Urinary incontinence

• Pelvic floor exercises - WHW Dec 2001
• Urinary incontinence higher after hysterectomy - WHW Sept 2000
• Women speak out about incontinence - WHW Dec 1999
• Incontinence treatments compared - WHW July 1999
• Bossing your bladder best - WHW July 1999
• Urinary incontinence- from 'Feeling Fabulous at 40, 50 and Beyond' (1996)

Resources

• Maritime Women's Bladder Health resource
• WHIS Factsheet: Uterine Fibroid

Pelvic floor exercises

December 2001 Women's Health Watch

A third of women have urinary incontinence three months after childbirth, according to research carried out in New Zealand, Birmingham and Aberdeen. However the researchers say there is little information about best practice for treating incontinence after childbirth and most women do not seek treatment. The research team trialled a conservative programme where women were visited by nurses and asked to follow a basic pelvic floor exercise programme of eight to ten short sessions a day. The researchers say the conservative management helped prevent the likelihood of urinary and faecal incontinence persisting after 12 months. The benefits were greater for women with more severe symptoms.

Ref: BMJ 2001;323:1-5

Urinary incontinence higher after hysterectomy

September 2000 Women's Health Watch

Women having hysterectomies should be warned about the risks of developing urinary incontinence. A study in the Lancet reports that women who have hysterectomies are at least 40 percent more likely to develop urinary incontinence compared to women who do not have the procedure. Women over the age of sixty were 60 percent more likely to become incontinent. The researchers say hysterectomy may damage the pelvic nerves or pelvic support structures and increase the risk of incontinence, although this may not develop for some years after the hysterectomy is carried out. Reasons for the delayed onset of incontinence are unclear but the pattern is similar to that of childbirth where incontinence often occurs five to ten years later.
Ref: Lancet 2000; 356: 535-39

Women speak out about incontinence

December 1999 Women's Health Watch

Urinary incontinence disrupts the lives of many New Zealand women, yet it remains a subject which is seldom discussed.

Despite its prevalence, urinary incontinence is seen by many as a taboo, something which is unacceptable and should be kept secret. Both women and health professionals mistakenly believe urinary incontinence is an inevitable part of the aging process and a natural and irremediable effect of childbirth and that nothing can be done to cure it. Few New Zealand women seek treatment and those which do seldom receive the support they require.

According to a qualitative research study on female urinary incontinence conducted in Auckland recently by social anthropologists Michele Lennan and Fuafiva Fa'alau and gynaecologist Dr Jackie Smalldridge, this is simply not true. Urinary incontinence can be treated very effectively...Read More

Incontinence treatments compared

July 1999 Women's Health Watch

Pelvic floor exercise should be the first choice of treatment for stress incontinence, according to a Norwegian study.

Researchers compared the effect of pelvic floor exercises, electrical stimulation, vaginal cones and no treatment for genuine stress incontinence in 107 women between the ages of 24 and 70 years of age.

Improvement in muscle strength was significantly greater after the women practised pelvic floor exercises and the study concluded training of pelvic floor muscles is superior to electrical stimulation and vaginal cones.

The researchers also reported adverse effects with the use of electrical stimulation and vaginal cones, and that patients' tolerance for electrical stimulation and vaginal cones was low.
Ref: BMJ 1999; 318; 487-493.

Bossing your bladder best

July 1999 Women's Health Watch

Behavioural treatment for urge incontinence was the most effective strategy in a recent randomised controlled trial. Volunteers aged between 55 and 92 with urge incontinence were randomised into a biofeedback-assisted behaviour group, a drug treatment group (oxybutynin chloride) or placebo group.

For all three groups, reduction in incontinence was most pronounced early in treatment, then progressed more slowly. Behavioural treatment, which showed a mean 80.7% reduction in incontinence episodes, was significantly more effective than drugs (mean 68.5% reduction) and both were more effective than placebo control (mean 39.4% reduction).

Patient perceived improvement was greatest for behaviourial treatment (71.4% much better) vs 50.9% and 26.9% for drug treatment and placebo respectively.
Ref: JAMA, 1998; 280: 1995 - 2000

Urinary incontinence- from 'Feeling Fabulous at 40, 50 and Beyond' (1996)

Read here

Resources

Maritime Women's Bladder Health resource

Developed by health professionals experienced in caring for women who suffer from involuntary loss of urine (urinary incontinence). It is designed to provide incontinent women with information so they may make informed choices about their health. www.womensbladderhealth.com

WHIS Factsheet: Uterine Fibroid factsheets