A man inspired by his friend’s courage in living with incontinence hopes to break the stigma around the condition by running the Bracknell Half Marathon yesterday (29th April 2012).
Duncan Gennery, 40, will raise money for the Bladder and Bowel Foundation, the UK’s leading Incontinence charity, that has supported his friend Tim Harvey, 51.
Mr Gennery said: “I hope this will raise awareness, even if just one or two people pick up the phone and get some help that can change their lives, rather than worry about how they are going to get through the day.”
Mr Harvey, from Hanworth, said: “Because of the nature of the condition, no-one wants to talk about it. So many people suffer in silence. I think it is absolutely fantastic that Duncan is running to raise awareness.”
The friends both work as traffic officers for the Highways Agency.
Mr Harvey suffered from urgency – suddenly needing to go to the toilet – in his 20s and 30s but the problem got worse and he found himself sometimes being unable to make it to a toilet in time, which meant he had to plan his day around where to find a toilet. He also asked others to buy him incontinence pads because he was too embarrassed to buy them himself. He eventually decided he had to overcome his fears to seek help, and saw a GP. He had an operation to increase the size of his bladder but it was not successful and he had a later procedure to remove control of his bladder, so he now wears a catheter. After suffering from depression, Mr Harvey has dedicated himself to raising awareness of the condition so others do not go so long without seeking help.
He said: “I don’t want anyone else to go through what I have. If just one person seeks help, then that’s all I can ask.”
Women with urinary incontinence who also enjoy their regular cup of coffee or tea don’t have to worry about the extra caffeine making their condition worse, suggests a new study.
The new research published in Obstetrics & Gynecology, May 2012 stands in contrast to the common recommendation that women with continence issues stay away from caffeinated foods and beverages.
“If a woman feels she wants to abstain from caffeine that’s completely fine, but based on our results, women with moderate incontinence shouldn’t be concerned,” said Mary Townsend, the study’s lead author from Brigham and Women’s Hospital and Harvard Medical School in Boston.
Still, the findings cannot say whether caffeine might have a shorter-term impact by making women need to urinate soon after eating or drinking something caffeinated.
According to Townsend, there are some biological reasons that may prompt women with incontinence to stay away from caffeine, i.e. that it increases the production of urine and may give some the urge to go. But it’s been unclear whether a daily caffeine habit is tied to worsening incontinence over the long run.
To try to answer that question, the researchers looked at data on about 21,500 women enrolled in two large studies, each of which tracked the long-term health of U.S. nurses through surveys starting in the 1970s or 1980s.
Townsend and her colleagues selected women with light incontinence, defined as leaking urine one to three times per month , from participants who were asked about incontinence and caffeine consumption in 2002 or 2003.
The women were questioned about how much caffeine they ate or drank in the form of coffee, tea, soda or chocolate over the previous few years.
Two years later, when they were again surveyed about incontinence, about 20% of women said their symptoms had deteriorated and they now leaked urine at least once per week. This was consistent regardless of how much caffeine they’d reported eating and drinking.
The researchers also didn’t find a link between women who increased their caffeine consumption between the survey years and worsening urinary symptoms, either for general incontinence or for overactive bladder in particular.
Townsend said most women in the study did not even tell their doctors about their incontinence.
She also said the new findings, need to be confirmed with more research because there’s a possibility that caffeine could make urinary symptoms worse over longer than a few years.
The study was also limited because incontinence symptoms were reported by the women themselves and not measured by a doctor, and the researchers didn’t take treatment for incontinence into consideration.
Pelvic floor exercises are safer and significantly more effective than medication for managing urinary incontinence
A recent study published in Modern Medicine Magazine says that Pelvic floor exercises are safer and significantly more effective than medication for managing both stress and urgency urinary incontinence. It also said that regardless of the therapeutic approach, patient compliance is critical to long-term success.
Overall, drugs for urinary incontinence (UI) were said to have relatively little benefit, as side effects kept compliance low, and long-term safety was still questionable. Contrastingly pelvic floor exercises could make a significant difference if women stuck with it, according to a Comparative Effectiveness Review conducted by the Effective Health Care Program arm of the American Agency for Healthcare Research and Quality (AHRQ).
