By Noimot Olayiwola/Staff Reporter
People who experience a sudden need to urinate followed by instant bladder contraction or involuntary loss of urine while coughing, sneezing, laughing or exercising have been advised to seek immediate medical attention as they could be having problems associated with urinary incontinence.
“We have found that many people are still finding it difficult to openly discuss that they have urinary incontinence . They need not suffer in silence. It is high time they started discussing the problems with a physician as there are a number of ways they can be assisted and protected from the psychological, physiological and sociological effects of leaking urine,” Urology consultants Dr Adralan Ghafouri and Dr Omar Isam Mohamed Ali told Gulf Times yesterday.
Both consultants working at the Dysfunction Unit of the Hamad Medical Corporation’s Urology Department, disclosed that many patients also thought it was part of normal life changes while growing older and thus did not deem it necessary to seek medical intervention.
“Statistics show that the prevalence of incontinence worldwide ranges between 4-36% with varying degrees in each country and the problem could have a really negative impact on life,” they maintained.
The department, which has recently installed a second Urodynamic machine procured for QR200,000 from a Canadian company, receives yearly between 400-450 patients, comprising both males and females.
According to Dr Ghafouri, there are different types of incontinence with the most common being stress, urge and mixed incontinence.
“Stress incontinence occurs during certain activities like coughing, sneezing, laughing, or exercising while urge incontinence involves a strong, sudden need to urinate followed by instant bladder contraction and involuntary loss of urine. In this case, you don’t have enough time between when you recognise the need to urinate and when you actually do urinate and mixed incontinence involves more than one type of urinary incontinence,” he explained.
According to him, though both women and men suffer from urinary incontinence, with women mostly suffering stress incontinence due to a number of risk factors including: being female, multiple childbirth, chronic coughing (such as chronic bronchitis and asthma), ageing, obesity and smoking.
They said factors that could lead to incontinence in men are injury to the urethral area during surgical interventions, some medications and surgery of the prostate or pelvic area.
“The ability to hold urine and control urination depends on the normal function of the lower urinary tract, the kidneys and the nervous system. A patient must also have the ability to recognise and respond to the urge to urinate. The average adult bladder can hold over two cups (350ml-550 ml) of urine,” Dr Ghafouri explained adding that two muscles were involved in the control of urine flow: the sphincter, which is a circular muscle surrounding the urethra and the detrusor, which is the muscle of the bladder wall.
“A person must be able to squeeze the sphincter muscle to prevent urine from leaking out and the detrusor muscle must stay relaxed so that the bladder can expand. In stress incontinence, the sphincter muscle and the pelvic muscles, which support the bladder and urethra, are weakened. The sphincter is not able to prevent urine flow when there is increased pressure from the abdomen such as when you cough, laugh, or lift something heavy,” he explained.
Dr Ali mentioned that diagnosis of the condition can be done through a number of means including physical examination of the genital, rectal and pelvic floor, pad test, urinalysis and a procedure called flowmetry.
“Treatment depends on how severe the symptoms are and how much they interfere with the patients’ everyday life.There are four major categories of treatment for stress incontinence, which are behavioural changes, medication, pelvic floor muscle training (Kegel exercise) and surgery- when every other treatment method has failed,” he explained.
“Some women may use a device called a vaginal cone along with pelvic exercises, while biofeedback and electrical stimulation may also be helpful for those who have trouble doing pelvic muscle training exercises,” he mentioned.
However, Dr Ali maintained that there were still no effective approved oral medication to treat stress incontinence and that the only available medication was to treat depression, the use of which is being discouraged due to its side effects.
He added that the Urodynamic department has recorded up to 95% success rate with the use of a simple 20 minutes procedure called “day procedure” to help patients correct stress incontinence.
People who experience a sudden need to urinate followed by instant bladder contraction or involuntary loss of urine while coughing, sneezing, laughing or exercising have been advised to seek immediate medical attention as they could be having problems associated with urinary incontinence.
“We have found that many people are still finding it difficult to openly discuss that they have urinary incontinence . They need not suffer in silence. It is high time they started discussing the problems with a physician as there are a number of ways they can be assisted and protected from the psychological, physiological and sociological effects of leaking urine,” Urology consultants Dr Adralan Ghafouri and Dr Omar Isam Mohamed Ali told Gulf Times yesterday.
Both consultants working at the Dysfunction Unit of the Hamad Medical Corporation’s Urology Department, disclosed that many patients also thought it was part of normal life changes while growing older and thus did not deem it necessary to seek medical intervention.
“Statistics show that the prevalence of incontinence worldwide ranges between 4-36% with varying degrees in each country and the problem could have a really negative impact on life,” they maintained.
The department, which has recently installed a second Urodynamic machine procured for QR200,000 from a Canadian company, receives yearly between 400-450 patients, comprising both males and females.
According to Dr Ghafouri, there are different types of incontinence with the most common being stress, urge and mixed incontinence.
“Stress incontinence occurs during certain activities like coughing, sneezing, laughing, or exercising while urge incontinence involves a strong, sudden need to urinate followed by instant bladder contraction and involuntary loss of urine. In this case, you don’t have enough time between when you recognise the need to urinate and when you actually do urinate and mixed incontinence involves more than one type of urinary incontinence,” he explained.
According to him, though both women and men suffer from urinary incontinence, with women mostly suffering stress incontinence due to a number of risk factors including: being female, multiple childbirth, chronic coughing (such as chronic bronchitis and asthma), ageing, obesity and smoking.
They said factors that could lead to incontinence in men are injury to the urethral area during surgical interventions, some medications and surgery of the prostate or pelvic area.
“The ability to hold urine and control urination depends on the normal function of the lower urinary tract, the kidneys and the nervous system. A patient must also have the ability to recognise and respond to the urge to urinate. The average adult bladder can hold over two cups (350ml-550 ml) of urine,” Dr Ghafouri explained adding that two muscles were involved in the control of urine flow: the sphincter, which is a circular muscle surrounding the urethra and the detrusor, which is the muscle of the bladder wall.
“A person must be able to squeeze the sphincter muscle to prevent urine from leaking out and the detrusor muscle must stay relaxed so that the bladder can expand. In stress incontinence, the sphincter muscle and the pelvic muscles, which support the bladder and urethra, are weakened. The sphincter is not able to prevent urine flow when there is increased pressure from the abdomen such as when you cough, laugh, or lift something heavy,” he explained.
Dr Ali mentioned that diagnosis of the condition can be done through a number of means including physical examination of the genital, rectal and pelvic floor, pad test, urinalysis and a procedure called flowmetry.
“Treatment depends on how severe the symptoms are and how much they interfere with the patients’ everyday life.There are four major categories of treatment for stress incontinence, which are behavioural changes, medication, pelvic floor muscle training (Kegel exercise) and surgery- when every other treatment method has failed,” he explained.
“Some women may use a device called a vaginal cone along with pelvic exercises, while biofeedback and electrical stimulation may also be helpful for those who have trouble doing pelvic muscle training exercises,” he mentioned.
However, Dr Ali maintained that there were still no effective approved oral medication to treat stress incontinence and that the only available medication was to treat depression, the use of which is being discouraged due to its side effects.
He added that the Urodynamic department has recorded up to 95% success rate with the use of a simple 20 minutes procedure called “day procedure” to help patients correct stress incontinence.
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