Some statistics about incontinence
- Two-thirds of individuals who experience loss of bladder control symptoms do not use any treatment or product to manage their incontinence. 1
- Urinary Incontinence affects 200 million people worldwide. 1
- About 17% of women and 16% men over 18 years old have overactive bladder (OAB) and an estimated 12.2 million adults have urge incontinence. 1
- One in four women over the age of 18 experience episodes of leaking urine involuntarily. 1
- On average, women wait 6.5 years from the first time they experience symptoms until they obtain a diagnosis for their bladder control problem(s). 1
- Stress urinary incontinence, the most prevalent form of incontinence among women, affects an estimated 15 million adult women in the U.S. 1
- Urinary Incontinence is twice as common in women as in men.2
- Pregnancy, childbirth, and menopause are major reasons of the increased prevalence of incontinence in women as compared to men. 1
- Between the ages of 18 and 44, approximately 24% of women experience incontinence.3
- For women over age 60, approximately 23% deal with incontinence.3
Sources
1 National Association for Incontinence, Facts and Statistics, http://www.nafc.org/index.php?page=facts-statistics
2 WomensHealth.gov, Urinary incontinence fact sheet, http://womenshealth.gov/publications/ourpublications/fact-sheet/urinary-incontinence.cfm
3 American Medical Systems, Urinary incontinence, http://www.americanmedicalsystems.com/womens_conditions_detail_objectname_womens_urin_incont.html
Caesareans no guarantee against incontinence
Post-partum urinary incontinence is less common in women who have a caesarean delivery but it is still a persistent problem for one in seven women a recent study has shown.
A prospective study of more than 1500 nulliparous women found that persistent urinary incontinence was experienced by 25% of all women up to 18 months after giving birth.
Rates of urinary incontinence among women who had a caesarean were about 40% those of women who had a spontaneous vaginal birth, but persistent incontinence was still seen in 16% of women after a caesarean, according to the findings published in the British Journal of Obstetrics and Gynaecology this month.
New device reduces risk of post prostatectomy incontinence
A ‘nerve-spotter’ is being tested as a way to reduce nerve damage which can cause incontinence following surgery. The device detects the location of crucial nerves buried in the tissue and invisible to the eye, thus enabling surgeons to avoid accidentally severing them.
Doctors are now trialling it in prostate surgery to reduce post-operative incontinence and impotence. It’s estimated that around 30 per cent of prostate cancer patients suffer some degree of erectile dysfunction after a prostatectomy (prostate gland removal). This is usually a result of damage to two sets of nerves next to the prostate gland, one set of which controls sexual functioning and the other continence. In some cases, these side-effects are temporary, but in around 20 per cent of patients they can last for up to two years or longer. Many men will use male incontinence pads during this period.
At the moment, surgeons have relatively unsophisticated ways of avoiding the nerves, relying on anatomical ‘signposts’ such as the seminal vesicles (tiny sacs at the back of the prostate gland) and their judgment, however the problem is that these markers vary with each man.
The new device, called the ProPep Nerve Monitoring System, helps the surgeon monitor the position of the nerves. Two wire-like electrodes are placed in the tissue around the prostate and urethra (the tube that carries urine from the bladder) and these electrodes are connected to an external monitor.
The electrodes emit a small electrical current and the speed at which this current passes through the tissue shows if there is a nerve there as nerves, unlike tissue, are highly efficient carriers of electricity. When nerves are detected, the electrodes produce a warning signal, displayed on the monitor for the surgeon to see during the operation.
‘Surgeons welcome anything that will help pinpoint the nerves to give better outcomes for sexual function and continence,’ said Professor Raj Persad
Link between Incontinence and Alzheimers to be investigated
Does Alzheimer’s disease lead to incontinence? Not necessarily, asserts a University of Virginia researcher in the USA. A new grant from the National Institutes of Health will help professor Karen Rose determine whether people living with Alzheimer’s are incontinent because of the disease, or whether their incontinence and night time agitation – common symptoms of the progressive brain disease – are connected and might be, therefore, better and more thoughtfully managed.
“People assume that incontinence is part of the disease, that ‘that’s the way it goes,’ but that may not be, in fact, true,” said Rose, who will lead the two-year study. “The answer isn’t necessarily just putting a diaper on someone.”
