Urinary incontinence is embarrassing to talk about and hard to admit, but doctors say it can be fixed.
“You don’t need to live your life wearing a diaper all the time,” said Dr. Christopher Hutchison, at Intermountain Healthcare’s Riverton Hospital in Salt Lake City.
He said he often has to go the roundabout way of getting women to talk about their urinary incontinence, but a good percentage of his patients are dealing with it.
“I’d say about 40 percent of them won’t say anything about it if I don’t ask,” he said.
Various types of incontinence — stress incontinence, urge incontinence or a mixture of the two — can be caused by poor genes, weak muscles, unhealthy lifestyles and/or an overactive bladder muscle, among other things. Most commonly, a leaky or bulging bladder has something to do with vaginal prolapse, which is a splitting of the muscles in the vaginal wall, allowing the bladder to sag internally.
Multiple pregnancies, hysterectomy and menopause can also contribute to the causes of female incontinence. However, that is not always the case.
Many women put up with the symptoms, but Hutchison said nearly all types of incontinence can be fixed, resulting in a better quality of life.
“There’s a social stigma associated with incontinence,” Snyder said. Putting up with the symptoms over the years, however, will not cause permanent damage.
Weight loss can sometimes help in the case of stress incontinence, which happens when coughing, sneezing, jogging or other activity leads to a loss of control of the bladder. But oftentimes, women must endure the inconveniences of urine leakage while losing the weight as most types of exercise can spur it on.
Men don’t typically have the same issues with incontinence because their bladder is supported by the structure of the pelvis, Hutchison said.
He hopes women aren’t just living with the constant annoyances incontinence causes, dealing with absorbent pads or diapers. Most cases, he said, can be prevented by “just taking care of yourself.”
Chronic constipation, consumption of caffeinated or carbonated beverages, as well as those with artificial sweeteners, can irritate the bladder, leading to more trips to the restroom and an inability to completely empty the bladder, Hutchison said. Smoking, which breaks down the body’s collagen supply, and chronic coughing that puts stress on muscles can also lead to incontinence
Snyder, a specialist who deals with kidney, bladder and prostate issues, said he’s seen patients ranging from 17 years of age to 81, but urinary incontinence symptoms are most common in women during their late 30s and early 40s.
Achieving normalcy is the goal of any treatment, which can include medications, surgery and nonsurgical procedures.
“The secret is a good relationship between the patient and her doctor,” Snyder said, adding that an open dialogue helps to arrive at the best possible outcomes, which is an informed decision.
Darren Fletcher and Lewis Moody experiencing Ulcerative Colitis
Darren Fletcher
The announcement by Manchester United, the Scottish Midfield Dynamo is suffering from Ulcerative Colitis is sad news for both himself and also the team but it does help increase awareness of this disabilitating condition amongst the general public.
Talking to the Guardian Newspaper, Dr. Ian Arnott, a leading specialist in ulcerative colitis and consultant gastroenterologist at the Western General hospital in Edinburgh said:
“Ulcerative colitis can be a very disabling condition and leaves people weak, tired, frustrated and lacking energy. It can change people’s lives completely. They can’t be very far from the toilet so aren’t able to go out very much. Patients tell me that when they go to a nearby town or city, they know exactly where every toilet is, because they often get very little warning about needing to go to the toilet. It can mean that people have accidents with their bowel motions. It’s an embarrassing condition – it’s a difficult subject to talk to people about.”
Ulcerative colitis is inflammation of the large intestine (both the colon and rectum) accompanied by development of ulcers in this area which can have a tendency to bleed. These are what can cause the common symptoms of the condition, diarrhoea and passing blood and mucus, often accompanied by stomach pains.
The cause is not known and the condition can affect anyone, though some believe it to be genetically linked as it is often common amongst relatives. One common belief is that some factor such as food, atmospheric pollution or stress may trigger the immune system to cause inflammation in the large intestine in people who are genetically prone to developing the disease.
People who live with the condition will have good periods of remission when they feel normal, this can last up to a month or even a few years – and bad periods when they feel dreadful and can be forced to go to the toilet six, eight or even 10 times a day, including nightime.
About 2 in 1,000 people in the UK develop Ulcearative Colitis and it can develop at any age but most commonly first develops between the ages of 10 and 40 years old. Statistically non-smokers are more likely to get Ulecerative Colitis than smokers though smoking obviously brings other dangers to health which far outweigh this benefit.
Crohn’s disease also has similar symptoms, and the two conditions are referred to together as inflammatory bowel disease (IBD). One in 200 people in the UK develop IBD, so around 300,000 have that overall.
To diagnose Ulcerative Colitis the normal test is for a doctor to look inside the large intestine by passing a special telescope into the rectum and colon. A stool sample is also commonly done during each flare-up and sent to test for bacteria and other infecting germs.
