ISSUE Experts say there are quite a few treatment options to help women cope with incontinence and improve their quality of life. All they need is the courage to seek medical help
C onsidering that 30 to 50 per cent of all women endure this embarrassing problem, it is surprising that incontinence receives so little attention — be it in terms of preventive or curative measures. All the more so, when medical science says lifestyle factors can play a major role in emphasising or negating its impact.
Have you ever experienced difficulty in holding urine, leakage of urine (in acute cases, a burst of urine) when the bladder is full or when you laugh, run, jump or sneeze? If your answer is yes, then you suffer from incontinence. While genetic factors and hormonal changes play a role in triggering the problem, there are other causes too such as weakening of the pelvic muscles following childbirth, and lifestyle factors such as infrequent urination as a matter of habit and excessive intake of caffeine.
In our society, few women pluck up the courage to seek medical help. “Often, patients consult me about other problems and I have to gently prod them with questions before they open up about incontinence,” says Alpa Khakhar, consultant urogynaecologist, Apollo Hospitals.
Incontinence is not necessarily an age-related issue. “I have treated college and school-going patients,” says M. R. Pari, consultant urologist, Fortis Malar. The percentage of men who suffer from incontinence happens to be very low; generally, older men are more likely to be affected.
A cure for incontinence is possible. If not a complete cure, at least a vast improvement in the condition can be achieved, so that one can lead a near-normal life. But first, the underlying reason for the problem has to be determined by studying the individual's medical history, doing a physical examination, and undergoing a few tests. “This is critical because each type of incontinence has to be treated in a specific manner,” informs Vidya Rangan, consultant urogynaecologist.
For instance, there may be stress urinary incontinence, urge urinary incontinence, mixed urinary incontinence, overflow incontinence (as in women who are not able to move about much because of neurogenic damage and hold a lot of urine in their bladder). Or the problem may simply be a matter of nocturnal enuresis (bedwetting). Once the reasons are established, it is possible to manage the problem.
The good news is that a wide range of curative measures is now available. They include simple solutions — bladder re-training by visiting the restroom according to a fixed schedule; slowly lengthening the time between visits, doing exercises to strengthen the pelvic floor, treating urinary infection if any with antibiotics, using bladder relaxants for irritable bladder, and modifying lifestyle and diet which aggravate the condition. In severe cases, surgical intervention is resorted to. “Today, there are laparoscopic procedures to remedy the pelvic or bladder position with minimal hospitalisation and even day procedures such as the TVT or TOT techniques to deal with incontinence,” informs Dr. Khakhar.