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 When doctors asked about urinary incontinence and offered to treat
it, women were two to three times more likely to have a reduction in
symptoms than when doctors ignored the condition until patients
complained, they found.
“It’s very sad because most women don’t ask for help because they
think there is no help for them,” lead researcher Dr. Els Visser
told Reuters Health.
“What we proved with this study is that there is help for them,” she
said.
A general practitioner, Visser was a doctoral student at the
University of Groningen in The Netherlands when she did the
research.
Women in the study were patients in general practices in The
Netherlands, at least 55 years old. Out of 2,390 women who filled
out questionnaires, a third, or 744, reported involuntary urine loss
at least once a month. Ultimately, 350 women with incontinence
participated in the study.
Primary care doctors in the study were randomly assigned to either
raise the question of incontinence, or to provide “standard care.”
Doctors who asked about incontinence symptoms also ordered tests to
assess the problem and then worked with urologists and physical
therapists to come up with a diagnosis and a treatment plan.
In the standard-care group, doctors waited for the patient to ask
for help with her incontinence.
A year later, 34 percent of the 105 women in the intervention group
who completed the study reported that their symptoms were less
severe, researchers wrote in the journal Maturitas.
Most women had improved as a result of physical therapy and
lifestyle changes, including limiting alcohol and coffee
consumption, Visser said.
The most common treatments, given to 105 women, were pelvic floor
muscle training, bladder training and biofeedback from a registered
pelvic physiotherapist. In addition, six women received medication,
three had surgery, and 41 were referred for further diagnostic
evaluations.
Of the 184 women in the control group, only three received
treatment.
The women in the intervention group were nearly twice as likely as
those in the control group to report a reduction in the severity of
incontinence, the study found.
And when the researchers looked only at women with moderate to
severe incontinence (leaving out those with mild symptoms), a
reduction in symptoms was nearly three times more likely for women
who’d been treated, compared to those who hadn’t been.
Tatyana Shamliyan, who has done similar research, told Reuters
Health the study underscores the value of having doctors ask women
about urinary incontinence.
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“We have to work hard in this area because it affects the quality of
life for many women,” she said.
Shamliyan, who’s now a quality assurance director at Elsevier in
Philadelphia, was not involved in the current study.
“It should be a public health issue,” she said. “It’s not shameful.
It’s very common, and it’s treatable. The stigma should be removed.”
Shamliyan says teenage girls should learn about the benefits of
pelvic floor muscle training after childbirth in health-education
classes. Urinary incontinence afflicts not only aging women but
women following childbirth, she said.
One in three women over age 55 experiences symptoms of urinary
incontinence, Visser said.
Since 2003, physiotherapists with a specialty in pelvic floor
training have been working in The Netherlands, she said. But pelvic
floor muscle training is not standard practice in the U.S.,
Shamliyan said.
She bemoaned the fact that urinary incontinence is not part of the
curriculum in U.S. nursing schools.
“We receive invitations for mammography. It should be the same for
urinary incontinence. We would ask, do you have the symptoms? If you
do, contact your physician,” she said.
In The Netherlands, Visser said, doctors write prescriptions for
incontinence pads. The country with 16.8 million people spent 162
million Euros on adult diapers in 2012, Visser said.
“That’s quite a lot,” she said. “So it’s a very expensive condition.
But it’s not only in the Netherlands. It’s everywhere.”
Her message to patients: “Don’t hesitate to ask your doctor. You can
be helped.”
SOURCE: http://bit.ly/134Yvqz Maturitas, online December 1, 2014.
(This story corrects the ninth paragraph to indicate a success rate
of 34 percent in the 105 women in the intervention group who
completed the study)
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