When Ulcerative Colitis is first developed it is usual to take medication until symptoms clear. After that a course of medication is then usually taken each time symptoms flare up. The drug selected depends on both the severity of the symptoms and the location of the inflammation, other drugs may be advised to take daily to prevent further flare-ups which reduce by up to 50% the likelihood of experiencing a flare-up.
About 25% of people with the condition need surgery at some stage, the most common procedure is the removal of the large intestine.
Although not related to incontinence the condition shares many similarities in that view people talk about the condition, former England Rugby Captain, Lewis Moody has also now come forward and talked about his own experiences of the condition, including how he tried to hide it. “There was no way I was going to let my secret out to a bunch of rugby players who would then mock me mercilessly. I ended up hiding it from them for three years and I slumped into a state of depression.”
However sharing your experiences can help and Moody admitted that hiding it hadn’t been helpful. “Eventually, I decided to tell my best friend at Leicester, Geordan Murphy. He had guessed something was up. He was sympathetic, of course, but he didn’t overdo it. Geordan made me realise that perhaps it had not been the best course to keep everything to myself. Slowly, events made it inevitable that others would know. The England management were more than understanding, as were the Leicester coaching team when I finally mustered the courage to tell them. Ironically, I became less stressed about my condition when people knew about it. Being stubborn about it and keeping it a secret had simply made life harder for myself.”
The need to know the location of toilets wherever you travel is also shared, and regular toilet use is important as well, as well as the use of absorbent incontinence products when necessary to give confidence.
Mums ‘need not put up with incontinence’
Issue Codes Incontinence Products for Women
Women who have given birth should not view urinary incontinence as an avoidable part of motherhood, it has been claimed.
Noreen Dockery, a chartered physiotherapist who specialises in rehabilitating the pelvic floor, told the Irish Independent that female incontinence is a “very common” problem.
She revealed that a greater number of women are choosing to seek help for incontinence nowadays, but that she still sees patients who wait until their children are teenagers before getting advice.
According to Ms Dockery, it is “far preferential” to deal with post-pregnancy incontinence a few months after a woman has given birth.
“It is hard for women, though, especially with a new baby; but, if it’s left too late, symptoms can deteriorate, especially in menopause when the muscle tone gets more relaxed and hormones are involved,” she explained.
Ms Dockery revealed that one of the goals of physiotherapy for this condition is to lengthen or relax the woman’s pelvic floor muscles so that they are no longer in spasm.
“The pelvic floor muscles are very much connected to the abdominal muscles, and releasing tension here can have a major effect on the tension found in the pelvic floor,” she told the news provider.
“Most patients feel their pelvic floor is weak but in actual fact the resting tension or already elevated tone prevents the muscle from lifting any higher.”
The physiotherapist also emphasised the fact that women with female incontinence should not feel isolated, as many other women suffer from the same issues after having children.
Studies suggest that about 13 per cent of women in the UK are affected by urinary incontinence to some extent, along with five per cent of men.
There are a number of other risk factors for incontinence alongside childbirth, including age, depression and a high intake of caffeine.
Pregnancy, childbirth and urinary incontinence
Urinary incontinence is a common condition, with research suggesting that around 13 per cent of UK women are affected to some extent. One of the most important known risk factors for female incontinence is childbirth, with a significant proportion of women relying on incontinence supplies during pregnancy, immediately after giving birth and, in some cases, for months or even years to come. Here, we take a closer look at the problem, possible reasons for the links between pregnancy, childbirth and incontinence, and ways in which women can manage their condition. 90
Incontinence during pregnancy
The extra weight that is placed on the bladder during pregnancy typically causes women to urinate more often than usual. However, some also experience urinary incontinence and depend on products such as Tena Pants Super. The reasons for this are not yet fully understood; it may be that the weight of pregnancy causes incontinence, or that hormonal fluctuations contribute to the problem. In most cases, the incontinence resolves itself soon after giving birth, although some women continue to experience problems.
Risk factors for persistent incontinence
A number of factors relating to pregnancy and childbirth can increase the risk of ongoing female incontinence. Pregnancy itself is a known risk factor for urinary incontinence, with research indicating that women who develop stress incontinence during pregnancy or in the first six weeks after their baby’s birth are more likely to still be experiencing problems five years later.
There is evidence to suggest that a vaginal birth – as opposed to having a caesarean section – may be associated with an increased risk of stress incontinence, although studies have produced conflicting results. For instance, a recent investigation published in the obstetrics journal BJOG by British scientists found that women who delivered exclusively by caesarean section were only slightly less likely to have urinary incontinence than those who only had vaginal births. In fact, 40 per cent of caesarean-only patients who took part in the ProLong Study still reported urinary incontinence.
Other pregnancy-related factors that may increase the risk of incontinence include giving birth to a high number of children and having babies with a higher-than-average birth weight.
