One In Three Women Will Suffer From Incontinence

Tue, June 07, 2011

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KMUW / Briana O’Higgins

A staggering number was released last month by the American Urological Association. In their lifetime, one in three women will suffer from Stress Urinary Incontinence or SUI.

A condition outlined by Whoopi Goldberg in a new commercial for Poise pads:

SUI falls under the greater umbrella of incontinence, which includes urge incontinence, overflow incontinence, and mixed incontinence among others. SUI – which accounts for that one in three number is marked by an involuntary loss of urine as a result from an environmental trigger.

Sandra Vassos is the Executive Director of the American Urological Association Foundation.

Vassos: Their symptoms can involve when you are picking up your child or you are picking up something heavy you might experience leakage, so those are triggers to the SUI, or while conducting rigorous activity, some women experience bladder leakage when they sneeze or when they cough.

Along with the new statistic, the American Urological Association unveiled a new campaign to educate women about SUI, a condition many associate with adult diapers and the elderly.

Vassos said the amount of leakage can be anywhere from a few tiny drops to tablespoons or more, and that incontinence does not necessarily come with age.

Vassos: It is not a natural part of aging, which is something we did discover through this campaign. A woman at any age can suffer from stress urinary incontinence.

Aging is a risk factor, as is pregnancy, neurological issues and obesity.

But many women without risk factors also experience SUI and other forms of incontinence, as do men and children, though in significantly smaller numbers.

But why, then, do so many women experience incontinence? Dr. Sanford Fitzig is a urologist at Via Christi.

Fitzig: I don’t know why women’s bladders really work very well. Because the urethra is very short, and the fact that women are dry, is one of the miracles. Well think about it, the urethra is only about an inch and a half long, and you know, it’s different from a man’s urethra which is like six or eight inches, so the muscles have longer to contract and keep guys dry.

And said Dr. Fitzig, if the muscles that work to hold in urine, called the pelvic floor muscles, are stretched from something like childbirth, or there is a neurological problem where the muscles have been compromised, leaking becomes all the more likely.

And even though SUI is common, it isn’t talked about with equal regularity.

Sandra Vassos of the American Urological Association said in their research on SUI, they discovered women were not talking about it, or bringing it up with their physicians.

Vassos: It’s something they don’t want to bring up because it is bladder leakage. We’ve discovered that many women think that it is normal and why bring it up. And our campaign is that it is not a normal part of aging or childbirth or exercise and they should be empowered to ask the question.

If they don’t want to, said Vassos, women don’t have to live with SUI. There is an array of treatments for the condition, from exercise to surgery.

Pam Palmer is a physical therapist with Palmer Physical Therapy for women. She said at first most of her patients say they don’t have any trouble with incontinence.

Palmer: Until I say, now I am talking about laughing and coughing and sneezing, you’re leaking a couple drops. “Oh well, yeah, that.” So almost everybody that comes in here has some sort of urinary incontinence to be honest with you.

Sandra Vassos said getting patients to talk and physicians and medical practitioners to ask is one of the first steps in treating SUI.

What comes second depends on the patient.

At Pam Palmer’s clinic that means exercises focused mainly on dysfunction in the lower back causing nerve problems, a relatively new method of treatment that has limited academic literature and clinical trials, but according to Pam Palmer and other doctors and physical therapists, great results.

Palmer: It’s been the neatest thing of my career, and it just kinda came by accident. What you see and what you read in books and what happens in life isn’t really what always occurs.

Dr. Fitzig said first he makes sure he understands everything that is going on, and that there is often multiple issues with someone experiencing SUI, sometimes even another form of incontinence, some of which can be treated with drugs.

Fitzig: We don’t have good drugs for stress incontinence, we have good drugs for urgency incontinence. And if you treat the urgency part, their stress incontinence may get better and they won’t need anything else done.

If drugs don’t work, or don’t make sense for the patient, Fitzig uses exercises called Kegels. A method of tightening the pelvic floor muscles that improves a patient’s ability to hold in urine.

Fitzig: If the medications don’t work, if the exercises don’t work, then we will do an operation and we will put in a sling where we will put it underneath the urethra and that helps with the stress incontinence.

The success rate of surgery said Fitzig is around 85 percent, with multiple types of slings available. But with all the options he said, there is no reason a woman should have to wear the pads that Whoopi Goldberg is advertising if she doesn’t want to.

The new campaign from the American Urological Association about SUI is called “It’s time to talk about SUI,” and according to the professionals dealing with the issue, it goes beyond the women who are suffering right now.

Again, Sandra Vassos of the American Urological Association.

Vassos: Anecdotally, I can tell you that many individuals are, and we hear this a lot from our physicians and members and from the public. Individuals are placed in nursing homes primarily from what we hear, again anecdotally, because of incontinence conditions because it is a difficult thing to have a loved one that cannot control their urine.

And said Pam Palmer, that is going to be a problem in the near future.

Palmer: And with our growing number of baby boomers and aging people, that is going to be a huge burden on society, and a huge burden on women if we don’t get something taken care of. It is so under reported and women have to know that they need to tell their doctor and there is something that can be done.

An online self-assessment tool to determine if your symptoms are associated with Stress Urinary Incontinence: American Urological Association [link]

Funding for KMUW’s Sound Mind & Body series is made possible, in part, by Via Christi Health.