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Archive for August, 2009

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Study Shows Incontinence Improves With Weight Loss

Monday, August 31st, 2009

Being overweight is known to be a risk factor for the development of incontinence. A study in the New England Journal of Medicine, published in January 2009, supports this idea. Research has shown that there is a relationship between excess weight and incontinence, and that losing weight can lessen episodes of incontinence.

The study included 338  American women who were over the age of 30, had a BMI (body mass index) between 25 and 50, and suffered from incontinence episodes at least 10 times per week. At the end of the study, women in the intervention group who were attempting to lose weight through diet and exercise lost approximately 17 pounds each, or an average of 8% of their body weight.

As a result of the weight loss, women in the intervention group decreased their episodes of incontinence by 47%. They experienced fewer episodes of stress incontinence, which was a direct result of extra weight applying pressure on the bladder. The women, however, did not experience a decrease in urge incontinence symptoms. To see the NEJM article, click here.

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What is a pessary, and how can it help with incontinence?

Sunday, August 30th, 2009

Pessaries are devices that are inserted into the vagina to support the uterus and bladder which may become weakened and sag downwards, thus leading to incontinence. Pessaries will only help stress incontinence, or inontinence that results from a stress placed on the bladder, which often occurs when a person coughs, sneezes, lifts a heavy object, exercises, or laughs. They do not help in cases of urge or overflow incontinence bacause these types of incontinence result from different physiological processes.

Pessaries come in a variety of shapes and sizes, and must be fitted by a physician in order to work effectively. At one time, pessaries were one of the only options open to women who suffered from incontinence. Although they are used less frequently than they used to be, they are still useful for women who do not wish to take medications or are unable to, or for those women who want to avoid surgery.

Pessaries are not permanent devices, a fact which makes them popular with some women. They need to be removed periodically to be cleaned. Some women take them out and clean them themselves, while others prefer that their doctor or a nurse performs this procedure for them. You may need to be checked more frequently in the beginning to make sure the pessary is fitting properly. A small percentage of women will find that their incontinence is worsened following insertion of a pessary, smply because their organs are brought back into proper alignment. If you suffer from stress urinary incontinence, a pessary may be an option for you.

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Autologous Muscle Cell Injections- Effects on Stress Incontinence

Saturday, August 29th, 2009

There is exciting news for those who suffer from stress incontinence. Stress incontinence occurs as the result of some form of “stress” on the bladder, such as coughing, sneezing, lifting heavy objects, exercising, or even laughter. Stress incontinence is the result of weakened pelvic muscles or bladder musculature.

Autologous muscle cell injections are being used to treat stress urinary incontinence. Muscle cells are taken from a person’s own muscle, generally in the thigh, and are transplanted into the urethral sphincter at key spots. Because the muscle cells come from the person’s own body, there is no risk of rejection. There may be some discomfort at the injection site.

Best of all, results of a study of 29 women in the US showed that quality of life was vastly improved following the injections, with 68% of the study participants experiencing an improved quality of life 3 months after the injection. Researchers intend to expand the study to include a wider range of patients. Autologous muscle cell injections can be done on an outpatient basis with no restriction on activity following the injection. A report of this research was made at the American Urological Association (AUA) 104th Annual Scientific Meeting (Abstract 1526. Presented April 28, 2009).

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Episiotomy and Faecal Incontinence

Friday, August 28th, 2009
An episiotomy is a medical procedure in which the muscular tissue between the vagina and the rectum is cut. An episiotomy is performed when there is a need to enlarge the vaginal opening during childbirth, and is usually done when there is a perceived need to “speed up” the delivery process. Women are more likely to have an episiotomy done during first deliveries than during subsequent ones.

Performing an episiotomy, however, is not a benign procedure. There are risks associated with an episiotomy, such as bleeding and infection. By far the most serious complication of episiotomy is tearing of the tissues into the anal sphincter, which may result in anal, or faecal, incontinence. In addition to uncontrolled passage of faeces, women may also pass wind uncontrollably, which may be equally distressing.

If you have had an episiotomy and suffer from incontinence, whether urinary or faecal, one of the most important things you can do is to perform Kegel exercises routinely. Kegel exercises will help to strengthen the damaged pelvic floor muscles. In addition, you should see your physician and discuss your incontinence with him/her. If you are planning to give birth, episiotomy is something you may want to discuss with your physician to clarify under what conditions an episiotomy may be done and other methods that can be tried first to speed delivery if the need arises.

Other Faecal Incontinence Articles

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What is Incontinence Biofeedback?

Wednesday, August 26th, 2009

Biofeedback is a method of understanding an action that takes place in the body through the use of lights or sounds. Biofeedback can be used in incontinence to help women who are having difficulty in learning to control their pelvic floor muscles. Because pelvic floor muscles do not come neatly labelled, some women have trouble locating these muscles in order to peform Kegel exercises.

Biofeedback is used as a tool to teach you how to isolate and exercise these muscles, which are so important in bladder control. Using sounds and computer graphs, a therapist can help you to exercise the all-important pelvic floor muscles, which can help improve incontinence.

Biofeedback is not painful. During biofeedback, sensors are placed on either side of the anus, as this is where the pelvic floor muscles are closest to the surface. Sensors are also placed on the abdomen because many women use their abdominal muscles instead of their pelvic floor muscles when performing Kegels. A graph and lights and/or sounds will be emitted from the computer attached to the sensors while you are performing Kegels, and you will be able to see clearly when you are using your muscles correctly. Most women require only a few sessions before they are able to perform Kegels effectively and efficiently.

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Diuretics and Incontinence

Tuesday, August 25th, 2009

A diuretic can be defined as any drug that increases the amount of urination. Drugs in this class act in different ways, but they all have the same result- forced urination.