Treatment and management
Women are usually advised to do pelvic floor exercises to strengthen the muscles that control urination and reduce the risk of stress incontinence. In order to exercise the muscles, women should pretend they are trying to stop the flow of urine, holding this squeeze for about ten seconds. This should be repeated for three or four sets of ten contractions each day in order to strengthen the pelvic floor musculature. Results will not be seen immediately, but women should start to notice the benefits within a few weeks.
Women who are still experiencing bladder problems several weeks after giving birth should speak to their doctor, as they may require treatment. This may include medication, such as the anti-depressant duloxetine, which is thought to interfere with chemicals involved in the transmission of nerve impulses to the muscles around the urethra so that they contract more strongly.
In certain cases, doctors may recommend surgery to tighten or support the muscles around the urethra. Surgery usually has a high rate of success, but it usually not considered until other treatment options, including pelvic floor exercises, lifestyle changes and medication, have failed to provide relief.
Incontinence supplies
Women with pregnancy-related incontinence have a range of products to choose from to help manage their condition on a day-to-day basis. Products include disposable incontinence pads, such as Cottons Comforts Pantyliners and Cottons Comforts Light, and washable products such as Ladies Cotton Briefs with extra absorbent built-in pads. Selecting the right incontinence supplies can greatly improve women’s quality of life and enable them to get out and about without fear of embarrassment.
Women with overactive bladder may benefit from pilates
Issue Codes Incontinence Products for Women
Women with overactive bladder syndrome may benefit from doing pilates exercises that are specifically designed to strengthen the pelvic floor, it has been claimed.
Dr Bruce Crawford, who helps people with urinary incontinence in the US, told KoloTV.com that just one month of pilates for the pelvic floor, or ‘pfilates’, can help people to hold in their urine.
“This is the most successful method of pelvic floor rehabilitation that we’ve encountered,” the expert told the news provider.
Patients are hooked up to a screen while they are performing the exercises, enabling them to visualise the muscles they are working and perfect their technique.
One patient who has benefited from the innovative approach is Karen Carabio, who tried pfilates after her medication stopped working.
She revealed: “It’s been huge to completely avoid surgery and getting away from medication has freed me completely.”
Overactive bladder syndrome is common in the UK, with research cited by Patient.co.uk indicating that as many as one in six adults are affected.
Furthermore, studies show that about one-third of people with an overactive bladder have episodes of urge incontinence.
Female incontinence ‘not a normal part of ageing’
Issue Codes Incontinence Products for Women
Women should be aware that female incontinence is “not a normal part of ageing” and can often be avoided or managed with the correct lifestyle changes and treatment, it has been claimed.
Dr Lonny Green, director of Virginia Women’s Continence Centre in the US, insisted that the majority of women do not have to live with incontinence.
Speaking during National Bladder Health Awareness Week in the US, Dr Green explained that women can get treatment and advice by speaking with a specialist in female urology.
“We see a large number of patients who have dealt with pelvic dysfunction and incontinence for years,” Dr Green revealed.
“Often, these issues could have been avoided – if not improved – with awareness and proper treatments.”
Figures suggest that 13 per cent of UK women are affected to some extent by urinary incontinence, although many of these have only mild symptoms and can manage their condition effectively with products such as Tena Lady.
The vast majority of cases of urinary incontinence are either stress or urge incontinence, both of which may respond to conservative treatments, such as lifestyle changes and bladder training.
‘Pacemaker’ device provides relief from urinary incontinence
Issue Codes Incontinence Products for Women
Scottish patients with urinary incontinence can now benefit from a revolutionary new device that can help to relieve the problem.
The device employs a technique called permanent sacral nerve stimulation (SNS) to send electrical pulses to nerves at the base of the spine that control the bladder.
It is the size of a £2 coin and is implanted in the patient’s back in order to relieve their incontinence.
By stimulating the sacral nerves, the device is designed to retrain them so that the patient no longer leaks or empties their bladder at the wrong time.
According to an article in the Daily Record, many patients between the ages of 19 and 80 have already benefited from the new technique, which is now offered by NHS Greater Glasgow and Clyde.
Consultant urologist Graeme Conn told the news provider: “This is proving to be [a] very successful treatment and our patients of all ages are responding well.”
The device – which should last for around five years before needing to be replaced – is fitted under a general anaesthetic.
Experts have found that it works well in patients with an overactive bladder, which is characterised by sudden urges that are difficult to ignore.
One of the most common symptoms of an overactive bladder is urge incontinence, where the person experiences a sudden urge to squeeze out urine and is unable to reach the toilet in time.
As a result, many people with an overactive bladder use incontinence supplies, such as Tena Lady, to help them manage their condition effectively.
