Epperson said.
Treating urinary incontinence — by avoiding overhydration, too much caffeine and artificial sweeteners and performing Kegel exercises to strengthen pelvic muscles — can help women avoid using absorbent liners or briefs, Arya said.
In the United Kingdom, midwives show pregnant women how to perform Kegel exercises, she said. The exercises can prevent urinary incontinence, a condition that women can experience after child birth. “We have fallen short of doing that because we have our patients who see doctors who are not as good as midwives, unfortunately, when it comes to preventive care,” Arya said.
Millions of Britons suffer from urinary incontinence, however Marlene Brown, 71, a retired secretary from Wembley in London had a new treatment for the problem.
“Around ten years ago I started needing to go to the toilet all the time — it felt as if something was constantly pressing down on my bladder. My life started to revolve around the bathroom. When I went out to the theatre, for example, with my husband Tom, I’d go before I left home, then at the station, before the show and during the interval. I tried drinking less so I wouldn’t feel so desperate, but I just ended up incredibly thirsty and with a headache.
After about a year of this I went to my GP — he said the problem was that my bladder muscles were contracting too readily. He prescribed drugs to relax the muscles and that helped a bit. I was also referred to a physiotherapist, who taught me daily exercises to strengthen my pelvic floor muscles. But I still had a constant urge for the bathroom and it was making my life miserable.”
Then last March Marlene saw an article in the Daily Mail about a new procedure where they stimulate a nerve in the ankle, which leads to the bladder, to get the bladder acting normally again. Her GP agreed to refer her to North Middlesex University Hospital where they were doing the surgery.
The new procedure involved putting a needle into her ankle for thirty minutes at a time, with an electrode under her foot to create a circuit. This would stimulate a nerve that runs from the spine to the ankle, passing the bladder on the way — thus getting the nerves sending normal signals again.
“I started the treatment in November, though I still didn’t quite believe it would work. First, they put a needle into the inside of my right ankle, about 2cm deep — I just felt a tiny prick, and didn’t need an anaesthetic. Then they put the electrode, which looked like a sticky pad, on the bottom of my foot. The needle was attached to a machine that emitted a small electric charge; it gave me a gentle tingling feeling in my toes. I was shown how to control the machine, gradually turning it up through the half-hour session. Immediately after the treatment, out of habit I looked for the nearest toilet, but realised I didn’t need one.”
Over the next 4 months she had another 11 sessions of treatment. Soon after treatment started the feeling of urgency faded and by the end of the treatment she didn’t feel she needed to rush as she had done previously.
While doctors don’t know exactly how it works, stimulating the nerve with electricity seems to reset it; the nerve then stops sending the signals of fullness from the bladder. This operation carries a small risk of infection, and means a small scar and recovery time of two to three days.
Percutaneous tibial nerve stimulation, the procedure Mrs Brown had, is an exciting development and is an improvement on sacral nerve stimulation. It’s based on the same principle, nerve stimulation, but because it acts on the ankle, not the bladder, it’s less invasive and there’s no recovery time; that means the patient can go straight home afterwards.
Around five million women and two million men in Britain suffer from urinary incontinence, which can make life difficult and can even turn some people into virtual recluses because they’re frightened to leave the house. Stress incontinence, when people can leak when they laugh, sneeze or cough, can be made worse by childbirth or as the muscles supporting the bladder weaken as we age.
Urge incontinence causes you to feel you need to go urgently and really can’t hold on any longer. It’s a problem with the bladder and often develops as we get older. It’s thought that in urge incontinence, faulty nerve signals trigger small bladder contractions, meaning messages go to the brain telling it that the bladder needs to empty.
Psychological triggers such as anxiety, the sound of running water or even seeing your own front door, can worsen this feeling of urgency. Patients can try avoiding caffeine, which irritates the bladder and increases the feeling of urgency.
They may also be offered bladder retraining sessions — for example, deferring going to the toilet — and tightening the pelvic floor muscles so they can resist the urge.
The country is facing a dementia time-bomb with many cases going undiagnosed.
Alzheimer’s charities are saying that many people living with dementia don’t have a diagnosis and so aren’t receiving the support, benefits and the medical treatments that are often available.
Although everyone is a little bit forgetful now and again, but when memory loss starts to interfere with your daily life it is important to get it checked out as soon as possible. The sooner people are diagnosed, the sooner they can get support and start planning for the future.
Studies have shown that an early diagnosis can save the thousands of pounds, because it can delay the need for sufferers to receive care outside of their own home.
The Alzheimer’s Society recommends that anyone concerned about memory problems should speak to their GP. Symptoms include struggling to remember recent events, despite being able to recall things that happened in the past, and finding it difficult to follow conversations or programmes on TV. Other warning signs include regularly forgeting the names of friends or everyday objects, being unable to recall things you’ve heard, seen or read, having difficulty in making decisions, repeating conversations or losing the thread in speech, and having problems thinking and reasoning.
Feeling anxious, depressed or angry about your forgetfulness or finding that other people are commenting on your forgetfulness are other signs.
