Under-diagnosed urinary incontinence needs more experts

Recently, a survey conducted among 1,000 women for one or the other kind of urinary incontinence (involuntary leakage of urine) problem in the last six months, showed that as many as 60 per cent of them had the condition, says Dr Professor N Rajamaheswari, president, Urogynecology and Reconstructive Pelvic Surgery Society of India (URPSSI). 

She adds, “Some of them are so embarrassed about the condition that they do not even confide about it to their spouses. Most of these cases are associated with childbirth, pregnancy and menopause” Broadly categorised into three types _ stress (due to increased pressure on the bladder while for instance, coughing, sneezing or laughing), urge (an urgent desire to pass urine and sometimes urine leaks before you have time to get to the toilet) and continuous (an abnormal communication between vagina and the urinary tract as a result of a surgery). 

Dr Muruganandham K, senior consultant, Head of Urology, Global Hospitals, says among 100 women with the condition, just about 10 to 15 per cent seek medical help. He adds that multiple deliveries at a young age can serve as a trigger among women. “It could be a lifestyle -related condition as well with factors like alcohol, smoking and increased consumption of caffeine,” he says. On the treatment side, as many as 15-20 per cent of the would need to undergo a procedure like pelvic reconstructive surgery, points out Dr Rajamaheshwari.  

“We would suggest surgical procedure only if day-to-day activity is affected, or when they tend to keep away from social gatherings. In extreme cases, the affected person has to wear a pad all day. For the rest, we could do with medicines, coping skills and pelvic floor exercise,” she says. In a bid to meet the shortage of professionals who can perform the procedure across the country to train more doctors. “The idea is to reach out to the needy patients from across the country,” added Dr Rajamaheshwari.  

Pelvic reconstructive surgery also involves uterus prolapse (muscle weakness or relaxation may allow your uterus to sag or come completely out of your body in various stages) apart from urinary incontinence. “Training more doctors in the procedure can introduce more specialists in the community, as the doctors trained go back and train more,” she said. In the recent workshop conducted by URPSSI and Medway Hospital, 44 major surgeries were conducted for both conditions.