One person who has benefited is Yvonne De Los Santos, who had gone about her daily life for years without knowing she had a problem.

“I just thought, oh, I had an accident. I didn’t think to seek help,” Yvonne says.

Yvonne’s gynecologist eventually referred her to physical therapist Marlene Kuntz.

“Some women believe that this is normal. It is not normal to leak at any age,” Marlene says.

Marlene is using a bio-feedback method to help Yvonne strengthen her pelvic floor and to manage her incontinence.

“We have the woman connected via a sensor to a specialized computer and the computer is able to show them what their muscle is doing,” Marlene says.

The computer helps Yvonne know which muscles to contract. Marlene uses a series of computer graphics to help Yvonne visualize and pinpoint the muscles that control urine flow.

While this may not be the answer for everyone, it’s an option to be considered before medication or surgery.

Marlene says, “I think it gives women freedom, you know, to be able to do what they enjoy doing and don’t have to worry about getting to a bathroom.”

The therapy runs about 8 weeks and some patients have seen positive results as early as the 4th week

Many find it difficult to manage, leading to frustration and even isolation and depression in the worse cases. Yet, incontinence is not a disease, but rather a symptom of underlying conditions that affect men and women of all ages and backgrounds.

The many causes of incontinence include pregnancy, surgery, infections or even just being overweight. It also can be triggered by a variety of other diseases, such as multiple sclerosis, muscular dystrophy and even diabetes.
There are also different types of incontinence:
• Stress incontinence: A small amount of urine is released by such everyday physical activities even ones as basic as, coughing, sneezing or laughing. This is generally due to weakened pelvic floor muscles and in many cases can be easily treated by activities such as pelvic floor exercises.

• Urge incontinence: The urge to urinate comes on so suddenly that it is impossible to reach a toilet in time. This generally results in larger losses than stress incontinence. Bladder re-training may help improve this condition.

• Overflow incontinence: The bladder is constantly filled, causing it to release small amounts of urine frequently.

• Reflex incontinence: The absence of bladder control is due to impaired nerve function. This is often linked to other diseases.

• Faecal Incontinence: Impaired rectal sensation or muscle control results in the loss of faeces (stools) or the staining of underclothes.

We always advocate discussing the symptoms with your own health professional as they are best placed to diagnose your own symptoms and condition and recommend appropriate treatments.

Bladder weakness basically means you’re unclean

This is a myth. No one should have to feel damp or unclean. The most usual way to avoid this is to use a bladder weakness protection product, which ensures dryness by locking urine and odour away from the body for complete freshness and discretion.

It has nothing to do with virility

Actually, this is true. Bladder weakness in itself does not affect virility, and leakage doesn’t usually happen during sex. So, unless you’ve experienced nerve damage due to surgery or have other underlying problems, there’s no reason why you shouldn’t enjoy a full and happy sex life.

No one I know has bladder weakness

Bladder weakness is surprisingly common, with 1 in 8 men experiencing it, so you may well know someone who has it. Perhaps they’ve just chosen to keep it to themselves and have discovered products that provide total security and discretion.

If you really try, you can control it

This is a false affirmation. No one is deliberately incontinent. There are numerous causes and types of bladder weakness, and there are incontinence products especially designed so that men can manage the situation and get on with their lives.

Bladder weakness means you can’t drive long distances

With the right protection you can drive wherever and whenever you like. So rip up the map and go explore. There’s no need to worry about unexpected traffic jams or not being near a toilet.

Bladder weakness is a sign of old age

Another myth about male incontinence – just like women, millions of men experience bladder weakness at some time during their life, often when they’re under 50.

Got questions about male incontinence and bladder weakness? Leave them on our comments section below or if you prefer to ask in confidence then you can email our Nurse specialist Shona, by clicking on the link below, we will endeavour to answer your questions as quickly as possible but if the answer is complex then we may need to ask you some specific questions before a response is given.

Ask Shona
Please note that all advice can only be considered as an opinion based upon the information you supply and that we are unable to provide any form of diagnosis or advice specific to your condition. We highly recommend that you always consult your GP, Practice Nurse or Continence Advisor.

The Oxybutynin Hydrochloride is used to treat urinary incontinence and other bladder conditions and is commonly prescribed to children with an uncontrollable nocturnal bladder or elderly people with bladder control problems.

MHRA is recalling four batches of 5mg tablets; according to the agency these batches might contain high levels of an active ingredient.

The affected batch numbers are 09D02, 09D04, 146401 and 146402.

The findings were made during the early stages of the drug’s production and to be on the safe side, the MHRA decided to recall these batches while an investigation takes place.

The incontinence device is battery operated and can be described as a pulse generator that gives a continuous shock to the nerves that control the bladder.

The implant could be an alternative for those with urinary incontinence who run out of options with regards to treatments. There are few incontinence treatments that can claim to cure people with urinary incontinence and it is possible that implanted pulse generators will do just that.

But it is too early to establish this method as a reliable treatment for incontinence as results on the subject were considered of poor quality and difficult to assess.

