Taking the Stigma Out of Incontinence
Discussing topics like overactive bladder and urinary incontinence may induce embarrassment, but they’re hardly rare instances. As many as four million Canadians are affected by a urological condition, or about 10 percent of our population.
Wide scope
The actual number of people affected by these conditions may be much higher, however, as a body of evidence suggests that urinary incontinence and overactive bladder are frequently under-reported.
This may be because of embarrassment, but it could also be because they’re often seen as a normal part of aging—a common misconception according to Dr. Adrian Wagg, a professor specializing in geriatric medicine and incontinence at the University of Alberta.
“Although incontinence is more common in later life, that’s often because people tend to have other health issues as well,” Wagg says.
A heavy burden
Incontinence and overactive bladder are unique in that the emotional anguish they inflict on sufferers is often equal to the physical discomfort they produce. Quality of life, mental health, personal relations and economic productivity can all be impacted.
“Some of the problems associated with being incontinent are often related to a poor quality of life, says Wagg. “Notably, people don’t go out, they don’t socialize, they refrain from activities to avoid incontinence. There’s also associated depressi- on and other comorbidities.”
And while it’s certainly true that these conditions affect both young and old alike, according to a 2013 report by Statistics Canada, seniors who report having incontinence are about 50 percent more likely to experience loneliness than those who don’t suffer from the condition.
The report notes that people with incontinence may voluntarily limit their use of social resources that could help prevent loneliness due to fear of embarrassment should the condition become obvious.
Treatment options
Because incontinence is considered embarrassing, many who suffer from the condition don’t seek out treatment for fear of being ostracized by friends, family, and society as a whole.
As such, efforts to increase awareness about the range of treatment and supply options that exist is a primary goal among health care practitioners.
Indeed, depending on the type and cause of incontinence, treatments can range from lifestyle changes and exercise, to medication and surgical intervention.
“The gold standard, conservative, non-surgical treatment is pelvic floor muscle therapy,” says Wagg, which involves exercises designed to strengthen the muscles of the pelvic floor to increase bladder control.
As one moves up in severity, medication or surgery are other options for urinary incontinence and overactive bladder. Unfortunately, the number of urogynecologists in Canada is fairly low, and waiting times are quite long.
Improving access to treatment
“We do have somewhat of an issue across the provinces and territories with variable access to both medications for overactive bladder, which does impair the chance of getting the best results with medication,” says Wagg.
“We have variable access to more sophisticated treatment, and we have a rather weak state of access to services across-the-board,” he continues.
Concern about a lack of services has been raised by The Canadian Continence Foundation, which recently published a white paper on the need for better access to high-quality, local continence care services.
But while it’s true that more work needs to be done to raise the profile of continence care, according to Dr. Wagg, Canadians are more united in the cause today than ever before.
“We’re gaining a heightened awareness of the problems and the impacts of the conditions. We have a wide network of experts and clinicians who are attempting to develop new treatments. We have a fledgling consumer charity that is acting on behalf of people with the conditions. There’s a long way to go, but we’re making good strides,” he says.