No-one needs to suffer in silence with incontinence
Millions of people experience faecal and urinary incontinence – but due to embarrassment they’re rarely talked about openly. Here, colorectal consultant Julie Cornish and consultant gynaecologist Kiron Bhal talk about what treatments are available
stimulator unit into the buttock.
“This is connected to electrodes which rest on the nerves in the lower spine.
“The stimulator sends impulses to the nerves and muscles that control the bowel and anus.
“Initially, a temporary electrode lead is connected to a portable battery unit outside the body but if symptoms are improved enough, this is replaced by an implanted battery.”
SNS has a 70-85% success rate for improving faecal incontinence symptoms and in some people may result in complete resolution of symptoms.
However, there can be complications such as pain, lead fracture and battery replacement.
Long-term success rates (over 10 years) are about 50% in current literature. This treatment is not routinely funded by the NHS in Wales.
There are significant developments in the battery technology for SNS as new-generation batteries become smaller and rechargeable so they won’t need to be replaced as often.
Current battery life is five to seven years but this is expected to increase to 15-20 years with new developments. put up with the problem for a long time before going to see their GP and starting along the treatment pathway.”
Here Mr Bhal answers some oftenasked questions about female incontinence. What age group of women tend to suffer most? The condition is common in women of childbearing age and tends to peak in the menopausal age group (after the age of 50 years) How common is incontinence during pregnancy? Data from European studies suggest that the figure is around 40% in the UK. Does the problem get worse after childbirth? Yes. Hormone changes during pregnancy and added pressure on the bladder from pregnant uterus and a subsequent delivery can cause the disruption of the supporting structures that support the pelvic floor and thus the bladder itself.
This leads to a weakness in the area that contributes to the inability to voluntarily halt leakage of urine during activities such as coughing or exercising as well as leading to “urinary urgency” – not being able to wait . What are the non-surgical options available? Changes in lifestyle – losing weight, reducing caffeine intake and cutting back on drinks in general can all help.
Supervised pelvic floor muscle training with specialized physiotherapists for a minimum of three to six months can also help as can bladder retraining. There are also medications that can help relax the bladder. What surgical treatments are available? Once conservative measures have been unsuccessful then patients may need a bladder function test called urodynamics which helps determine the type of urinary incontinence before surgical treatment may be offered.
However, surgical treatments depend on the reason for the incontinence and are discussed with patients on an individual basis.
Further information can be found at www.bladderandboweluk.co.uk, www.bladderandbowel.org and masic.org.uk