People who are worried about their memory or that of someone they know can also contact Alzheimer’s Society National Dementia Helpline on 0845 300 0336.
The correct incontinence products can help the many people who experience continence issues alongside their Alzheimers, for example pull-up pants reduce the risk of the pad being removed by the wearer. For more hints and tips for those Caring for someone with incontinence our Carer’s leaflet can be downloaded from our website.
This week’s Daily Mail features a revolutionary new treatment that Doctors have devised treatment for enlarged prostate that involves placing a tiny anchor in the gland. One in four men over 80 will have been treated for an enlarged prostate.
The anchor treatment has been developed to treat an enlarged (non-cancerous) prostate, a condition also called benign prostatic hyperplasia (BPH). The prostate often becomes larger with age, causing symptoms such as reduced or weak urine flow, or frequent night-time urination. The prostate is a doughnut-shaped gland that sits around the urethra as it exits the bladder. It often becomes larger with age, causing symptoms such as reduced or weak urine flow, or frequent night-time urination. There may also be hesitancy, and a feeling that the bladder isn’t empty.
Although current treatments can improve the symptoms, there are potential side-effects. With drug treatments these include sexual dysfunction, dizziness and headaches, as well as decreased libido and one study found that more than a quarter of men stop drug treatment early, mainly due to adverse events and lack of effectiveness.
The gold-standard surgical technique is called transurethral resection of the prostate or TURP. Research suggests that erectile dysfunction rates post-surgery can be as high as 30 per cent, performed under general anaesthetic, the technique involves cutting away a section of the prostate gland. However, research suggests that erectile dysfunction rates post-surgery can be as high as 30 per cent.
The new technique, called Urolift, is a minimally invasive way of pulling back the overgrown prostate tissue to widen the urethra to allow normal flow to return. In the procedure, which is carried out under local anaesthetic, a plastic tube is inserted into the urethra and pushed through to the part of the urethra that has been narrowed. This movement widens the urethra, but it would soon narrow again once the tube was removed. To prevent this happening, the inserted device contains a special needle.
Once the device is in place in the middle of the gland, the surgeon triggers the device to send the needle through the surrounding prostate tissue to the outside of the gland. The needle is threaded with surgical thread. At the other end of the thread there is a tiny anchor which secures it on the inside of the gland. The thread is then pulled tight, pulling the gland away from the urethra, taking the pressure off.
New research shows the treatment can be highly effective, in a study carried out at centres in Australia, including the University of Sydney, 64 men who had suffered with urinary tract problems for an average of five years underwent the treatment. The results show there was an average improvement in prostate symptoms of 60 per cent across the men.
This was based on the International Prostate Symptom Score or IPSS which measures a number of factors including urine flow and none of the men had sexual functioning problems as a result of the procedure. ‘This study demonstrated that meaningful relief can be achieved without compromising sexual function with a minimally invasive mechanical therapy,’ say the researchers.
For many men who have recently undergone prostrate surgery, small pads specifically designed for Men such as Tena Men, can help significantly in managing continence issues during the first few weeks post surgery.
We wrote last week mentioning the launch of new Tena Slip Stretch XXL, a new disposable pad (Slip style All in One) from Tena. This joins the Prevail XXL in our range of range of Disposable Bariatric Pads. The Prevail Pads fit up to a 240cm waist.
In addition we also now offer a range of washable incontinence pants in Bariatric sizes. This includes Men’s Y Fronts, Ladies Pants, Pouch Pants and also the more absorbent Unisex Pants. These washable incontinence pants are all available in sizes fitting up to a 58 inch (153cm) waist.
TENA have now launched their first product specifically designed for Bariatric customers in the UK, and this is available from Allanda, Incontinence Experts.
TENA Slip Stretch XXL offers a new definition of comfort and complete leakage security for individuals with hip sizes of up to 178cms (70 inches). TENA Slip Stretch XXL features a soft textile back-sheet and easy to use wide, reclosable fixation hooks enabling multiple re-adjustments making it simple for caregivers to achieve the perfect fit. The Breathable Stretch Side panels provide a comfortable fit and gently stretch to follow the body’s movements.
These pads also feature TENA’s FeelDry™ technology to quickly draw liquid away from skin to keep skin healthy.
For customers requiring a larger bariatric product we also offer the Prevail XXL All in One pads, which fit waist sizes up to 240cm (94 inches).
Allanda have now added a selection of Disposable Bibs to our existing Bib Range to give our customers more choice than ever.
These handy, disposable serviette bibs come with integral front pockets and back ties for dignified and hygienic protection at meal times. The two cellulose layers absorb fluid, and the intermediate plastic film acts as a barrier to protect clothing. The front pocket collects any spills while the integral back ties secure the serviette in place, close to the user neck. Following meals, the reverse side of the cellulose tissue can be used as a napkin.
We also offer two types of washable bibs, our standard washable bib is a tartan coated fabric, designed for easy cleaning.
Another great new product from Allanda! Our great value disposable aprons protect clothes from liquid spills and splashes and form part of an effective infection control strategy.
