Incontinence is a Treatable Problem

Viagra, the headline-making impotence pill, helped make sexual dysfunction a household word. And that's exactly what a hose of new treatments may soon do for urinary incontinence--the accidental leakage of urine--and one of the last remaining taboo topics in medicine.

Nearly 25% of Americans age 18 or older experience one or more symptoms of urinary incontinence. That equals approximately 17 million people, 85% of whom are women. Yet only 20% of sufferers are currently under a doctor's care. The average women with incontinence waits 8 years before seeking medical help.

In women, incontinence is caused by pregnancy and childbirth, hormonal deficiency, urinary tract infections, or by the bladder or other pelvic organs slipping out of place. Among men, incontinence is often a result of prostate problems.

But thanks to new medications and/or behavioral modifications, fully 85% of sufferers can expect to be cured of their problem if they seek help.

Whether people avoid the topic because of embarrassment, because of the belief that incontinence is a natural consequence of growing old, or simply because they don't know that help is available, the result is needless suffering. Beside discomfort, incontinence contributes to depression, social isolation, and inactivity. In fact, many people with incontinence may refuse social invitations and avoid sexual intimacy because they fear they'll lose control of their bladder.

Urinary incontinence is often temporary, usually treatable, and sometimes curable. And it's never too late to address the problem. The first step is making an accurate diagnosis.

You can also expect an examination for medical conditions such as urinary tract infections, or, in men, prostate problems that may cause incontinence, and a test to measure how much urine remains in your bladder after urination. Other common tests include blood work that tests for levels of a variety of substances that may point to causes for incontinence. There's also cytoscopy, which involves inserting a small tube with a tiny camera into the bladder so the doctor can see the urethra and bladder. Ultrasound exams use sound waves to check the condition of the kidneys, ureters, bladder, and urethra. These tests and several others can help your doctor determine what type of incontinence you have.

Two new prescription alternatives in drug therapy were approved within the last year.

A new formulation of oxybutynin (Ditropan XL) allows patients to take the medication once a day instead of every few hours. This medication works by curbing bladder spasms.

The new medication tolterodine (Detrol) relaxes the bladder, which can reduce the number of times a person needs to urinate in a day by as much as 21%.

In addition to Ditropan XL and Detrol, options include:

~Estrogen preparations for postmenopausal women can now be administered continuously in low does directly onto vaginal tissue via a small, flexible plastic ring called an Estring.

~Over-the-counter decongestants such as Sudafed and Actifed (brands of pseudoephedrine) may help temporarily by contracting the smooth muscles of the urethra.

~The antidepressant imipramine (Tofranil) may be prescribed (in very low doses) because it helps tone the sphincter.



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