Norwegian Study identifies genetic factor in incontinence
Urinary incontinence in women is known to be linked to factors such as age, obesity and childbirth injury however a study from Norway reveals that a genetic factor is also involved and that Women are more likely to develop urinary incontinence if their mothers or older sisters also have this problem.
The scientists studied family history in a group of over 2,000 incontinent women, comparing them with 6,000 women whose relatives did not have a problem with incontinence. They found that daughters of mothers with urinary incontinence had a 1.3 times average risk of being incontinent themselves. The risk was double the average if the mother had severe symptoms.
Female siblings had a 1.6 fold increased risk of incontinence if their older sister had the problem. The gene or genes involved remain to be discovered but these findings shed new light on a the condition.
Allanda joins Facebook
With much talk of the “Social Media Revolution”, Allanda has now set up a Facebook page! This new page can be found at https://www.facebook.com/AllandaLtd. This pages gives you the opportunity to contact us via Facebook if you prefer that to normal email and is also where we will post news about treatment and management of incontinence conditions.
Christmas Delivery Information
Christmas is our busiest time of year and we encourage all customers to order as soon as possible for delivery before Christmas to ensure that your delivery arrives in good time.
Problems with weather this month could cause unforeseen problems and also our carriers can be busier than expected though we always endeavour to deliver on time.
To offer the best service to our customers we remain open throughout most of the Christmas Period, only closing on Tuesday 25th December, Wednesday 26th December and Tuesday 1st January for the bank holidays. (We will close at 12pm on Monday 24th December and Monday 31st December as well). Our website remains live throughout the entire period.
We recommend that orders ideally need to be received by 12pm on 19th December for delivery before Christmas Day, as we aren’t able to guarantee the service of our carriers over the festive period which is their busiest due to the large volumes of Christmas presents they also deliver during this period.
We will continue despatching orders through the Christmas period and in theory next day orders despatched after the 19th should still be delivered on the next working day but are not able to guarantee this.
Orders received after 12pm on Monday 24th December will be despatched on Thursday 27th December when our warehouse re-opens after the Christmas period.
Please note if your order is under £25 it will be sent by Royal Mail and these deliveries may take up to a week during December.
Tena Wet Wipes Video
Skincare is very important in Continence Management. Ageing makes the skin sensitive to ongoing exposure to moisture and contact with urine and faeces, this may easily initiate skin degradation causing irritation, itching or infection. There use of wipes and cleansing products are important to maintain skin hygiene and health. TENA Wet Wipes are specifically designed for continence care and are pre-moistened with a 3-in-1 formula to cleanse, restore and protect skin with just a single wipe. Also the “clean touch” system ensures safer and easier handling as it requires only one hand to open the pack lid. Find out more about how they work with our new video.
Marathon runnners warned about potential incontinence risks
Marathon runners may be preoccupied with shin splints, chafing and blisters on race day, but they should also consider bladder health, a U.S. researcher says.
“The added stress on the body that comes with running a marathon can cause urinary stress incontinence problems during the race or down the road,” Dr. Melinda Abernethy of the Loyola University Chicago Stritch School of Medicine, said in a statement. “People who already suffer from incontinence also are at risk for bladder-control issues while running.”
Stress incontinence – the loss of urine from physical activity such as coughing, sneezing and running — is the most common form of urinary incontinence, and affects women more often than men.
Researchers at the Loyola University Health System plan to survey Chicago area runners to study the relationship between long-distance running and pelvic floor disorders, Abernethy said. Until more is known, Abernethy recommends runners monitor their fluid intake and go to the toilet at least every few hours during a marathon.
“Putting off going to the bathroom during the race is not healthy for your bladder,” Abernethy said. “Runners also should avoid diuretics, such as coffee or tea, before the race, because this can stimulate the bladder and cause you to visit the bathroom more frequently.”
Abernethy added pelvic floor exercises such as kegels, may help runners prevent urine leakage during the race.
Abena Abri-San Incontinence Pads now available from Allanda
Abena Abri-San
Abena’s incontinence products are produced in Denmark, Sweden, Germany and France. Abena incontinence products are amongst the more technologically advanced.
The Abena Abri-San range forms a complete range of anatomically shaped pads for all degrees of incontinence from for lighter through to moderate or heavier incontinence. Abri-San Incontinence pads are designed to be worn with mesh support pants or close fitting underwear.
The new advanced double 3 layered absorbent core ensures fluids are locked inside the absorbent core and contact with the skin is minimised. Also the new soft and discreet textile back sheet offers greater wearing comfort and no rustling or noise.
Allanda now offer Abena Abri-San in Mini 3, Normal 4, Midi 5, Plus 6, Super 7 and Forte 9 absorbencies.