Diuretics may be prescribed to treat any number of conditions, such as edema (swelling), heart failure, liver disease and kidney disease. Lasix (furosemide), Aldactone (spironolactone) and Hydrochlorothiazide are all types of diuretics that may be described. Diuretics may also be prescribed to help control blood pressure. Caffeine is another type of diuretic.

How do diuretics affect incontinence? It’s simple- diuretics force your kidneys to produce more urine, and this increased urine production may lead to new incontinence or worsening of incontinence symptoms, especially in older people.

If you are taking a diuretic and find that you are experiencing incontinence, talk to your doctor. Your physician may be able to prescribe a diuretic that is less likely to cause incontinence. You should not quit taking your diuretic, as this may make the problem you were taking the diuretic for worse; instead, make an appointment with your doctor. Avoiding caffeine may also help you control your symptoms of incontinence.

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Antidepressants and Incontinence

Sunday, August 23rd, 2009

Although there are a few antidepressants that can actually improve urinary incontinence, some of the members of this class of drugs may make symptoms worse.

How do antidepressants make incontinence worse? Certain antidepressants may decrease the contractility of the bladder, resulting in overflow incontinence. In other words, the bladder fails to empty properly or completely, allowing the bladder to “overfill”, leading to a leakage of urine. Additionally, in some people, taking antidepressants decreases their awareness of the need to urinate, resulting in incontinence.

If you feel that your antidepressant may be contributing to your incontinence, you should speak to your physician. You should not, however, quit taking your antidepressant suddenly, without speaking to your doctor. This may cause other serious symptoms. If your doctor agrees that your antidepressant may be causing your incontinence, he/she may suggest an alternative antidepressant that is less likely to cause incontinence symptoms.

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Botox for Urge Incontinence - Not Just For Wrinkles

Friday, August 21st, 2009

Botox has been used for years as a wrinkle reducer, and has also recently been hailed as a breakthrough for treating migraine headaches. More importantly, and of interest to those who may be suffering from urge incontinence, Botox has been shown to be effectve in reducing or eliminating symptoms in urge incontinence.

How does it work? Urge incontinence is the product of an overactive bladder, and people who suffer from urge incontinence feel an urgent need to urinate as the result of bladder spasms. They also feel the need to urinate frequently due to these unpleasant bladder spasms. Conventional treatment consists of bladder retraining, medications and sometimes surgery.

Botox has been found to be effective in treating urge incontinence when it is injected into the bladder muscle that is responsible for the bladder spasms, thus reducing urgency and frequency. The downside of Botox is that it is not a permanent cure- Botox wears off in a matter of months, necessitating further treatment. However, in studies people who have been treated with Botox report a reduction in symptoms and, in some cases, a complete absence of symptoms following Botox injections. Botox has not been approved for this purpose, but trials are taking place. If this treatment interests you, you may want to consider if there are any trials taking place near you. To read more about this exciting new breakthrough, click here.

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Bladder Weakness & Your Doctor’s Appointment - What to Expect

Sunday, August 16th, 2009

You have made the decision to visit your doctor to discuss your bladder weakness. You may be wondering what is in store for you during your visit. Knowledge is power, and knowing what to expect will decrease your anxiety and allow you to get the most out of your visit.

First of all, you can expect your doctor to question you extensively regarding episodes of bladder weakness, including when they occur, how often they occur, anything you have noticed that makes your bladder weakness worse or better, and when your bladder weakness started. You may also expect questions regarding the amount of fluids you consume (including caffeinated and alcoholic beverages), medications you are taking, your health history, any surgeries you have had, and whether you have any abnormal urinary symptoms such as blood in your urine.

It may be very helpful to keep a bladder (voiding) diary for at least a week before your appointment. Keeping a voiding diary will enable you to collect a lot of meaningful information to take with you to your appointment, such as when and how much you drink, and when you are most likely to experience bladder weakness. This information can help your doctor pinpoint with more accuaracy which type of incontinence you have.

In addition to asking a lot of questions, your doctor may examine you. For women, this may include a vaginal exam to check for muscle tone, as well as checking sensation of the perineum. This is done simply by asking if you can feel pressure  in the area when it is touched. For men, a prostate exam may be part of the examination, in order to determine whether the prostate is enlarged. Palpation of the abdomen may be performed to ensure that there is no abnormal enlargement of the organs.

A urinalyisis (UA) may be done to check for infection of the urinary tract. Other tests, such as an ultrasound or other specialized test, may be ordered depending on your personal circumstances, your history and your doctor’s findings. These tests may help your doctor decide on the best treatment for you.

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How is Constipation Related to Bladder Weakness?

Saturday, August 15th, 2009

Bladder weakness is often a symptom of a treatable condition. Constipation is one problem which, when treated, can lead to a resolution of bladder weakness. Constipation can be caused by not drinking enough fluids, not eating enough fibre, not getting enough exercise, stress, certain medications, some neurological conditions, pregnancy, laxative overuse and various other problems or conditions.

You may be wondering exactly how constipation can affect the bladder; in fact, the same nerves that supply the pelvis also supply the rectum, so a problem affecting one may also affect the other. In addition, hardened stool as a result of constipation can apply pressure to the urethra and bladder, causing a sense of urgency.

Improving constipation may lead to an improvement in bladder weakness. This can be accomplished by increasing water intake, eating a well-balanced diet rich in fruits, vegetables and fibre, and partaking in regular exercise. If these self-help measures are not effective in relieving constipation, you may consider consulting your doctor, who may be able to pinpoint the cause of both constipation and the resulting bladder weakness.

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