URINARY Incontinence

One of the reasons that keeps some women away from outdoor activities and they find embarassing to discuss is urinary incontinence. Although not threatening to life, this disorder caused by lack of control to hold back urine, often spoils the quality and makes life miserable.

Incontinence of urine is quite common; around 10% of adult women suffer from this disorder. The typical sufferer is a woman above 40, overweight and had suffered injury to the pelvic muscles while bearing children. The leakage of urine into undergarments or clothes is often intermittent during fits of coughing, sneezing or while lifting heavy objects. It sometimes progresses to a state of constant dribbling.

The consequences are a feeling of being “soiled” or a constant worry of it. Often the smell of urine can be a source of embarassment in social gatherings that strong perfumes are unable to cover. She starts shying away from group activities, prefers to remain isolated, begins to lose self-esteem and often becomes depressed. The sense of leakage and “soiling” leads them to avoid sex.

Use of pads or STs helps provide temporary respite during travel and when gong out for long periods. If needed to be used regularly however, it can be expensive. Further, the constant feeling of being “wrapped up” can hardly provided a sense of freedom or confidence in close interpersonal physical relationships, and one starts getting “bound up” in spirits as well.

If one can come out of the initial inhibition and seek help, this disorder often responds well to treatment. The 1^st step is to strengthen the muscles of the pelvis and the sphincter, by exercises that a gynecologist or urologist could teach. The weak muscular sphincter near the bladder neck gets strenghthened and control returns. Medications to increase the tone of these muscles can also help provide early relief especially while while waiting for the muscles to regain strength through exercise.

Few women with persistent incontinence require surgery. The pelvic muscles are tightened and a sling  passed around the urethra to restore control. This surgery is not risky, but needs to be performed by an expert for good results.

Incontinence does occur in males as well, but is less common. It usually follows surgery for the prostate. Sometimes it occurs when diabetes, surgery or neurological diseases damage nerves that convey bladder sensation or impulses to sphincter muscles.

The satisfaction of feeling the fullness of the bladder, and keeping one’s control on when and where to void urine is something we take for granted. Incontinence is a disruption of this fine control, that disrupts our social lives. Help is available as long as one is willing to overcome the initial embarassment and seek it!

 As published in HT City ( Hindustan Times) dated 21 march, 2010.