The analysis of 905 studies found that nonpharmacologic treatment—Pelvic Floor Exercises —can result in significant benefit, making up to 100% difference in incontinence rates, with no adverse effects. Similar rates of success were reported, regardless of whether patients used biofeedback with the exercises.
By comparison, the report noted that drug treatments are more effective than placebo, but the degree of benefit was low for all drugs, with fewer than 200 cases of continence attributable to treatment per 1,000 women. Dry mouth, constipation, and blurred vision were cited as the side effects chiefly responsible for low compliance with the prescription drugs.
Women with daily stress urinary incontinence perceive clinical benefit from a treatment when frequency is reduced approximately 50%, but they typically only report improved quality of life and clinical success when they experience at least a 70% reduction in frequency. Similarly, more than 60% of women with persistent urgency, stress, or mixed urinary incontinence report complete treatment satisfaction when they experience more than 70% reduction of incontinence episodes.
The review reports that available diagnostic tests are of minimal value in distinguishing women with stress or urgency urinary inconitinence. Although nonsurgical treatment decisions are driven by clinical evaluation with validated tools for diagnosis of urinary incontinence, multichannel urodynamics was no more accurate than patients’ self-reports of symptoms at predicting who would benefit from nonsurgical options.
Urinary tract infections (UTIs) are fairly common, especially among the elderly. But what most people don’t understand is that some of the symptoms of a UTI can mimic incontinence or the early signs of dementia.
A urinary tract infection is a bacterial infection that occurs anywhere along the urinary tract. The most common symptoms include a fever, painful urination, strong need to urinate and foul-smelling or cloudy urine.
However, in older adults some of these symptoms do not present, like fever, or may be something experienced often, like strong need to urinate, due to age and bladder weakness.
As the infection progresses, it can bring about additional symptoms such as confusion, agitation, poor motor skills and other behavioural changes. Because these symptoms are also warning signs of dementia, a UTI can often be overlooked or misdiagnosed.
According to the American National Institutes of Health, there are several conditions that make the elderly more susceptible to urinary tract infections. These include diabetes, catheters, incontinence, immobility and kidney stones. Untreated, a UTI can lead to sepsis, a potentially life-threatening bloodstream infection; which is why it is so important to monitor and treat any infections.
Some suggestions for reducing the risk of developing a UTI include:
- Drink plenty of fluids.
- Change undergarments and/or incontinence products frequently.
- Always cleanse the genital area from front to back using appropriate skin care.
- Avoid or reduce caffeine and alcohol intake.
- Add cranberry juice or pills to your diet, unless you have kidney stones or are on blood-thinning medication.
Anyone suspecting a urinary tract infection should see a healthcare professional as soon as possible.
Constipation can cause urinary or faecal incontinence as the impacted stool puts pressure on the bladder and weakens rectal and intestinal muscles so strategies for managing constipation-related incontinence are important including dietary changes and using products that keep skin dry and healthy.
Incontinence caused by constipation can affect individuals of all ages. Wake Forest Baptist Medical Center researchers in the U.S.A. recently published a study in the journal Urology that found constipation often is a cause of bedwetting in children. Laxative therapy cured 83% of the children and adolescents studied within three months, reported an article published in U.S. News & World Report.
Constipation is one of the more easily treatable, temporary medical causes of urinary or faecal incontinence, here a some tips for managing constipation-related incontinence:
-It’s important that older people consult their doctors about how much water to drink. Drinking water helps prevent constipation, but too much can cause frequent urination.
-Eating more fibre can help soften stool and improve digestion. Foods rich in insoluble fibre include vegetables, whole grains, nuts, beans and berries.
-Food and beverages that can cause bowel irritation include spicy or oily foods, alcohol, caffeine, and dairy products for the lactose-intolerant.
-A health care professionsal may suggest medications, stool softeners, laxatives, or enemas to loosen impacted stool.
-Use quality incontinence products that are made from advanced, absorbent materials that keep urine and stool away from skin.
-Implement a proper skin care regime that includes cleansing, moisturizing and protecting, to keep skin healthy and prevent infection.
