A shopping spree in Milan, a hike in Ecuador, an island-hopping cruise. On vacation, you can escape most everyday hassles -- except incontinence. At every turn, it's unfamiliar territory. If you have an accident, what can you do?
"Everyone who has incontinence has developed some coping strategies," says Roger Dmochowski, MD, a urologist and director of the Vanderbilt Continence Center in Nashville. "They do what they need to do. It's amazing how good some people are at estimating their bladder's...
Cayton suffered from "stress incontinence" -- a condition where urine leaks when a woman coughs, sneezes, laughs, runs, or lifts something heavy. It's surprisingly common, but difficult for patients to discuss. According to the American Urological Association in Washington, D.C., an estimated 10 million women in the United States aged 25 and above suffer from some form of incontinence.
Most often, stress incontinence develops when the pelvic floor muscles weaken as a consequence of childbirth or normal aging, says Andrew Duxbury, M.D., assistant professor of Gerontology and Geriatric Medicine at the University of Alabama, Birmingham.
Urge incontinence, another form, affects mainly older women and occurs when the pelvic muscles contract inappropriately. It results in an unexpected, often uncontrollable urge to urinate. Some women also suffer from mixed incontinence, a combination of the two.
In any form, incontinence is likely to isolate a woman who has it. Cayton, for instance, often skipped social gatherings because of her condition.
The good news? You don't have to suffer in silence. According to the Center for Aging at the University of Alabama, incontinence can be cured or controlled 80% of the time. Physicians usually recommend the least aggressive treatments first: behavioral modification, such as biofeedback, or physical therapies, such as electrical stimulation or different types of Kegel exercises. Some medications also prove helpful.
More invasive treatments include the injection of collagen, which causes the tissues surrounding the urethra to swell and close off the base of the bladder. If pelvic tissues or sphincter muscles have collapsed, doctors may suggest reconstructive surgery. In other cases, surgical devices can be inserted or tissues tucked to relieve pressure on weak or stressed muscles.
One of the latest therapies for incontinence is a device known as the NeoControl, an office chair fitted with magnets in its seat. Approved by the Food and Drug Administration in June 1998 for the treatment of all forms of incontinence in women, the NeoControl was studied at the Cleveland Clinic and at hospitals and medical clinics in Chicago, Philadelphia, and Orlando.
The patient sits fully clothed on the chair, and the device exercises and strengthens the pelvic floor muscles. Explains NeoControl co-inventor, Niall Galloway, M.D., associate professor of Urology at Emory University in Atlanta, "By creating a pulsating magnetic field, the new procedure induces strong contractions in the pelvic floor. This builds strength and endurance in muscles that have been weakened by childbirth, surgery, or injury."
One study on NeoControl appeared in the June 1999 issue of the journal Urology. Researchers at Emory University in Atlanta observed 83 women, aged 35 to 83, diagnosed with stress incontinence. Patients used the NeoControl device for 20 minutes twice weekly for six weeks. At the study's end, physician researchers found that 34% had no leakage all, and overall incidents of leakage were reduced from 3.3 to 1.7 daily.