However, the new device is unlikely to be effective in patients with a different form of incontinence called stress incontinence, in which the patient experiences a sudden loss of urine when they laugh, cough, sneeze, walk, exercise or do heavy lifting.
Figures from the Bladder and Bowel Foundation suggest that some nine million people in the UK are affected by some degree of stress incontinence.
Urinary incontinence ‘a symptom, not a disease’
Female incontinence is not a disease in itself, but rather a symptom that can usually be treated effectively, an expert has claimed.
Dr Dexter Arrington is an obstetrics and gynaecology doctor at Silver Cross Hospital in Illinois, US.
He regularly sees women who are ashamed of their reliance on incontinence pads, such as Tena Lady, but insists there is no need for embarrassment as the condition is very common.
Dr Arrington told the Herald News: “Urinary incontinence isn’t a disease, it’s a symptom.
“It can be produced by everyday habits, underlying medical conditions or physical problems.”
Fortunately for the millions of women who experience bladder weakness and incontinence, there are effective treatments.
Surgical treatments can often be carried out as outpatient procedures, removing the need for hospital stays.
However, doctors usually recommend a number of lifestyle changes before considering surgery.
These include reducing your caffeine intake, drinking six to eight glasses of water a day, losing weight if necessary and doing pelvic floor muscle exercises.
Oestrogen use linked to female incontinence
Women who take oestrogen for several years appear to have a heightened risk of developing urinary incontinence, according to a new study.
As women approach the menopause, their body starts to make less of the hormone oestrogen and some people choose to take hormone replacement therapy (HRT) to replace the oestrogen that has been lost and reduce their symptoms.
But scientists at Emory University in the US believe the therapy may be associated with an increased risk of adult incontinence.
The research team analysed data on 167 postmenopausal women in order to investigate the relationship between oestrogen use and new cases of female incontinence.
None of the women were affected by urinary incontinence at the start of the study in 1993.
However, 47 women (28.1 per cent) reported uncontrolled urine loss when they were re-interviewed in 2004, including 31 women who were unable to engage in certain activities because of their incontinence.
Women who had taken oestrogen for at least five years were up to four times more likely to have incontinence than those who had taken it for less than five years or not at all.
Issue Codes Incontinence Products for Women
Publishing their findings in the journal Menopause, the study authors concluded: “Postmenopausal community-dwelling women with a history of oestrogen use for five years or more were more likely to report newly incident urinary incontinence with condition-specific functional loss after ten years of follow-up.”
Dr Gina Northington, who was involved in the study, told Reuters Health that a patient’s history of oestrogen use may be an “important factor” in determining their risk of developing urinary incontinence.
The urogynaecology specialist advised women to discuss the pros and cons of oestrogen therapy before taking HRT.
“In addition to other risks associated with oestrogen, such as breast cancer and blood clots, this is another reason to make sure oestrogen is taken for the shortest amount of time, if it needs to be taken,” she added.
Non-surgical treatment shows promise for stress urinary incontinence
Issue Codes Incontinence Products for Women
An innovative non-surgical treatment for stress urinary incontinence has shown promise in a recent three-year clinical trial.
Scientists presented their findings on the Renessa treatment at the annual scientific meeting of the American Urogynaecologic Society and the South Central Section of the American Urological Association in September.
Renessa is a non-surgical treatment that is designed to alleviate stress incontinence – one of the most common types of adult incontinence.
The procedure usually takes less than an hour and patients enjoy a rapid recovery, typically returning to work and resuming usual activities the following day.
During the procedure, a small device is passed through the urethra – the tube leading from the bladder to the genitals – and heat is gently applied to the tissues at the base of the bladder.
This heat treatment causes the collagen in the bladder tissue to become firmer, thereby improving the bladder’s ability to resist leakages.
In their clinical trial, scientists at North Shore-LIJ University in Manhasset, New York, found that around 71 per cent of patients who underwent Renessa treatment reported improved quality of life 36 months later.
Dr Harvey Winkler, co-chief of urogynaecology at the university and author of the poster presentation on the therapy, said: “These results confirm that the majority of patients treated with the non-surgical Renessa procedure experience lasting improvements in symptoms and quality of life.
“The procedure also appears to be very safe, as no serious adverse events were reported at any time during the follow-up period.”
Scott Cramer, medical president and chief executive officer at Novasys Medical, which developed the Renessa therapy, said that stress urinary incontinence can have a “significant negative impact” on women’s quality of life.
He noted that there are safety risks associated with surgical procedures for prolapse and female incontinence, making it more important than ever for women to have safe, effective and less invasive treatment options to help reduce their reliance on incontinence supplies, such as Tena Lady.
“When conservative therapies for stress urinary incontinence such as Kegel exercises fail, Renessa is the logical next step in the treatment pathway before proceeding to a more invasive surgical procedure,” he added.