Made from 80 gauge/20 micron polythene, our single use premium disposable aprons are liquid resistant and prevent the transfer of fluids making them perfect for catering, cleaning, dentistry, first aid and medical procedures.
For ease of use each apron features a halter neck and waist ties so they slip on and off quickly and easily and are 107cm long (neck to knee length) by 70cm (approx.) wide.
Disposable Aprons are an important part of an effective infection control strategy as their use prevents bacterial contamination when changing environments as well as saving on laundry costs.
We have 4 options in our new Apron range at present:
- White Singles (Pack of 100) and White Roll (Roll of 200) formats, ideal for bedside, cleaning and medical environments.
- Blue Singles (Pack of 100) and Blue Roll (Roll of 200) formats, suitable for catering and food-handling environments.
A fresh smelling room or home can help you feel good and to help you achieve that fresh smell and avoid unpleasant odours, Allanda offer a wide range of Neutradol, Odour destroying sprays.
Neutradol was the first odour destroyer to be introduced in the air freshener market and its unique formula has not been equalled by any of its imitations. Even many years after its launch, as laboratory tests confirm, it is still the best air freshener available in the market.
Neutradol does not just mask unwanted smells like ordinary air fresheners, it destroys all bad odours, even the most persistent, leaving the air fresh and clean. Its formula, high technology / performance led, contains over 50 ingredients and their complex combination breaks down the bad odour molecules and eliminates them. Neutradol is hygienic, non-toxic and is safe for use in the home or elsewhere.
Allanda offer a wide range of Neutradol sprays in both Pump Spray and Aerosol formats and standard and travel sizes. Our full range is the 50ml Travel Pump Spray, 125ml Pump Spray and 300ml Aerosol Spray
An article recently in the Daily Mail highlighted the importance of seeing your GP to discuss health concerns and to look beyond the obvious when treating incontinence and dementia.
When Carole Smith started tripping over more often, she started to worry. ‘ ‘I’d often bruise myself quite badly, but I never mentioned it to anyone. My walking had become more laboured and slower, too.’
There was another problem as well in that often she couldn’t reach the toilet in time.
‘It started ten years ago. I was so embarrassed and upset. I didn’t tell anyone — not even my GP.’
Then in 2006, when she was 67, Carole tripped on a kerb while carrying some shopping home and broke her ribs. She was taken to hospital, badly bruised and after that, a team of six physios came to my house for a week. She realised while they were there that the assumption was that dementia was setting in.
‘They were quite patronising and started trying to tell me things like how to cross roads safely and how to step up kerbs, as though I’d forgotten how to do it. But as far I was concerned, I still had all my marbles and was perfectly able to navigate around my house.’
Three months after the physio, Carole went to her GP to seek an explanation who asked to see her walk across the room. ‘She commented on the fact that my gait was wide and I was unable to keep my knees near each other and said she wanted to refer me to a neurologist for further tests.’
Her GP told Carole she thought the problem was hydrocephalus and said the incontinence and the way Carole was walking and falling were classic signs.
Hydrocephalus is an abnormal increase of cerebrospinal fluid in the brain.
When this fluid builds up it starts to affect the brain’s function, causing symptoms such as gait disturbance (a wide, slow, shuffling gait with unsteadiness, particularly when turning); cognitive impairment such as memory loss, confusion and urinary incontinence.
‘The result was instantaneous. ‘I was in (hospital) for three days having the fluid drained off through a small tube in my back,’ said Carole, who was diagnosed with normal pressure hydrocephalus.
‘Of these three symptoms, the gait disturbance is the one that always appears,’ says Richard Edwards, consultant neurosurgeon at Frenchay Hospital, Bristol. ‘The cognitive problems and incontinence usually accompany it, but not always.’
Carole was diagnosed with normal pressure hydrocephalus (NPH), where the cause of the build-up is unknown.
Acquired hydrocephalus is caused by damage to the brain after a head injury or after conditions such as stroke, brain haemorrhage, brain tumour or meningitis. The condition is most common in people aged 60 or older and its trio of symptoms are also classic signs of other conditions, such as Alzheimer’s or Parkinson’s disease, so it often goes misdiagnosed.
Incredibly, it’s estimated that 2 per cent of all people over 60 who’ve been diagnosed with dementia actually have normal pressure hydrocephalus, which equates to about 10,000 people in the UK.
‘One study showed that NPH affects about five people per 100,000,’ says Mr Edwards, ‘which means we should be treating about 3,000 new cases a year. Instead, we’re treating about 300.’ He stresses the need for better awareness and testing, so fewer people are misdiagnosed. With a proper diagnosis, the symptoms of this kind of hydrocephalus can be alleviated.
For GPs and the public alike, there can be other indications to watch out for. ‘For example, if a person has been diagnosed with Parkinson’s, but they’re not responding to medication, then hydrocephalus should be considered,’ says Mr Edwards. Carole is thankful her GP spotted the signs so quickly.
The full article can be found at: http://www.dailymail.co.uk/health/article-2097376/How-dementia-beaten-drain-brain.html#ixzz1lnHYT7nL