On the subject, Dr. Edwin Arnold, at the department of urology at Christchurch Hospital, in New Zealand stated:

“For those who have tried all nonsurgical approaches – including bladder retraining, physiotherapy for the pelvic floor muscles and medications – yet the symptoms persist, it is worth discussing this option with your primary care doctor, who may refer you on to a urologist,”

And added:

“This treatment for incontinence is not for everyone and even if the operation is undertaken, it does not always work, so a patient’s expectations should remain realistic.”

Lead researcher Dr. Phillip Zimmern said:

“The collagen injection is also a good alternative for those who cannot afford recovery time from surgery or are too medically unfit or frail to undergo a second surgical procedure to cure stress urinary incontinence.”

Collagen injected into the tissue surrounding the urethra, tightens the urethral sphincter and prevents  urine from leaking.

The study monitored patients who received a periurethral collagen injection between January 2000 and December 2006, Dr Zimmern (lead researcher) and his team used a 3-D ultrasound to pin-point the exact location and volume of collagen remaining in the urethral walls several months after the first injection, to ascertain when a second injection was considered.

Where the ultrasound indicated normal collagen levels but the patient was still experiencing cases of stress incontinence, another therapy was suggested. Besides that, the study received a 93% positive feedback from patients who considered themselves clinically improved or cured.

Dr. Zimmern stated:

“Women need to know they do not have to live with stress urinary incontinence. Although collagen injections might not work for everyone, the option is out there, and patients need to communicate with their physicians that they are afflicted with the condition to discover what treatments are possible.”

For men, the problem is slightly different, the prostate gland enlarges as men age and presses on the bladder, squeezing the urethra and inhibiting urine to pass, in these individuals it is common to retain urine in the bladder even after urination. The retained urine can increase and stretch the bladder causing damage to muscles that control the bladder as well as the kidneys.

Men and women have similar incontinence symptoms but different treatments. In some cases urinary incontinence signals a larger health problem, so don’t be ashamed to talk to your doctor, only he or she can help you regain control of your bladder and diagnose any other health issue you might have.

To help break the embarrassment barrier Physical Therapist Linda Yates from the US has developed a program to help women develop skills to manage and resolve incontinence. The program will encourage women to break down the barriers and help women request treatment to stop women from suffering in silence. The program will teach women skills to help them manage and in some cases resolve it completely.

The program also addresses other health issues, like osteoporosis, women who have shoulder tightness following a mastectomy and help women that are experiencing pelvic or back pain during or following pregnancy.

“The best part of this program is very private, which is good” stated Linda Yates.

As mentioned on What to Expect with Surgery for Stress Incontinence – Part 1, there are two types of surgical procedures for stress incontinence, surgery through the abdomen and surgery through the vagina,

Surgery for stress incontinence through the abdomen

If you’re having surgery through a cut in your lower abdomen, such as ‘open retropubic colposuspension’ or a sling. you will expect:

* a stay in hospital for several days.
* general anaesthetic during the operation.
* your operation to last one hour to two hours.
* a tube called a ‘catheter’ inserted to empty the bladder.
* the catheter to be removed after a day or so to pass urine normally.
* the pain to subside after a few days, but you’ll receive painkillers.
* recovery time of six to eight weeks.
* no driving or sex for 6 weeks.
* no exercise until your doctor has given you the green light.

If you had a type of surgery called the keyhole surgery you will be able to go home sooner.

Surgery for stress incontinence through the vagina

If you’re having a type of surgery called ‘anterior vaginal repair’ or ‘needle suspension’, you will expect:

* to stay in hospital for several days (not as long for open colposuspension due to the outside skin not being cut).
* a general anaesthetic (so you may sleep during the operation) or an anaesthetic into your spine (you stay awake but you can’t feel anything).
* the operation to take between 40 minutes and 60 minutes.
* a tube called a ‘catheter’ inserted to empty the bladder..
* the catheter to be removed after a day or so to pass urine normally.
* some pain after the operation, but you’ll receive painkillers.
* the pain to subside after a few days.
* recovery time of up to six weeks.
* no type of exercise until your doctor has given you the green light.

Surgery for stress incontinence aims to give more control over the bladder; however, it may not always cure the problem completely and having a surgical procedures for stress incontinence are not usually suitable if you still plan to have children, or think you might want to in the future. Not everyone with stress incontinence needs surgery, but if your problems persist, your doctor may suggest it.

We would like to hear from people who have received surgery for stress incontinence and would like to share their experience and success (or not) with others. Please comment below.

A surgery for stress incontinence aims to improve support for the muscles around the bladder entrance to help the urethra to stay closed to prevent it from leaking. There are two types of surgical procedures for stress incontinence, one is surgery through the abdomen and the other is a surgery through the vagina.

In both cases there are three things to consider before making your final decision; first, surgery for stress incontinence is not recommended if you are planning to have children; second, no operation can be guaranteed to cure your stress incontinence, but most offer a good chance of making an improvement and third, there are risks of developing extra problems (complications) depending on the procedure.

In next week’s post you’ll find detailed information on each surgical procedure, i.e. how long each procedures lasts, recovery time, etc…