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Bladder Control is the Neglected Health Issue

Poor bladder control is an insidious problem that can have a big impact on your quality of life.  It may start with occasionally increased urinary frequency or needing to rush for the toilet, which becomes hourly toilet visits and leakage accidents, dictating travel, family activities, meeting and social schedules.  Friends, family and colleagues notice.  Decreased confidence, embarrassment and isolation follow.

Bladders interrupt movies, dictate choice of the worst restaurant tables (near the toilets), clothing (black covers accidents although malodour is more difficult to hide) and interrupt sleep, affecting daytime energy typically resulting in reduced exercise/activity. Sufferers are viewed differently at work because of toilet breaks; stop taking holidays/trips that take more than an hour between toilet visits. It’s easy to become increasingly reclusive and isolated (incontinence is a leading reason for admittance to nursing care).

Most people accept the decline in their bladder control as a natural part of ageing, Lower urinary tract symptoms (LUTS), especially overactive bladder (OAB) with urinary urgency and/or frequency and Urinary Incontinence (UI) affect millions of Australians. The total affected population is difficult to quantify though, because bladder issues are seen as embarrassing and are underreported. Many people won’t tell their doctor and half of sufferers won’t even tell their partner.

Bladder weakness is more common than you think. It affects 25% of reproductive age women, 50% of post-menopausal women, and 50% to 75% of women in nursing homes. Male lower urinary tract symptoms (LUTS) affect 50% of men over 50 years old and they increase dramatically with age. Only 50% of the time is male LUTS due to benign prostate enlargement.  The other half it is a primary bladder problem, usually OAB, that is causing the male urinary symptoms. In these cases a bladder, not prostate, approach is required.

The basic types of bladder control problems include urinary urgency or having to rush to the toilet; urinary frequency with 8 or more toilet visits per 24-hour period; nocturia (getting out of bed more than once a night) and urinary incontinence / bladder accidents / weakness.

OAB (overactive bladder) is a term that incorporates both urinary frequency and urgency. Urgency UI can be linked with OAB if the person gets warning but doesn’t reach the toilet in time and affects one in 6 men and women. Stress UI occurs without warning with coughing, laughing, jumping, etc. and affects more women, especially after childbirth and with increasing age.

These conditions can be debilitating, prematurely ageing those affected due to interrupted sleep and the resultant fatigue, cessation of exercise, mobility and socialising; the key factors attributed to longevity. And sufferers can eventually become reclusive, lonely and depressed.

Medical treatments for bladder control problems, UI and OAB include physical and behavioural therapies such as Kegel's pelvic floor exercises and bladder retraining. Pharmaceutical drugs have a drying effect in the bladder and elsewhere and common side effects include dry mouth, constipation, blurred vision, nausea, abdominal pain, drowsiness and memory loss. Recent research shows the memory loss with these medications is often permanent. Many sufferers resign themselves to the use of adult incontinence pads; the fastest growing household products category, and are the third largest landfill waste problem globally.