Between 70 percent and 90 percent of those living with Alzheimer’s are cared for by family members in their homes, and many who are treated for agitation – another common occurrence among this population – are given sedating medication which may have an effect on their continence. Roughly 53 percent of Alzheimer’s patients suffer from incontinence, Rose said.
One in eight people 65 and older, are living with the degenerative brain disease, which robs victims of memory, cognitive function and physical control.
Urinary incontinence, common in Alzheimer’s patients, often means families feel cornered into sending their loved ones into a nursing home. The study’s goal, Rose said, is to offer solutions to families caring for their loved ones.
“It’s very intimate, very personal, these things,” Rose said, “and it can be a tipping point for institutionalization.”
Rose, along with colleagues and professors John Stankovic and John Lach, and collaborator Janet Specht from the University of Iowa, will study a group of 50 local individuals with Alzheimer’s who are at least 65 years old who receive care at U.Va.’s Memory and Aging Care Clinic. Those with Alzheimer’s will wear a wrist actigraph at night – a device created by Lach and Stankovic that measures physical movement and agitation – and will sleep on beds with wetness sensors. They will also be recorded for verbal agitation between the night time hours of 9 p.m. and 7 a.m. Data will be collected over five days and nights, and tabulated to see whether physical and verbal agitation precedes bed-wetting and whether there are timing issues to consider – whether a person is incontinent early in the evening or in the morning, for example – that might help families better keep ahead of the problem.
Rose said the study could ultimately inform the way families manage incontinence by offering a template for home study of Alzheimer’s patients and their continence patterns. She said her study will bring a difficult topic better into the light.
“There’s a stigma attached to all of this – the disease, the incontinence, the burden on families,” Rose said. “But we still don’t know whether some very basic things are linked. We don’t know that urinary incontinence is just part of the disease. Are they agitated because they’re incontinent? Are there things we can do to relieve that?”
Rose, an associate professor of nursing and director of the Bachelor of Science in Nursing program, has taught acute and specialty care courses at the school since 2006.
Horse tranquilliser drug linked to Incontinence
Drug experts are warning about the dangers of ketamine – a horse tranquilliser increasingly being used as a party drug. Airedale Bradford & Leeds Primary Care Trust warn that prolonged or heavy use of the drug can cause urinary incontinence and bladder blockage as well as damage to the kidneys and urethra.
A survey of UK dance drug users found that one-third of respondents had taken ketamine and of those over a quarter reported experiencing urinary symptoms. Dr Andrew O’Shaughnessy, consultant in public health for Airedale Bradford and Leeds PCT, said: “Ketamine use is a growing problem which, if not stopped, will lead to much human misery and increasing NHS costs during the decade. We urge users to stop now.”
Improve your Bottom Line – small changes to help you improve continence
We featured a video yesterday from the Continence Foundation of Australia (CFA) and mentioned the advertorial featured on Australian Television.
This feature gives lots of importance advice to help you improve or cure your bladder condition so we thought it was worth featuring as it would be a great starting point to take control and improve your incontinence.
Don’t let Incontinence Hold you Back – Continence Foundation of Australia Key Messages
In Australia, the Continence Foundation of Australia (CFA) has launched an innovative nationwide campaign to get the message across to the community at large that continence issues are not a natural part of ageing and can be prevented, cured or better managed.
The 12-month long campaign, Healthy Bladder and Bowel Habits, features a Youtube video – Don’t let incontinence hold you back- a commercial which aired on two television stations, an advertorial on a daytime chat show, and a series of activities.
Launched during World Continence Week in late-June, the campaign highlights the need for people to make bladder and bowel health a priority, to both manage and prevent continence problems.
CEO of CFA, Barry Cahill, has emphasised the importance of informing older Australians of the facts and dispelling the myths about bowel and bladder control, both in the community and aged care sector.
This, he added, is especially important given the size of the problem in Australia.
Mr Cahill estimated that around 40 per cent of people aged over 75 are affected by incontinence.
“It is one of the biggest health issues within our community, but one we rarely talk about,” Mr Cahill said.
“Millions of Australians are living with incontinence but most people are reluctant to discuss the problem with anyone, including their GP.