Abena Abri-San Sizes (Approx.):
| Product | Length | Width |
|---|---|---|
| Mini 3 | 330mm | 160mm |
| Normal 4 | 440mm | 200mm |
| Midi 5 | 540mm | 280mm |
| Plus 6 | 630mm | 300mm |
| Super 7 | 630mm | 360mm |
| Forte 9 | 730mm | 370mm |
BOTOX(R) licensed for the management of urinary incontinence
BOTOX(R) has been licensed by the Medicines and Healthcare Products Regulatory Agency (MHRA) for the management of urinary incontinence in adult patients with neurogenic detrusor overactivity (NDO) due to subcervical spinal cord injury (SCI) (traumatic or non-traumatic) or multiple sclerosis (MS), who are not adequately managed with anticholinergics. The marketing authorisation is specific for Allergan’s botulinum toxin type A product and is a milestone in bringing this treatment to people living with MS or SCI who have urinary leakage, providing them with a long-term solution for bladder control.
Approximately 140,000 people in the UK are living with MS or SCI. Between 75-80% of people with MS and 60-80% of people with SCI will suffer from some degree of bladder dysfunction including urinary incontinence. Urinary leakage in patients with MS or SCI is frequently caused by a condition called neurogenic detrusor overactivity, which results in involuntary contractions of the bladder during the filling stage when the bladder should be relaxed. This overactivity can lead to urinary incontinence (uncontrolled urinary leakage). Current treatment options include oral medications that need to be taken daily.
However, less than 30% of patients manage to stay on oral medication for longer than a period of 12 months. If oral medications fail to control the leakage, then patients may require surgical intervention. Targeted injections with Allergan’s botulinum toxin type A product into the bladder muscle have been shown to reduce the involuntary contractions and increase bladder capacity. In turn, this reduces the number of urinary leakage episodes and may even stop leakage altogether in some patients.
“Historically, the management of urinary incontinence due to NDO has relied on daily medications. However, many patients find that daily medications are difficult to adhere to and sometimes these medications have limited effect,” said Professor Christopher Chapple, Urology Department, Royal Hallamshire Hospital, Sheffield NHS Trust.
Many people who have neurological diseases and are suffering from urinary incontinence remain undiagnosed and untreated. Amy Bowen, Director of Service Development at the MS Trust, explained, “For many people with MS, urinary leakage is frequently seen as a taboo subject with patients often reluctant or too embarrassed to talk about the symptoms to anyone. As a result, many people with MS can feel distressed, socially isolated and that they lack of control over their condition. It is a really positive development that there is now an additional, effective treatment option to help manage this difficult problem. Hopefully, more people with MS who are struggling with urinary leakage will feel confident to discuss these symptoms with their MS specialists and find the treatment option that is right for them.”
Pelvic Floor exercises effective at treating incontinence
If you are suffering with urinary incontinence, you need to look at pelvic floor exercises and bladder training. You may have read previous articles about these exercises but if you had not taken previous research findings seriously, a July 2012 review by the American based Agency for Healthcare Research and Quality (AHRQ) should give you more reason to start pelvic floor (otherwise know kegel) exercises.
According to the review, about 25% of young women and 44% to 57% of middle-aged and postmenopausal women experience involuntary urine loss. Their findings show that age, pregnancy, childbirth, menopause, hysterectomy, and obesity put women at a higher risk of suffering from urinary incontinence.
Fortunately, there are several forms of treatment for women suffering from urinary incontinence. An independent team of investigators analysed 889 studies and prepared a comparative effectiveness review. The AHRQ review compared different treatments for urinary incontinence that included doing pelvic floor muscle (Kegel) exercises, bladder training; using medical devices, weight loss, medications and electrical stimulation, among others.
They found that “pelvic floor muscle training, combined with bladder training is effective for treating women with urinary incontinence without the risk of side effects. The drugs for urgency incontinence showed similar effectiveness. However, with some drugs, more women discontinued treatment due to bothersome side effects.”
New guidelines to help family doctors identify and treat incontinence
Millions of women experience a loss of bladder control, or urinary incontinence, in their lifetime. It’s a common and often embarrassing problem that many patients don’t bring up with their doctors – and when they do, it may be mentioned as a casual side note during a visit for more pressing medical issues. New guidelines from doctors at the University of Michigan Health System offer family doctors a step-by-step guide for the evaluation of urinary leakage, to prevent this quality-of-life issue from being ignored.
“I think a lot of physicians don’t realize that this problem can be successfully treated without surgery or other major interventions and there are some pretty simple things they can do in the office to make a big difference for a lot of women,” says lead author Abigail Lowther, M.D., clinical lecturer in the Department of Family Medicine. “We hope to give primary care providers a framework for how to evaluate and treat different many forms of incontinence without the need for referral to a specialist.”
The article was published in the Journal of Family Practice this month (Reference: “Managing incontinence: A 2-visit approach,” Journal of Family Practice, September 2012, Vol. 61, No.9.)
