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

A 2009 study by the University of California, San Francisco showed that women who lost as little as eight percent of their body weight experienced an average 47% reduction in episodes of both stress incontinence and urge incontinence, with some seeing the number of incontinence episodes drop by an astounding 70%.
The study’s findings, which were reported in the New England Journal of Medicine, concluded that reduction in urinary incontinence can be considered among the primary benefits of even moderate weight loss in significantly overweight women.

The study included a group of 338 overweight and obese women between 45 and 60 years of age, all of whom were experiencing at least 10 episodes of urinary incontinence per week. The participants were divided into two groups, one of which was put on an intensive six-month weight loss program that included diet, exercise, and lifestyle modification.

The other group of participants did not take part in any structured weight loss program, but were given educational classes on the importance of weight loss to incontinence management.

At the end of the six months, the participants in the weight loss group had dropped an average of eight percent of their body weight, while the control group showed an average weight loss of just over one percent.

Episodes of urinary incontinence dropped in both groups during the study period, but the difference between the groups was striking. The weight loss group reported 47% fewer episodes on average, while the control group reported 28% fewer episodes. The weight loss group showed a clinically relevant drop in the number of episodes of all types of incontinence, the researchers said, but episodes of stress incontinence showed the most dramatic reduction.

Stress incontinence, which is the involuntary loss of urine caused by seemingly inconsequential actions such as sneezing, coughing, or laughing, or by movement such as exercise or lifting, is one of the most common female health problems in the US.

More than 13 million women experience stress incontinence, and it is estimated that one in three women will experience it at some time. The condition is caused be weakness in the pelvic floor muscles, including the sphincter muscle that closes off the bladder. Weakness in these muscles can be caused by a number of factors, including pregnancy, childbirth, menopause, certain medical procedures (notably, hysterectomies), and some medications.

Major depression, hypertension, enlarged prostates, and older age are all associated with an increased risk of moderate to severe urinary incontinence (UI) in men, a large study suggests.

The findings, which provide one of the first snapshots of urinary incontinence in men, may help improve doctors’ ability to identify men who are suffering from the condition, says study head Alayne Markland, of the University of Alabama at Birmingham.

Overall, 4.5% of American men were found to experience moderate to severe urinary incontinence, which corresponds to having leakage at least once a month, the study showed.

The rate increases with age, from 0.7% in men ages 20 to 34 to 16% in men age 75 and older, the study showed.

The findings were presented at the annual meeting of the American Urological Association.

Studies suggested that urinary incontinence is less common among men than women, but there was felt to be a lack of data on Urinary Incontinence and risk factors in men, Dr. Markland felt.

So she and colleagues analyzed data from 5,297 men aged 20 and older who participated in the National Health and Nutrition Examination Survey, a nationally representative survey of the U.S. population.

Men were interviewed in their homes, and Urinary Incontinence was assessed using the 12-point Incontinence Severity Index in which participants are asked if they leak and if so, how much and how often. Moderate to severe Urinary Incontinence was defined as a score of 3 or higher.

Among all the men, major depression and hypertension were associated with a 2.6-fold and a 30% increased risk of moderate to severe UI, respectively.

Each 10-year increase in age was associated with an 80% increased risk.

Among the 3,010 men aged 40 and older, enlarged prostate — called benign prostatic hyperplasia (BPH) — was associated with a 20% greater chance of having moderate to severe UI.

The rate of moderate to severe Urinary Incontinence did not differ by race or ethnicity.

A total of 49% of the men had what is known as urge urinary incontinence, in which you feel like you have to go but can’t get to the bathroom in time, Dr. Markland said. Thirteen percent had stress urinary incontinence, which occurs when an activity, such as coughing or sneezing, causes a small amount of urine to leak. The rest had a combination.
BPH a Known Cause of Urinary Incontinence

BPH is a well-known cause of UI, says Ira Sharlip, MD, clinical professor of urology at the University of California, San Francisco.

“Nightly bathroom runs may be the first sign of an enlarged prostate, other symptoms may include trouble starting a stream of urine, leaking, or dribbling” says Dr. Sharlip, who was not involved with the study.

That’s because an can press against the urethra (the tube that carries urine out the body) and block the flow of urine. This causes the bladder wall to become irritable. The bladder begins to contract even when it contains small amounts of urine, causing more frequent urination.