“…While it is true that ageing causes changes to the lower urinary tract, this does not necessarily lead to incontinence.
“It is vital to understand and treat the underlying health issues that are causing incontinence.”
Incontinence is one of the principal reasons for entry to a Care Home.
The CFA believes that around 70 per cent of people affected by incontinence do not discuss the issue with anyone, including their GP, while around 60 to 70 per cent of people affected can be cured or better managed.
“Talking about bladder and bowel health and raising awareness of the issue should be the responsibility of all health professionals.
“Understanding incontinence and recognising that it can be prevented, cured or better managed benefits residents and clients in the aged care sector by helping them to regain control.
“Medical professionals are integral in identifying those at risk and asking the right questions so they can refer their patients to appropriate continence services.
“Making bladder and bowel health a part of our everyday conversation will also help to destigmatise the issue in the community, and empower people who are experiencing issues to seek help.”
Management of incontinence has been shown to consume a large part of nursing staff time.
According to CFA, the health issue also impacts a person’s self-esteem, motivation, dignity and independence; lowers a person’s productivity and length of participation in the workforce; and impacts on social and volunteer activity in the community.
Incontinence is more prevalent than asthma – more than 2 million people are incontinent in Australia – anxiety disorders (2.3 million) and arthritis (3.1 million).
In 2010, the total financial cost of incontinence was estimated to be $42.9 billion – or $66.7 billion including the cost of burden of disease; the total productivity loss due to incontinence was $34.1 billion; and the opportunity cost of informal (unpaid) care provided by loved ones to those with incontinence was estimated to be $2.7 billion.
Mr Cahill said that given a quarter of the population lives with continence problems, and the enormous social and financial costs associated with the issue, bladder and bowel health can no longer be ignored by the community, health professionals or governments.
“There are many challenges associated with incontinence and the need to prioritise continued funding into the prevention, treatment and management of this frequently dismissed condition.
“This is particularly important given the projected increase in the prevalence of incontinence – 6.5 million people by 2030 – and the growth of our ageing
population.”
For more information about any of the foundation’s campaign or for a Healthy Bladder and Bowel Habits brochure, go to www.continence.org.au
Urinary Incontinence under reported in Young Women
Normally urinary incontinence is considered a problem of middle-aged and older women, especially those who’ve had a baby. But a study out today suggests even young women who’ve never been pregnant could suffer from the problem.
A new report published in Annals of Internal Medicine from Australian researchers is apparently the first study to look at the rate of urinary incontinence in the younger population. The study recruited healthy young women aged 16 to 30 on university campuses and at health clinics. The researchers asked the women to complete questionnaires about urinary incontinence during routine activities or sports, psychological well-being, physical activity, and health. They ended up with usable questionnaires from just over 1,000 women whose average age was 22.
About one in eight of the young women reported they’d experienced urinary incontinence.
Unlike previous studies, the researchers found no association between urinary incontinence and age, body mass index, physical activity, or past urinary tract infections. They say that could be due to the fact that the women in their study were relatively young, physically active and, for the most part, of normal body weight.
Women who had been sexually active but did not report use of oral contraceptives were more likely to report urinary incontinence than women with no history of sexual activity.
Urinary incontinence was also associated with lower psychological well-being. In previous research, “younger women have been shown to be subject to greater distress and restriction in activities from urinary incontinence than older women,” the scientists wrote.
Researcher Susan Davis, PhD, chair of women’s health in the Monash University department of medicine at the Alfred Hospital in Melbourne, says she and her collaborators had suspected that some women might be predisposed to incontinence without being pregnant. The study shows that this is apparently the case however it doesn’t establish clear reasons for this.
Possible reasons for the link between being sexually active and having urinary incontinence include the effects of intercourse and altered bacteria in the urogenital tract, according to the researchers.
Although other studies suggest urinary incontinence runs in families, this has yet to be backed up by solid genetic evidence.
Some answers to common questions about Incontinence
Do women have incontinence more often than men?