Studies have found that 10 to 40 percent of women older than 18 years old – and as many as 53 percent of those over 50 – are affected by urinary incontinence. Among the long list of culprits are childbirth, aging and obesity. Despite the prevalence of female incontinence, however, busy family doctors may not hear about the problem until well into a visit focused on separate health issues – and some doctors may not feel like they can help.
But the paper suggests three simple, immediate steps a doctor can take to address the problem while keeping the appointment on track: Collecting a urine sample, asking the patient to keep a diary that charts fluid intake and urination and scheduling a follow-up visit. By the second visit, the physician will have more information for further evaluation and a management plan. High-yield questions will also classify the type of incontinence being experienced. Questions may include asking how worried patients are that coughing will lead to a leak, how quickly patients need to find a bathroom when their bladder is full and whether washing hands – or the sound of running water – leads to leakage.
Urinary incontinence of all types can be a great disruption to daily activities, ranging from occasionally leaking urine after a cough or sneeze to having an urge so sudden that patients may not make it to the bathroom in time. For some, bladder leakage may be a symptom of another underlying medical condition.
Lowther says some women don’t broach the subject with doctors because they think loss of bladder control is a normal part of aging. But left untreated, it may get worse with time and lead to more restrictions, she says.
“We want to emphasize to women that this is not something they have to live with, that they should tell their primary care physicians about their symptoms,” Lowther says. “We also want to remind physicians that simple interventions can go a long way towards improving this problem for patients.”
Julie Goodyear talks about continence issues
Julie Goodyear has been causing havoc in the Celebrity Big Brother house.
“I sneeze, I pee,” she announced to fellow housemates, flicking away any embarrassment at suffering from urinary incontinence as if it were ash at the end of her trademark cigarette holder. In doing so she highlighted the millions of Britons who have poor bladder control.
It is estimated 14 million people in the UK have urinary incontinence and although it can occur at any time of life problems are most likely in middle age. One in five women over the age of 40 experience problems although men can also be affected, particularly if they have undergone prostate surgery.
However, as Julie, 70, has shown, there is no need to suffer in silence and there are many ways to deal with the problem.
Professor Linda Cardozo, an expert in urogynaecology at King’s College Hospital in London, says: “There is not one solution for everyone but there is help for absolutely everybody.”
There are four types of incontinence: stress, which causes leaks when you cough, sneeze or laugh; urgency, which is characterised by a sudden compelling need to pass urine; mixed, which is a combination of the two; and overflow, which occurs when the bladder overfills but there is no corresponding urge to urinate.
Childbirth increases the risk of problems. A Norwegian study published in the New England Journal Of Medicine found 10 per cent of childless women experience problems compared to 16 per cent of those who had children via caesarean and 21 per cent who had a vaginal delivery.
Other factors include loss of muscle tone as we age, obesity and lifestyle. Smokers like Julie are more likely to suffer because of their chronic cough. Constipation can also increase pressure on the bladder. White wine, champagne and caffeine-based drinks are the most irritating for the bladder but the fashion for downing copious amounts of water doesn’t help either.“Women often drink far more than they ought to. There is absolutely no need to drink all that sippy mineral water,” Professor Cardozo says.
“In a temperate climate the fluid intake recommended by renal physicians is 24mls per kilogram of body weight. For the average woman that would equate to 1,200 to 1,500mls a day.”
Diet versions of popular carbonated drinks are also more likely to cause problems than standard sugary ones. “The diet drinks are better for teeth and weight but they are not better for your bladder,” Professor Cardozo says.
Some forms of exercise are bad news. “Trampolining is about the worst, 70 per cent of women will leak when they are on a trampoline.” High-impact aerobics and weight training can also cause leaks but exercises to strengthen the pelvic floor, the sling of muscles which holds the bladder in place, will help reduce symptoms if you do them regularly. Professor Cardozo says pelvic toning devices may help, if only to identify the right muscles to flex and relax.
If in doubt ask your GP for a referral to a member of the Association of Chartered Physiotherapists in Women’s Health or search their website for a local one.
Incontinence specialists can offer distraction techniques such as sitting on the edge of a hard chair and other tips to minimise the risk of accidents.
If the problem is more troublesome you may be prescribed antimuscarinic drugs that suppress involuntary bladder contractions. A new class of drug which regulates nerve signals to the bladder will be available within a year or two.
Botox and other forms of botulinum A toxins are another option: injected into the wall of the bladder they can prevent for up to a year the muscle spasms which trigger leaks.
Surgical solutions involve slings to support the bladder, procedures to lift the neck of the bladder or placing a tape under the urethra which blocks urine if the pelvic floor drops. “It works like a hosepipe when kinked,” Professor Cardozo explains.
“The most important thing to remember is there is help available. Urinary incontinence is no longer such a taboo because there are so many high profile people who have now admitted to having problems.”