More research is needed to find out why depression and hypertension are associated with higher rates of UI, Dr. Markland said.

Medications called diuretics that are often used to treat may play a role, she says. They flush excess fluid from the body and can cause frequent urination.

Some of the drugs used to treat depression may also cause UI, Sharlip says.

“Urinary incontinence is something people don’t want to talk about,” says Lauren P. Wallner, PhD, MPH, a research fellow in the department of urology at the University of Michigan in Ann Arbor.

“If you’re having symptoms, bring it to the attention of your Doctor or Health professional as it can often be treated with medication, behavioral therapy and, in severe cases, surgery,” she said.

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.

This revolutionary device named the Urgent Neuromodulation System stimulates a group of nerves called the sacral nerve plexus. These nerves are involved in regulating the working of the bladder.

How it Works

In a pain-free procedure an electrode which has a fine needle at the end, is placed in the skin near the ankle, when the device is turned on it “tickles” the nerve generating and electrical impulse that will travel all the way up to the sacral nerve.

Each session last for 30 minutes, every week and is carried out as an outpatient procedure and research suggest benefits start to be seen after six weeks.

“This kind of stimulation represents an excellent option for patients who are unwilling or unable to tolerate adverse events from medications” said the researchers from several centres in America.

Bristol NHS Foundation Trust. “It does seem to have the required effects, and those effects seem to last, suggesting a long-term benefit.”

Unfortunately there is no quick-fix solution with either condition – the exception being certain surgical procedures – however with some focus and effort there are proved ways to curb male and female incontinence.

The first and perhaps most demanding way of numbering the number of incident of incontinence, is to lose weight.

Regularly emptying your bladder is a very important thing to do. It does not necessarily reduce or cure incontinence; it has preventative benefits that are necessary to stop the condition worsening. Not going regularly when you have incontinence can lead to problems such as an overstretched bladder or a bladder infection. The most important time to make sure you always go – even if you don’t feel little to no urge – is before and after means and before going to bed.

And even simpler method for dealing with incontinence is to breathe deeply, especially in instance of sudden urges, in which case try your best not to panic with calm inhalations. It helps to think confident thoughts that encourage you to feel in control; telling yourself you are not going to have an accident while you breathe.

By the same token, reducing stress and tension in your life is going to help this process of psychologically managing incontinence, the reason being that emotions and your body’s central nervous system are inextricably linked. Being depressed, anxious or angry all the while can negatively affect you bodily sensations. At the very least, it’s worth taking at least an hour out of every day to walk in the park, have a bath, watch a movie you know you like etc. Any activity that helps you to unwind – which, actually, is good to do regardless.

“after I had a drink, I’d need to go three or four times within an hour. I’m not the sort of person who gets embarrassed easily and I wasn’t going to stop going out and doing the things I enjoyed. But it does have an impact on your life.”

For a long time, Sue didn’t recognise that she was dealing with an incontinence problem, instead believing that she simply needed to go far more often than other people. Dr Shirin Irani, consultant gynecologist at Heartlands Hospital in Birmingham believes this is a common attitude among women living with incontinence – an attitude largely born out of an unwillingness to acknowledge and accept they may have incontinence issues, explaining that:

“There is an embarrassment which can stop women seeking help and also a sense it’s part of a woman’s lot.”

In her late 40s, the problem became more pressing and was only once she’d turned 50 that she finally saw her GP, who prescribed drugs to block the signals which tell bladder muscles to contract. She recalls:

“These didn’t help and I wasn’t offered any other treatment. You feel it’s something you have to live with.”

Usually bladder retraining exercises, combined with medication – that block the nerve impulses telling the bladder to contract – is enough to alleviate cases of incontinence for the majority of female sufferers. But some, like Sue, need further intervention. When she returned to her GP, she was referred to consultant urologist Jeremy Ockrim at University College Hospital, who is a practitioner of a new treatment called Sacral Neuromodulation and Botox injections for incontinence.

The Botox treatment involves the chemical being injected into the sides of the bladder to relax muscles, thus stopping contractions. ‘It has been helpful for many patients, but it isn’t perfect,’ says Mr Ockrim, who explains that:

“Patients need repeat injections every six to nine months and symptoms may return gradually. There is also a 20 per cent risk of paralysing the bladder muscles, which means the patient will need a catheter to pass urine.”