Unfortunately for women, yes. Urinary incontinence often occurs because of problems or weaknesses in muscles, support mechanisms and nerves that help to hold or release urine. Pregnancy and delivery, body changes associated with menopause and the way a woman’s female urinary tract is structured are among factors that contribute to twice as many women having incontinence problems. What’s important to know is that you don’t have to live your life wearing pads or being embarrassed by leakage. Incontinence is treatable at all ages.
Do symptoms differ for women?
The most common type of Urinary Incontinence for women is stress incontinence where coughing, laughing, sneezing, or other movements put pressure on the weakened bladder structure or surrounding muscles, resulting in urine leaks. With urge incontinence, women suddenly feel an uncontrollable urge to urinate and leak without control. Something as simple as hearing the sound of running water may be enough to prompt the release of urine. Mixed incontinence, a combination of stress and urge incontinence, also occurs much more frequently in women.
How is incontinence treated?
Significant progress has been made in treating incontinence effectively. Make an appointment with your Healthcare professional for an exam that will identify what type of incontinence you have. The doctor also will determine if you have underlying medical conditions that can cause incontinence.
Common medical reasons include pelvic growths, blockages and vaginal or bladder prolapses. Some medications also can contribute to the problem, so bring a list of all meds you take when you go to your appointment.
Depending on the type and extent of your problem, you may be referred for a course of treatment. This may include behavioral therapies such as fluid management, pelvic floor strengthening, bladder retraining, bulking agent injections, biofeedback or nerve stimulation (neuromodulation).
Finding the right combination for your needs may take some time and you will need to work with your Healthcare Professional to determine a treatment that works best for you. Sometimes surgery may be necessary; for instance, the bladder or urethra may have moved out of its normal position following childbirth.
What can I do to lessen my symptoms?
Some women find success by restricting certain liquids, such as coffee, tea, and alcohol. Severe constipation can worsen symptoms so try to keep your bowel movements regular. While absorbent undergarments such as adult diapers make the problem less visible, it’s important to use appropriate skincare products at the same time to avoid skin irritation and sores.
Clothing can affect incontinence and bladder conditions according to TENA
Fashionable tight-fitting jeans can cause bladder weakness and long- term health consequences, medical experts have warned. The uber-cool skinny denims, favoured by celebs such as Russell Brand, Jude Law and Joey Essex can increase the risk of urinary tract infections and in some agonising cases, men can even suffer with twisted testicles.
A study of 2,000 British men, conducted by TENA Men, the leading male incontinence brand, has revealed that 10 per cent of men have experienced an unpleasant side-effect as a result of wearing skinny jeans.
Dr Hilary Jones, TENA Brand Ambassador and campaign spokesperson, said:
“Men who wear tight or ill-fitting trousers or underwear which is restrictive around the groin area could be damaging their health.
“Wearing tight-fitting clothing over a prolonged period of time can lead to urinary tract infections leading to over-activity of the bladder- a type of bladder weakness as well as a low sperm count and fungal infections.
“I have seen several cases of men who have twisted their testicles due to wearing jeans that are far too tight.
“My advice would be to make sure you leave plenty of room around the groin area and that your pants and trousers feel comfortable so you’re not being restricted in any way.
“Please don’t put style before health.”
Tight-fitting jeans around the groin area can put additional pressure on the bladder but can also lead to bacteria breeding and re-entering the body causing urinary tract infections; this increases the need to urinate more frequently and can cause severe pain. Of those men suffering from skinny jeans, half had experienced groin discomfort, over a quarter had bladder troubles and one in five suffered a twisted testicle. Worryingly, one in four regularly squeeze into jeans- with the biggest reasons given for enduring tightness being ‘to show I can still fit in them’ and ‘because they look good.’
In fact, three in ten has suffered discomfort from tight jeans and 40% of men admit they sometimes sacrifice comfort over style. One in seven British men regularly wear skinny jeans, but more than a third confess they don’t actually know their correct jean size, whilst when it comes to picking jeans, just 7% described softness and comfort as an important factor.
Zoe Brimfield, TENA Men Brand Manager said:
“With this survey we were keen to highlight that while men may like the look of tight-fitting jeans, it’s important that they are not compromising their health. Wearing skinny or ill-fitting jeans can lead to bladder weakness as a longer-term consequence. Male bladder weakness is more common than people think, with 1 in 9 men in the UK currently experiencing some form of the condition.”