Incontinence and Women

Incontinence and Women by Jane Hankenhof Curry, BS, Gerontologist The stigma associated with incontinence has caused it to remain a “taboo” condition. Women may find bladder control to be so embarrassing that it’s not mentioned even to their personal physician. This silence can lead to unnecessary isolation, loss of freedom, and can have a negative impact on the quality of a woman’s life. If you are concerned about bladder control, it is essential for you to communicate with a medical professional. Today’s technological advancements offer a variety of successful treatments and, for some, even a cure. Women no longer have to worry about embarrassing odors or leakage and can continue an active lifestyle. A myriad of solutions are available to enable independence, enhance confidence, and improve the quality of life. Incontinence is defined as the loss of bladder or bowel control. It is a common medical condition that is estimated to affect almost 25 million Americans. Contrary to popular belief, incontinence is NOT a disease, nor is it a “normal” part of aging. Women with bladder control issues mistakenly think they just have to “deal with it” and they remain silent about their condition. Women may experience temporary or periodic bladder control issues following childbirth, during an illness, while taking certain medications or following a trauma. An assessment by a medical professional is the first step in determining the type of incontinence you may be experiencing and the best method of treatment to meet your individual needs. Your personal physician may recommend that you see a urologist who specializes in caring for individuals with urinary conditions. There are five common types of incontinence, which can be experienced either separately or in a variety of combinations. Stress incontinence is the leakage of a small amount of urine due to sudden pressure on the bladder experienced when laughing, coughing, exercising, or lifting a heavy object. Urge incontinence is a sudden “urge” to urinate that is so strong that the bathroom cannot be reached in time. Overflow incontinence occurs when the bladder fills beyond capacity and urine spills. Women may also experience the feeling of never being able to empty the bladder. Reflex incontinence is an involuntary urination without any sensation of a full bladder. It is possible to be completely unaware of the need to urinate when this happens. Functional incontinence can result from a surgery, restricted mobility, environmental barriers, medications, or mental disorders. Once the type, or combinations of types, of incontinence is determined you are on the road to a successful treatment, cure or effective management of the condition. Diet modification, behavioral therapy, pelvic floor exercises, medications, supportive devices, surgery, and disposable absorbent products may be determined by your health care professional to best meet your individualized needs. The simplest solution may be diet modification or the avoidance of foods that can irritate the bladder. Caffeine, citrus or spicy foods, and alcohol have been identified as bladder irritants. A medical professional may also suggest drinking more water to dilute urine, which may further reduce bladder irritation. Behavioral therapies and pelvic muscle re-education have been found to be low-risk techniques to decrease the frequency of urination in individuals. Examples of techniques to strengthen weakened pelvic floors are bladder retraining, biofeedback, vaginal weights, magnetic therapy, and electrical stimulation. Women with stress or urge incontinence, or the combination of both, have been found to benefit from these techniques. Drug therapy is another way to treat incontinence. Medications are prescribed to correct problems with the bladder or its outlet muscles. These medications may also be combined with behavioral or exercise therapies. Television and print advertisements have made certain brand names and the phrase “gotta go, gotta go” recognizable to many women. Drug therapies are available to treat urge, stress, and overflow incontinence. Supportive devices such as pessaries or bladder neck support prostheses can be placed inside the vagina to help support the bladder, uterus, vagina or rectum in the event their normal placement has changed. Childbirth, heavy lifting, straining during bowel movements, loss of estrogen at menopause and gravity changes during aging may contribute to vaginal muscle loss. Short term devices, such as plugs, block the urethra and provide excellent bladder control on a temporary basis. Surgery to restore the urethra and bladder to their normal position in the pelvis may be the treatment of choice with the presence of certain conditions or when other therapies have failed. Disposable absorbent products are also an effective and convenient way to manage incontinence. Today’s superabsorbent technology eliminates embarrassing odors, leakage, and skin breakdown. Absorbent products come in a variety of sizes, styles, and absorbency levels to meet each woman’s individualized protection needs. Pads worn in underwear, pull-on style protective underwear, undergarments, and full briefs are all designed to address light, moderate or heavy levels of incontinence. Identifying the type of incontinence coupled with the amount of urine flow and mobility level will assist in determining which product is right for you. It is very important to note that not all disposable products are created equal. Low performance products comprised of cotton fluff or products manufactured for menstruation are not effective in the management of incontinence. Bladder control products comprised of superabsorbent polymers offer the highest level of performance and will quickly absorb and neutralize urine. High performance products retain large volumes of urine, prevent leakage, control bacterial growth, eliminate odor and improve the quality of life. In addition, they also offer a cost-saving advantage. If you are interested in learning more about incontinence, there are many professional organizations, web sites, support groups and educational materials to assist you in your quest. Several organization are dedicated the issues of incontinence. The National Association for Continence (NAFC) is an organization dedicated to improving the quality of life of people with incontinence. They offer a resource guide filled with products and services for incontinence. NAFC can be found on the web at www.nafc.org or reached by phone at 1-800-BLADDER. The Bladder Health Council of the American Foundation for Urologic Disease (AFUD) sponsors Bladder Health Week and educates the general public and healthcare providers about bladder diseases and condition. AFUD’s web site is www.afud.org and they can be reached by calling 1-800-242-2383. If incontinence accompanies a specific disorder, such as Alzheimer’s, MS, or Parkinson’s Disease, the organization specific to these diseases may also provide incontinence information. In addition, your health care professional, local library and internet can also provide much more information on this very important issue. Jane Hankenhof Curry, BS, Gerontologist is the Education and Market Development Coordinator for Principle Business Enterprises, Inc. of Dunbridge, Ohio and can be reached at 1-800-467-3224 ext. #223. PBE is the manufacturer of Tranquility, a full line of high performance incontinence products, and can be found on the web at www.tranquilityproducts.com.