Harry Potter star, Helena Bonham Carter, has suprisingly revealed that she wore incontinence pads on set because her pelvic floor was too weak to control her leaky bladder following recent child birth in an interview with the Sunday Times “Style” Magazine. (Sunday Times 22 April 2012).
This highlights the importance of pelvic floor exercises throughout pregnancy, and even before for the 15,000 new mothers who give birth every week.
Details about how to do Pelvic Floor Exercises can be found in a recent video produced by Allanda featuring Ann Winder, Incontinence Expert. The video is featured on our website at www.allaboutincontinence.co.uk or at our YouTube channel.
The number of different products can be confusing, but it’s important to find the best product for your needs. Our latest video talks through the different types of incontinence products, both incontinence pads and incontinence pants and disposable and washable products. It also talks through basic product features to look for as well and how the products work.
We are always disappointed that Incontinence and how to manage the condition gets little coverage in the press considering how common the condition is so we were pleased to find a good article at Wales Online containing a good overview of types and causes and what to do. The full column is repeated below.
Q. I’ve started needing to use the toilet a lot more often in recent months and had a few embarrassing near-misses when I was out and about. It’s got to the point where I’m almost afraid to go out of the house in case I have an accident. What might be causing this?
A. Incontinence is very distressing and an estimated 3.5 million people in the UK have a bladder control problem, with half of these being aged 65 or over. However, the main thing to bear in mind is that you don’t need to struggle with this issue on your own – professional help is available.
There are different types of incontinence. The most common types are stress incontinence, urge incontinence and overflow incontinence.
Stress incontinence is leakage when you cough, sneeze, laugh or exercise (which for some people may include gentle exercise like walking). Stress incontinence is most usual in women and is caused by a weak bladder and pelvic floor muscles.
Urge incontinence is indicated by a sudden urgent need to pass urine, but not being able to reach the toilet in time. You may also need to pass urine more often than is usual and you may be woken several times at night.
Urge incontinence can often be caused by an overactive bladder and many people find that as they get older, their bladder becomes more unpredictable, gives less warning and needs emptying more often.
This is normal, until it becomes a problem or starts to cause incontinence. Overflow incontinence happens when the bladder does not empty properly. Urine builds up and it may overflow – often as frequent dribbling leakage. If you have overflow incontinence you may have difficulty starting to pass urine and feel that your bladder does not empty completely.
Whatever the type of incontinence, you can contact your GP or family doctor. They may examine you and carry out some treatments, referring you to a specialist if required. Alternatively, you can also refer yourself to an NHS continence clinic for assessment and advice about treatment from a specialist nurse, called a continence advisor. A hospital specialist such as a urologist, gynaecologist or geriatrician may carry out bladder tests and specialist treatments.
A new treatment for prostate cancer can rid the disease from nine in ten men without debilitating side effects, a study has found, leading to new hope for tens of thousands of men. It is hoped the new treatment, which involves heating only the tumours with a highly focused ultrasound, will mean men can be treated without an overnight stay in hospital and avoiding side effects such as incontinence associated with current therapies.
A study has found that focal HIFU, high-intensity focused ultrasound, provides the ‘perfect’ outcome of no major side effects and free of cancer 12 months after treatment, in nine out of ten cases whereas traditional surgery or radiotherapy can only provide the perfect outcome in half of cases currently. Experts have said the results are ‘very encouraging’ and were a ‘paradigm’ shift in treatment of the disease.
It is hoped that large scale trials can now begin so the treatment could be offered routinely on the NHS within five years. The National Institute for Health and Clinical Excellence will say in new guidance next week that the treatment is safe and effective and larger scale trials should go ahead.
Prostate cancer is the commonest cancer in men with more than 37,000 diagnoses each year approximately 10,000 deaths. Current treatments include surgery to remove the whole prostate or radiotherapy. Both of which can effectively treat the cancer but often cause side effects such as incontinence and impotence. However in many men prostate cancer will not progress to a life threatening disease meaning that radical treatment risks side effects unnecessarily. For this reason, research is now focused on reducing side effects.
