Physicians seeing more solutions for incontinence

Commercials on television have become a hot place for pharmaceutical advertising over the past few years. There are drugs available for a wide range of conditions, and one popular market for men and women is prescription medication for overactive bladders.

From the pills toted on television to new surgical procedures and physical therapy, incontinence of one form or another is a big industry. When you add in other items to deal with incontinence, like absorbent pads, then itÂ’s a multi-billion dollar industry.

But while cheery actors may talk about incontinence on television, itÂ’s still a medical problem that isnÂ’t much talked about in physicianÂ’s offices, say some local specialists. Many physicians who see patients on a regular basis and have the opportunity to make the first steps toward identifying and treating incontinence arenÂ’t doing so, either out of a lack of knowledge or of the general taboo nature of all things that occur in the restroom.

“If you ask a person if they’re incontinent, they’ll say, ‘What are you talking about?’” said Dr. Chad Lewis, a colorectal surgeon at Harris Methodist Southwest Hospital.

Incontinence is inability to control the bladder or the bowels, and it can either refer to urinary incontinence or anal incontinence. The problem can affect both men and women, and it can be complicated by things like an overactive bladder, which means having the urge to urinate a high number of times per day.

Incontinence can be caused by many things, but one of the big factors is age, physicians said. As a person gets older, muscles in the pelvic floor that control the bladder and bowel can weaken, meaning that accidents can occur and end with embarrassing results.

“We have some patients who don’t go out in public just because of the risk of embarrassment,” said Dr. Jeff Hantes, a urogynecologist and assistant professor in the obstetrics/gynecology department at the University of North Texas Health Science Center.

Muscles can also be affected by childbirth, making women more susceptible to incontinence than men, said Dr. Michael England, director of urogynecology at Baylor All Saints Medical Centers and director of gynecological surgery at the hospital. For decades, women have just accepted incontinence as part of their daily life because there werenÂ’t as many treatment options, he said.

“It’s a generational thing; your mother’s generation may have put up with it, but your grandmother’s generation definitely would have put up with it,” he said.

Drug research and physical therapy are typically the best ways to treat incontinence, England said, and new biofeedback procedures can allow physical therapists to better guide patients in strengthening muscles that arenÂ’t exactly easily defined.

“Nearly 100 percent of women have no idea where their pelvic floor is,” he said.

Another growing treatment option is surgery, such as the Interstim System by Medtronic, which acts as a sort of pacemaker for the bladder, sending mild electrical pulses to help control the muscles. England said he is doing a growing number of these procedures and that frequently his patients are older than 60, since menopause can further weaken the muscle tone in the pelvic floor and contribute to incontinence.

There are other surgeries that can help with incontinence as well, like the sub-urethral sling, a tiny mesh insert that helps protect the urethra during activities like exercise for those who have stress incontinence, Hantes said.

“You look at any of the medical marketing in journals, they say this industry is going to explode just because of baby boomers and that age group,” Hantes said. “It doesn’t have to be a normal part of aging; it is a medical problem.”

Lewis, who treats anal incontinence in his work as a colorectal surgeon, said patients should not be ashamed to discuss their bowel and bladder functions with their physicians, especially if they are dealing with anything that is uncomfortable or bothersome. In turn, physicians should ask patients about these topics and know they can always refer patients to specialists who can walk patients through possible treatments.

While there may not be a 100 percent fix for every problem, Lewis said, he does try to reassure patients that something can be done to at least alleviate every problem.

“I just have to reassure them that this is something I see all the time,” he said. “This is not unusual.”

Contact Bassett at ebassett@bizpress.net