Is it possible that in a civilized nation we accept that approximately one in three new mothers will become incontinent of urine and may remain so for decades? (Brubaker 2002)
Urinary incontinence (UI) means the unintentional leakage of urine. It is often termed 'bladder weakness' which is a misnomer as it rarely involves a problem with the bladder at all.
It remains a 'taboo' subject that is not openly discussed even with a partner; less so with a doctor, other health professional or friend. Stress incontinence is the most common form, and is caused by physical exertion such as exercising, laughing or sneezing. Urge incontinence is another form where the woman feels a strong urge to urinate and cannot stop herself. (NICE 2006) Whatever the type: it is distressing. The situation is only managed by the wearing of pads at significant cost to the pocket and, more importantly, self-esteem.
Antenatal advice, mainly given by midwives, is to regularly practice pelvic floor exercises, otherwise known as Kegel exercises to avoid the leakage of urine occurring. In a study summarized by Sue Dwyer (2006) of 3204 women, over a third of women practiced pelvic floor exercises from the beginning of their pregnancy to two years after the birth.
Why is it then that almost half these women still suffer with UI?
Possibly, the exercises are being performed incorrectly due to a lack of adequate initial supervision when identifying the correct group of muscles or not often enough. One study states it is necessary to exercise these muscles 80-100 times each day (Glazener, Herbison, Wilson, MacArthur, Lang, Gee, Grant 2001). Even on a more reasonable level it should be 8-12 times three times daily (Jozwik 2007) preferably in each position of lying, sitting and standing.
So, what else could be done?
Studies have shown that an intensive program of pelvic floor exercises overseen by a qualified physiotherapist (Chiarelli & Cockburn, 2002) or specialist nurse (Glazener et al, 2001) can help to reduce UI. The problem is that with resources scarce and exercises requiring great motivation women tend to become frustrated with the lack of long term results. Pelvic floor surgery is an alternative and is often chosen as a speedy answer to the problem but it can reoccur as the muscles weaken again.
How about a solution that allows you to take control?
The Kegel 8 Pelvic Health Device is a neuromuscular stimulator using a vaginal probe offering a choice of programs to suit the individual woman. It can be used discreetly at any time on a daily basis in any position. Studies have shown that electrical stimulation used alone or in conjunction with pelvic floor exercises can be of potential value in the management of UI (Berghmans, Bo, Hendriks, van Kampen & de Bie 2004).
Whilst the National Institute for Health and Clinical Excellence (NICE) launched new guidelines in October 2006 to improve treatment and care for incontinence, it seems unlikely that the NHS will have the time or resources to help the millions of women suffering in silence.