INCONTINENCE EXPLAINED

Although many people suffer from bladder and bowel problems, they are often too worried to ask for help and delay telling anyone until the problem has become very bad. This leaflet is designed to explain more about one of the most common types of incontinence known as Genuine Stress Incontinence (GSI).

If you would like to find out more about GSI after reading this leaflet, or about any other types of incontinence, either go and see your doctor or contact one of the groups listed on the back of this leaflet.

What is incontinence?

Incontinence is a condition which causes an uncontrolled leakage from the bladder or bowel.

There are different types of incontinence which affect men, women and children of all ages. Incontinence is not just a problem of old age, nor is it an inevitable part of getting older.

The four most common types of urinary incontinence are listed below:

Genuine stress incontinence is when leakage occurs during physical activities or movement which puts pressure on the bladder.

Urge incontinence is when you may have a sudden or uncontrollable urge to go to the toilet and cannot get there in time.

Overflow incontinence is when you experience frequent or constant dribbling and leakage.

Nocturnal enuresis is otherwise known as bedwetting.

This article will now explain more about Genuine Stress Incontinence.

Who can get Genuine Stress Incontinence?

Both men and women can be affected, although the condition is more common in women. It is a particular problem for women who have had a baby as the pelvic floor muscles which support the bladder are weakened during pregnancy. Around half of women who have experienced the menopause are also more likely to be affected because of a drop in the level of hormones keeping the vagina and bladder outlet strong and supple. In men, the surgical removal of the prostate gland is a common cause of stress incontinence.

What causes it and what are the symptoms?

Genuine Stress Incontinence occurs when the bladder outlet and pelvic floor muscles are weak and so movement or physical activity can cause leakage of urine. This activity can be anything from laughing, sneezing or coughing to running for the bus,

The most likely causes are from pregnancy, pelvic surgery, bladder infections, hormone deficiency, stroke and diabetes. In men, the most common cause is prostate surgery. Many people with untreated Genuine Stress Incontinence tend to avoid normal everyday activities, rather than seek help. They may find themselves avoiding public transport, planning trips via the nearest toilet, stopping or limiting physical exercise and even avoiding sex.

All of these restrictions will affect people's lives no end, causing unnecessary misery and distress.

What should I do if I have these symptoms?

The most important thing to do is to tell someone who can help. Do not let embarrassment mean that you suffer in silence - incontinence is a treatable problem. Arrange to see your doctor or contact one of the groups listed at the back of this leaflet.

When you go to the doctor, make a note of your symptoms beforehand. How long have you had the problem? How often do you go to the toilet and when? Do you have any other symptoms?

This will help the doctor to decide what should be done and will help you to remember what to say if you are embarrassed.

How is it diagnosed?

Your doctor will ask a few simple questions and may arrange for you to see a nurse, a Physiotherapist or a specialist nurse called a Continence Advisor.

Your doctor may ask you to undergo some simple tests to help with the diagnosis. These are likely to be the following:
A urine test to check whether there is any infection. Urodynamic tests to assess how well the urinary system is working and diagnose any abnormalities.

Some of these tests are done at the hospital.

Can stress Incontinence be treated?

The good news is that, in most cases, Genuine Stress Incontinence can be cured or greatly improved. If your doctor is not able to sort the problem out directly he or she may refer you to see a nurse, as mentioned above, or organise a hospital appointment so you can see a specialist such as a Physiotherapist, a Urologist or a Gynaecologist.

All of these medical professionals are experienced in dealing with incontinence so you need not be embarrassed to discuss your symptoms with them.

They see hundreds of people with the same conditions and are there to help.

Mild to moderate Genuine Stress Incontinence is normally treated simply with pelvic floor exercises, bladder training or with electrical stimulation of the bladder. In some cases tablets may be prescribed such as hormone pills for post-menopausal women.

In more severe cases, surgery is considered to be the most effective treatment. However, many people are unable or unwilling to undergo an operation, but the good news is that new treatments are being developed as an alternative to surgery.

One which has just become available involves the injection of collagen into the neck of the bladder.

This procedure adds extra bulk to the tissues at the bladder outlet, helping to stop urine leakage.