Unreported bladder control cases in women, a cause for concern

It is embarrassing and a huge factor for stress among women. The fear of it keeps one away from attending social gatherings and parties, but they do very little to seek help for it. Urinary incontinence is the involuntary leakage of urine, which means a person urinates when they do not want to. Control over the urinary sphincter is either lost or weakened. The condition can be 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). However, the commonest condition seen among Indians is stress incontinence, says Dr Muruganandham K, senior consultant, Head of Urology, Global Hospitals, adding that urinary incontinence has a prevalence rate of as much as 10 per cent in India.

A study conducted by Guna Associates in Urogynecology & Research for Incontinence (GAURI) titled ‘Prevalence of urinary incontinence and help seeking behaviour among women in Chennai’ a few years ago had revealed that as many as 40 per cent of the women in the city had the condition. 

Dr Karthik Gunasekaran, urogynecologist, who heads GAURI says that it is common than people often realise. He said, “The study we conducted had a majority of respondents in the 30-35 years’ age group. It is more of a hygiene problem for women and the study was an attempt to raise awareness. We found that it took many women a while to seek help from experts.” Dr Muruganandham says that if there are 100 women with the condition, only 10 to 15 come forward to seek treatment. “There is a lot of guilt involved and as a result, many keep it as a personal secret,” he adds.

One of the biggest contributing factors for incontinence is obesity apart from childbirth, hysterectomy, neurological conditions and medication. Dr Karthik says, “The risk of the condition is three times higher in those who have had a normal delivery, compared to those who have undergone C-section deliveries.” Dr Muruganandham 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 being major contributing factors,” he says.

Correcting or rectifying contributing factors can help in reversing the condition, he adds. “Reducing weight, cutting down on coffee, alcohol and smoking is one of the treatment option. There are pelvic floor exercises that can help strengthen muscles. Medical treatment, especially in the case of urge incontinence, involves bladder relaxants that have more than a 50 per cent success rate.” Surgical treatment for stress incontinence consists of a sling surgery with strips of surgical mesh to strengthen urinary tract or a Botox injection in the bladder in order to ease it. Lack of intervention in the long run can lead to urinary tract infection, points out Dr Sivabalan, Senior Assistant Professor in Urology, Madras Medical College. He says, “Many of these women choose to stay away from gatherings or social interactions as they fear the foul smell can lead to social stigma. Therefore, it is best for them to approach experts and seek timely help.”