Recently, a friend and I were talking about the changes we were experiencing as we reached middle age. I mentioned how I really am careful while exercising since I find that my knees aren’t as forgiving when I participate in activities that involve a lot of bouncing. My friend, who is turning 50 soon, laughed and said she understood. She relayed that her problem wasn’t her knees; instead, it was the surprise of having a bit of urinary incontinence that happened when a trainer asked her to jump rope. “Oh, honey, I shouldn’t do that anymore,” she told the trainer.
The National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) stated that while older women suffer from this condition more often than younger women, urinary incontinence isn’t an inevitable part of life. And it can be successfully treated.
A new study out of the National Institutes of Health found looked at two types of treatment for this issue. The study involved approximately 250 women who were, on average, 58 years old. The women were randomly placed into two treatment groups. One group had Botox injections in the bladder muscle and also took placebo pills for six months while the other group had a saline injection into the bladder muscle and took oral anticholinergic medications, which reduces bladder contractions because it targets the bladder muscle through the nervous system. The women then recorded the number of leakage episodes they had over a three-day period each month and completed a questionnaire about their symptoms and quality of life.
The researchers found that approximately 90 percent of the women in each group responded to treatment within a month’s time. Furthermore, about 70 percent of each group said their symptoms were adequately controlled at the end of the six month period.
The researchers also reported that 27 percent of the women who had Botox were not having any urinary leakage six months after starting the treatment as compared to 13 percent of the women who were taking oral medication.
At the end of the six-month period, all study participants were instructed to stop taking the pills. Researchers continued to monitor the effectiveness of both treatments for six additional months. They found that 52 percent of the women who received Botox reported adequate symptom control nine months after the start of the treatment as compared to 32 percent who took the oral anticholinergic medication. At the 12-month period, the figures were 38 percent for the Botox group and 25 percent for the medication group.
There were some side effects for both groups. The women who had Botox were more likely to experience incomplete bladder emptying as well as bladder infections. The women who took the medication were more likely to experience dry mouth.
"This is the first study to compare the effectiveness of Botox treatments to oral medication," said study senior author Susan F. Meikle, M.D., M.S.P.H., of the Contraception and Reproductive Health Branch of the NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and Program Director of the Pelvic Floor Disorders network. "Previously, Botox was reserved for women who had tried oral medications but found them ineffective. Because we included some women who had not been treated with oral medication before, these results suggest that Botox could be discussed as an option for first line treatment."
According to the NKUDIC, there also are other types of treatments for urinary incontinence, including bladder retraining and Kegel exercises, biofeedback, neuromodulation to stimulate the nerves to the bladder (also known as InterStim), vaginal devices for stress incontinence, surgery or catheterization. NKUDIC notes urinary incontinence also can be controlled through using menstrual pads that can cause leakage during exercise. Furthermore, restricting certain liquids such as coffee, tea and alcohol may also help reduce incontinence.
The clearinghouse also cautions women to not be afraid to mention their problem to their doctor. Instead, many women remain silent sufferers who end up wearing absorbent undergarments or diapers. This practice is unfortunate, because diapering can lead to diminished self-esteem, as well as skin irritation and sores,” the NKUDIC states. “If you are relying on diapers to manage your incontinence, you and your family should discus with your doctor the possible effectiveness of treatments such as timed voiding and pelvic muscle exercises.”
Primary Source for This Sharepost:
National Institutes of Health News. (2012). Study shows benefits, drawbacks, for women’s incontinence treatments.
National Kidney and Urologic Diseases Information Clearinghouse. (2010). Urinary incontinence in women. U.S. Department of Health and Human Services.
Published On: October 08, 2012