Focal HIFU involves careful selection of tumours, as small as a grain of rice, within the prostate gland and targeting them with highly focused ultrasound to heat them and destroy them. The benefit over previous HIFU and other treatments is that damage to surrounding tissue is minimised, meaning there are far fewer side effects.
In the study published in the journal Lancet Oncology, 41 men were treated with focal HIFU. After 12 months, none were incontinent and one in ten suffered impotence. The majority, 95 per cent, were free of cancer after 12 months.
Dr Hashim Ahmed, who led the study at University College London Hospitals NHS Foundation Trust andUniversity College London, said: “This changes the paradigm. By focusing just on the areas of cancer we reduce the collateral damage to surrounding tissue. Our results are very encouraging. We’re optimistic that men diagnosed with prostate cancer may soon be able to undergo a day case surgical procedure, which can be safely repeated once or twice, to treat their condition with very few side-effects. That could mean a significant improvement in their quality of life. “
He said after Nice guidance is issued next week, he expected other doctors to consider using the treatment.
Owen Sharp, Chief Executive of The Prostate Cancer Charity said: “We welcome the development of any prostate cancer treatment which limits the possibility of damaging side effects such as incontinence and impotence. These early results certainly indicate that focal HIFU has the potential to achieve this in the future. However, we need to remember that this treatment was given to fewer than 50 men, without follow up over a sustained period of time. We look forward to the results of further trials, which we hope will provide a clearer idea of whether this treatment can control cancer in the long term whilst ridding men of the fear that treating their cancer might mean losing their quality of life.”
Pelvic floor exercises are effective for treating adult women with urinary incontinence (the involuntary loss of urine) without risk of side effects, according to a new report from the U.S. Department of Health and Human Services’ (HHS) Agency for Healthcare Research and Quality (AHRQ). The report also found that in contrast drug-based treatments can be effective, but the degree of benefit is low and side effects are common.
The report, a comparative effectiveness review prepared for AHRQ’s Effective Health Care Program by the Minnesota Evidence-based Practice Center, was published today in Annals of Internal Medicine. The full report and summary publications for consumers and clinicians are available at www.effectivehealthcare.ahrq.gov.
“Urinary incontinence can affect women in a variety of ways, including physically, psychologically and socially—and some of these impacts can be severe,” said AHRQ Director Carolyn M. Clancy, M.D. “This new report will help women and their clinicians work together to find the best treatment option based on each patient’s individual circumstances.”
Urinary incontinence is extremely common in adult women, affecting approximately 25 percent of young women, up to 57 percent of middle-aged and postmenopausal women, and approximately 75 percent of older women in nursing homes. The condition can impose significant, potentially debilitating lifestyle restrictions. The cost of incontinence care in the United States alone averaged $19.5 billion in 2004, and by one estimate the annualized cost of women’s nursing home admissions due to urinary incontinence was $3 billion. Six percent of nursing home admissions of older women are attributable to urinary incontinence.
Researchers concentrated on two kinds of incontinence: stress incontinence, or the inability to retain urine during coughing or sneezing; and urge incontinence, which is an involuntary loss of urine associated with the sensation of a sudden, compelling urge to urinate that is difficult to defer. Both types usually occur when the urinary sphincter fails, often as a result of weak pelvic floor muscles, which support the uterus, bladder, and other pelvic organs.
Exercises to strengthen the pelvic floor muscles, similar to Kegel exercises, were found to be effective in increasing women’s ability to hold their urine. Pelvic floor muscle training combined with bladder training improved mixed (stress and urgency) incontinence, the report found. Estrogen treatment was found to be effective in treating stress incontinence, but with some side effects. Another drug treatment, the antidepressant duloxetine, was not found to be effective, while carrying high risk of side effects.
Overall, the report found that the drugs reviewed showed similar effectiveness. However, with some drugs, more women discontinued treatment due to bothersome side effects. The report provides comprehensive information about side effects with each drug to help clinicians and patients choose treatments with the most benefits and least harms.
Researchers said that while there is much evidence on clinical measures for treatment of urinary incontinence, such as grams of urine lost, there are fewer measures of quality of life related to the condition and its treatment