With the Sacral Neuromodulation treatment, a thin wire with a small needle on is implanted in the sacral nerves. An electrical current is then delivered through it, which enables the brain to inhibit unwanted signals from the bladder. This technique effectively suppresses the sudden contractions and the need to rush to the toilet. Patients trial a modulator for three weeks and can choose to have a permanent implant if it works – which is exactly what Sue decided, having noticed dramatic changes soon after the procedure:

“The effect was immediate… two hours after it was switched on, I hadn’t gone to the toilet once.”

She returned to hospital to have a permanent modulator – the size of a £2 coin – implanted under the tissue and skin of her lower back. While Sacral Neuromodulation has been approved by NICE since 2004, only 100 or so women have benefitted from the treatment in the UK – a major factor most likely being the cost.

The stimulator itself costs £8,500 and overall treatment is £12,000. Mr Ockrim, who has treated nearly 60 patients with sacral neuromodulation believes:

“It’s a large initial expense, but comparable with a lifetime of Botox injections…We should consider the social and personal cost for women with incontinence. They go out less, take time off work or even stop working.”

Besides drugs and treatments, individuals with urinary incontinence can take a few important steps of their own to help reduce bladder urges.

Reducing or stopping caffeine intake completely can be very affective, caffeine irritates and stimulates the bladder causing urgent, frequent urination and an increase in urine production.

It is often believed cutting back on the intake of liquids can reduce the urge to urinate, however this not true. In fact the lack of liquids can cause dehydration, causing urine to become more concentrated resulting in increased bladder urgency which can lead to bladder infection.

Excess amounts of alcohol and spicy food can also have negative effects to individuals suffering from urinary incontinence, try to avoid those as much as possible and you should notice a reduction on incontinence episodes.

Develop a regular schedule of urinating to encourage the bladder to hold more urine and work on gradually increasing the time between urination, but don’t hold it for too long as this can increase the risk of urinary tract infection.

The last tip is well known one of the readers of our blog but is always worth remembering as it is a highly effective incontinence treatment. If you thought of Pelvic Floor muscle exercises you were right! Also know as Kegel exercises, these exercises strengthen the pelvic muscles to help prevent leakages. Check out our guide to pelvic floor exercises.

The botulinum neurotoxin type A (BoNTA) is a variation of the commonly known Botox.

Seventy-four patients (51 women, 23 men) with refractory IDO incontinence were treated with intradetrusor injections of 200 U BoNTA, they were then evaluated in a non-randomised, open-label, cohort study.

Patients with urinary frequency, urge incontinence and stress incontinence were assessed using the condition-specific Urogenital Distress Inventory (UDI 6) before and 4 weeks after the BoNTA treatment.

The outcome of complete continence was 51% (38 of 74) 4 weeks after intradetrusor injections of BoNTA.

In patients who were not completely continent, the scores show their conditions of urinary frequency, urge incontinence and stress incontinence were all reduced significantly. The inclusion of patients with mixed incontinence may have resulted in underestimation of the complete continence rate.

50% of patients reporting complete continence 4 weeks after BoNTA treatment reveal the effiency of this emerging treatment for patients with refractory IDO incontinence.

Furthermore, in those whom complete continence was not achieved, there was a notable and significant reduction in reported urge incontinence, stress incontinence, and urinary frequency.

Story source http://www.urotoday.com/

The research which includes meditation-based deep breathing, relaxation and visualisation techniques is an effective management strategy for urge incontinence.

Study investigator Aaron Michelfelder, said: ‘The mind-body connection has proven to be particularly valuable for women suffering from incontinence. Cognitive therapy is effective with these women, because they are motivated to make a change and regain control over their body.’

10 patients with an average age of 62 who had been diagnosed with overactive bladder were used for the study. The research subjects listened to an audio recording with a series of relaxation and visualisation exercises at home twice a day for two weeks.

By tracking the number of times they experienced incontinence before and after participating in the meditation-based therapy, most of the research subjects were able to see a dramatic improvement in symptoms.

Loyola study investigator Mary Pat FitzGerald, MD, said: ‘Nearly one in four women suffers from a pelvic floor disorder, which includes incontinence. Cognitive therapy may play a vital role in a comprehensive approach to treating this disorder.’

Allanda provide all the help, advice and products you need, to deal with your incontinence condition. For more information please click here.