Recommendation says screen all women annually for urinary incontinence

New guidelines from the Women’s Preventive Services Initiative (WPSI) are recommending that all women of all ages should be screened annually for urinary incontinence. Urinary incontinence is the involuntary loss of urine estimated to affect up to 51 percent of women adversely affecting women’s physical, functional, and social well-being.  This fairly common incidence affects about 25 million Americans which breaks down to about 75% women who are affected and 25% men.

The screening would assess whether a woman is experiencing urinary incontinence and what affect it is having on her activities and quality of life.  If the screening finds a woman who has urinary incontinence, then she would be referred for further evaluation and possible treatment.

The problem with urinary incontinence is the reluctance and embarrassment of many women to discuss this issue with their doctor. One in four women over the age of 40 suffers from some type of urinary incontinence. Whether it’s leaking a little when laughing too hard, being unable to hold it until reaching the bathroom, or spraying instead of urinating in a steady stream, many women suffer unnecessarily from highly treatable problems. Instead of bringing it up at an annual physical exam or other medical appointment, many women may be enduring symptoms for a long time before the issue is addressed.  In fact, most doctors rarely even ask women about if they are having problems with urinary incontinence.  Only 1 in 12 women will ever get help and yet 80% of the time urinary problems can be completely cured.

A review of published studies were evaluated by researchers from Oregon Health and Science University on whether screening for urinary incontinence in women not previously diagnosed, improved physical and functional outcomes. Also assessed were studies on the accuracy of screening methods and potential harms. What was found was that no studies evaluated the overall effectiveness or harms of screening. Limited evidence suggested that some screening methods had fairly high accuracy for identifying symptoms of urinary incontinence in primary care settings.

The WPSI believes that screening has the potential to identify urinary incontinence in many women who are not discussing their situation with their doctor. An important reason for advocating for routine annual screening for all women of all ages is the fact that early intervention may reduce symptom progression, improve quality of life, and limit the need for more complex and costly treatments.

Why women experience more urinary incontinence than men

Why do women experience urinary incontinence more than men? Part of the reason is due to the anatomical differences in the pelvic region between men and women. Childbirth can also lead to problems of urinary incontinence as a result of weakened or stretched pelvic floor muscles. Other reasons might include changes in the bladder lining or bladder muscle in postmenopausal women or women with a chronic neurological condition such as multiple sclerosis. Multiple sclerosis is at least two to three times more common in women than in men.

What can be done?

Here are tips to try to train your bladder to prevent incontinence:

·      Try timed voiding or urinating on a regular schedule.  Have certain times of the day, such as right after eating a meal, to automatically use the restroom for urinating.

·      Try bladder guarding.  This is on the same line as timed voiding except that it teaches a person to deal with triggers that may cause them to want to urinate such as hearing the sound of water running.  When this happens, squeeze your muscles to hold in urine sending a message to the brain to wait. 

·      Control fluid intake – the more fluid you drink, the more likely you’ll have the urge to go.

·      Reduce pressure on the bladder by controlling coughing.

·      Minimize bladder irritants such as caffeine, alcohol, and carbonated beverages.

·      Do Kegel exercises faithfully.  This involves squeezing and releasing the muscles used to hold in urine.  It is particularly helpful for those with an overactive bladder and if done regularly, may bring about a 75-100% improvement.

·      Some people will need the help of a prescribed medication.  Depending on what type of incontinence a person has, will determine what type of medication is best.

·      When all else fails, other possible but more invasive solutions might include injections of Botox, a procedure called sacral neuromodulation or surgery.