An unreliable bladder can have a serious effect on a person's social life and confidence. And it's not only the very old who suffer from it - it affects 8% of females and 3% of males, and occurs for a variety of reasons.
Women are more prone to incontinence, because the female urethra is short and the continence mechanism is not as well developed as in the male. Multiple childbirths stretch and weaken the support of the bladder and urethra, and menopause sometimes weakens the vagina and urethra, which impairs the “closing” function of the urethra.
Other factors that may contribute to urinary incontinence include:
- prostatic hyperplasia;
- trauma, surgery or radiation to the pelvis;
- tuberculosis of the urinary tract;
- dementia; and
- spinal cord injury.
Types of urinary incontinence
There are four different types of urinary incontinence:
1. Stress incontinence, which occurs when urine leaks from the bladder when you cough, laugh, sneeze or do any other activity that places stress on the abdomen.
2. Urge incontinence – the leakage of urine associated with a great urgency or desire to urinate, which cannot be suppressed. For example, it kicks in when (even if you’ve been fine up until that moment) you get close to a toilet and suddenly find you can’t make it all the way.
3. Overflow incontinence happens when someone has difficulty passing urine, which causes the bladder to be permanently full. As the kidneys continue to produce urine, the excess spills out through the urethra – almost like a dam that’s overflowing.
4. Total incontinence is the continuous leakage of all the urine. It’s most often caused by an abnormal communication between the bladder and the vagina (called vesicovaginal fistula).
What’s the solution?
Fortunately, there’s a lot that can be done.
“For decades, thousands of women have quietly dealt with what they believed to be incurable ailments, but they don’t have to be silent anymore,” says Lizelle Grindell from the Biofeedback Clinic at the Sunninghill Netcare Hospital in Johannesburg.
Various tests, as well as surgical and non-surgical treatment options, are available.
The Biofeedback Clinic specialises in pelvic muscle rehabilitation, assisted by biofeedback and behavioural therapies.
“These treatments are very effective for a variety of bowel and bladder disorders and chronic pain syndromes,” says Grindell. Studies have shown that pelvic muscle exercises, relaxation training, electric stimulation and bladder training are effective in 85% of patients, she claims.
The first, and probably the most difficult step, is to acknowledge the condition and to speak to your GP about it – this is essential in seeking referral to a specialist centre.
(Wilma Stassen, Health24.com, September 2007, updated 2012)