At Home with Chris Jessen 2018 - 190
▲ WO M E N ' S H E A LT H
'THE MAJORITY OF PEOPLE CAN BE
EFFECTIVELY MANAGED WITH FAIRLY
around one third of all women. It usually happens when
the muscles in the pelvic floor or sphincter have been
weakened, often following pregnancy and childbirth. These
sets of muscles usually work together to hold urine in the
bladder so it doesn't leak.
Another type of incontinence is urge incontinence, or
bladder instability. This is when there is a sudden and
often overwhelming urge to pass urine and it can be
difficult to get to the toilet in time.
'Urge incontinence is caused by the bladder sending a
message to the brain that it is full, often too early, and the
bladder muscle contracting too soon,' says netdoctor.com
GP John Pillinger. 'This may be caused by cystitis or an
overactive or unstable bladder, which is when there is
an increased frequency of passing urine during the day
and possibly in the night, too. It can be related to
nerve problems, including stroke, dementia, multiple
sclerosis or spinal cord injury.'
eing incontinent is not something that
just affects older people. In the UK,
millions of women of all ages are affected
by bladder problems that mean they don't
have full urine control. These include
stress incontinence, increased frequency
and nocturia, which is the need to get up
for the toilet two or more times a night.
'As many as one in four women and one in 10 men suffer
from urinary incontinence, although healthcare professionals
think this is an underestimate,' says Jane Dixon, clinical
physiotherapist and specialist in bladder and bowel issues.
According to a study by the National Institute for Health and
Clinical Excellence (NICE), the most common problem is
stress incontinence, which is when activity or movement such
as coughing, sneezing, laughing or exercising puts pressure, or
stress, on the bladder causing it to leak. It is sometimes referred
to as bladder weakness. This type of incontinence is extremely
common, affecting around nine million people in the UK, and
190 | FEBRUARY 2018
WORDS: KIA HANSEN, IMAGES: GETTY IMAGES
If you suffer from any type of urinary incontinence, it's
important to seek help because it can affect your mental
wellbeing as well as your physical health. The negative effect
on self-esteem and dignity can lead to distress, isolation,
depression and, eventually, a loss of independence.
'The treatment of urinary incontinence varies according
to the type of incontinence, how troubling it is to the
person concerned and also their general level of fitness,'
says Dr Pillinger. 'The majority of people can be effectively
managed in general practice with fairly simple treatments
and without the need for surgery.'
And once you take that first step and talk about your
problem to your doctor, the good news is that there is
plenty of specialist help available.
'Initially, the patient should go to their GP who can refer
to specialist physiotherapists, continence advisory clinics
and specialist nurses,' says Ms Dixon. 'It's vitally important
that their problem is fully and accurately assessed, so that
a personal treatment plan can be put in place.'
Treatment may include making lifestyle changes; pelvic
floor muscle training (Kegel exercises), sometimes with
the use of vaginal cones or electrical stimulation; collagen
injections; hormone therapy or surgery.
Pelvic floor exercises generally involve doing a minimum
of eight muscle contractions at least three times a day for at
least three months. Research has found that women who
complete pelvic floor muscle training have a reduction in
urinary leaking and report a better quality of life.
Lifestyle changes include reducing caffeine and alcohol
intake, adjusting how much fluid you drink during the
day and losing weight, if necessary.
'No-one should suffer in silence as most people can be
helped or even cured,' says Ms Dixon.