INCONTINENCE NOT PART OF AGEING PROCESS

By Sakina Mohamed

KUALA LUMPUR, July 7 (Bernama) -- Lee, 41, doesn't understand why she feels
the urge to urinate so frequently.

The sudden urge to empty her bladder would happen while she is driving to
work, while being with her family at the shopping mall and even while working
out at the gym.

"Sometimes I feel I spend more time running to the toilet than on the
treadmill," she said.

Rohaiza, 29, a mother of one had this to say:

"It is extremely stressful at the shopping mall when you have a strong urge
to urinate but are forced to queue behind the others".

A year after giving birth Rohaiza noticed that she would 'leak' after every
sneeze or cough. She also found herself unable to 'hold it in' as she used to be
able too.

There have been times when she could not even make it to the toilet in time
and had 'accidents'.

"I can feel my problem really affecting my self-confidence. I used to enjoy
going to social events, but now even the thought of going for dinner with
friends scare me. What if I can't make it to the toilet in time and wet myself
in public?"

J. Perez, 36, says she cannot remember when was the last time she had a good
night's sleep.

"I would wake up at least two to three times a night because of the urge to
urinate. I often find it hard to fall asleep again after bolting out of bed in
the middle of the night to go to the toilet. As a result, I'm often groggy and
tired at work the next day," she said.

Lee, Rohaiza and Perez are all suffering from symptoms of overactive bladder
(OAB) or urinary incontinence, which affects one in six adults, yet are often
misdiagnosed.

Many who suffer from OAB, especially women, dismiss the idea of seeking
treatment despite the disruption it causes to their daily lives. This is because
they mistakenly think it is due to the ageing process and does not warrant
medical attention.


OAB CAN BE TREATED

"OAB or urinary incontinence is not part of ageing. It is a real medical
condition and fortunately, it can be treated," said the president of the
Malaysian Urology Association Datuk Dr Rohan Malek.

He said many women were reluctant to come for screening nor were they aware
of the various treatment options available.

"I think part of the reason of their reluctance to come for the screening is
probably embarrassment in discussing the problem with their doctor.

"Many also think it's a normal part of ageing or side effect they have to
bear after delivering children. They feel like they don't need to do anything
about because they can't even if they wanted to," said Dr Rohan, who is also a
Consultant Urologist at the Selayang Hospital.

Statistics based on a survey done on women in 11 countries in Asia found the
prevalence of OAB at 53.1 percent. The majority were in the age group between 29
and 59 years old.

In Malaysia, OAB affects approximately 11 to 22 percent of the total
population. Although childbirth is a common risk factor for OAB, the condition
can be caused by numerous other factors.

Dr Rohan said there are various ways to treat OAB including simple
physiotherapy and medication. Only severe cases require surgery.

"It is very affordable to treat OAB,and very rarely do we find the need to
perform operations on an OAB patient," said Dr Rohan.


TYPES OF INCONTINENCE

Urge and stress incontinence are among the most prevalent forms of urinary
incontinence.

Dr Rohan said stress incontinence is mostly due to weakened pelvic floor
muscles. The common reason for the weakened muscles is usually childbirth and
obesity.

"Stress incontinence can cause them to leak urine when they sneeze or cough.
Sometimes, if they also experience urge incontinence, they may find themselves
unable to hold in their urine before they can get to a toilet," he says.

He said treatment consists of physiotherapy and addressing related problems.
Pelvic floor exercises are a form of physiotherapy that can help the problem
tremendously.

Besides that, patients who are obese should work towards weight reduction
while those with a cough and an asthma condition should get those conditions
treated.

Meanwhile, those suffering from urge incontinence will find themselves
rushing to the toilet numerous times a day.

"A typical symptom of OAB is having to urinate more than eight times a day
and being unable to hold it in when it's time to go," says Dr Rohan.

"Patients will also find themselves experiencing nocturia - frequent
night-time waking to urinate."

He said this can disrupt their sleep and leave them drained the next day.

Some patients may have to wear pads and find themselves unable to
participate actively in sports, said Dr Rohan. This in turn can adversely affect
their self-confidence and lead to depression.

While some of the cases can be treated with antibiotics, patients must see a
doctor to confirm that there are no other serious underlying conditions
contributing to the symptoms.

"Sometimes, symptoms similar to OAB can be triggered by diabetes, stroke,
bladder cancer or kidney stones. These can be picked up through a urine test, so
it's important to come for a check-up."

Treatment for urge incontinence can be by bladder training or
anti-cholinergic medication.


MINISTRY LAUNCHES OAB IN WOMEN CAMPAIGN

In Malaysia, the problem of OAB or urinary incontinence is virtually
unchartered territories, said Dr Rohan.

"The last campaign we had was in 2001 involving two hospitals, at the Kuala
Lumpur Hospital and the Selayang Hospital. In Malaysia, OAB in women has not
been explored in terms of numbers, so it's hard to come up with an accurate
statistic because we have no idea how big the problem is."

He said this is because many women prefer going to their gynaecologists or
general practitioners, while the rest did not acknowledge it as a problem that
can be treated.

In a move to educate and highlight the burden of OAB and urinary
incontinence in women, the Malaysian Urology Association together with the
Ministry of Health Malaysia has organised a Urinary Incontinence In Women
Campaign at the Selayang Hospital and other selected government hospitals around
the country recently, starting June 26 this year.

The campaign which provides free health screening for women was also held
at the state of Sarawak General Hospital, Kuching from July 3 to 4.
-- BERNAMA


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