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Latest
Bladder Control News:
FDA Approves BioForm Injectable Implant for Treatment of Female Stress Urinary Incontinence: Next-generation bulking agent reported in clinical trials to have fewer re-injections and less material volume than other approved bulking agents. 
Recent
Bladder Control News:
Study: Genetic Predisposition May Play Role in Women Developing Incontinence: Daughters of mothers with urinary incontinence had a 1.3-fold risk of being incontinent and close to a two-fold risk of such symptoms if their mothers had severe symptoms of the condition.
Gold-Medal Winner Taking Overactive Bladder Education to Shopping Malls: Mary Lou Retton hopes frank discussion of her experience will help people recognize the symptoms of overactive bladder and bring it up with their physicians. 
Study: Detrol® LA Effective in Women With Mixed Incontinence: Women with mixed incontinence reported a greater treatment benefit for overactive bladder symptoms from Detrol LA than a placebo. 
Bladder Control Problems Much More Common Than Generally Realized: A survey found that about one-third of Americans between ages 30 and 70 have experienced some degree of bladder control loss.
Sacral
Nerve Stimulation Helps With Difficult Bladder Control Problems:
Researchers say this therapy that uses an implantable medical device
should get earlier consideration as a treatment option.
Behaviorial
Therapy Program Significantly Cuts Incontinent Episodes:
Researchers report success with a program that began with the importance
of pelvic muscle strength and instructions on pelvic exercises,
and details on how to keep a bladder control journal of daily voiding
habits.
Combination
of Therapies Effective for Many Patients:
Researchers say 76 percent of women who
completed a program of pelvic floor muscle rehabilitation and behavioral
therapy were symptom free at the conclusion of the study.

Overactive
Bladder Symptons Impact Sex Life and Intimacy:
A
poll found that the symptoms of overactive bladder can be severe
enough to significantly affect the sex lives and intimacy of many
people who have the condition. 
FDA
Approves Kegel Exerciser for Treating Stress Urinary Incontinence:
The
Kegel Exerciser has become the first progressive resistance
trainer approved by the U.S. Food and Drug Administration for the
treatment of stress urinary incontinence.
New
Biomaterial Being Tested in Treatment of Stress Urinary Incontinence:
Researchers
say early results of a clinical trial now underway indicate 100
percent effectiveness, no infections, no rejections and no erosion
of the implanted tissue. 
Cell
Transplants May Be Promising New Therapy for Urinary Incontinence:
Researchers
say skeletal muscle cell transplants in laboratory animals appear
to offer a safer, more effective and longer lasting treatment for
urinary incontinence. 
Botox
Injections May Help With Overactive Bladder:
Researchers say the injections can offer many patients a safe, but
temporary, solution to the problem of incontinence. 
Study
Shows Treatment Effective for Female Stress Urinary Incontinence:
Four out of five users of FemSoft® Urethral Insert reported
they never or rarely experience incontinence while the FemSoft Insert
is in place. 
Patent
Issued for Female Incontinence Control Device:
The Steridyne IVD promises relief to patients suffering from
female urinary stress incontinence, which affects some 12 million
women in the United States.
Embarrassment
Keeps Many From Seeking Treatment for Overactive Bladder:
Many people suffering from overactive bladder are too shy to get
help and are needlessly living a life of inconvenience and isolation.
Debbie
Reynolds Urges People to Seek Treatment for Overactive Bladder:
Famed Hollywood actress is speaking out on her battle with overactive
bladder, a condition affecting millions of Americans, as part of
new public education campaign.
New
Minimally Invasive Procedure Treats Stress Incontinence in Older
Women: Researchers say the half-hour procedure, known
as Tension-Free Vaginal Tape (TVT), is performed on an outpatient
basis and has been found safe and effective.

70%
of Women With Stress Incontinence Worry About Laughing in Public:
Survey finds women also worry about coughing and
sneezing for fear of having an accident.

Nursing
Visits Help Older Rural Women Reduce Urinary Incontinence: Easy
to use behavioral strategies work well, and once women know about
the techniques, many can manage their own continence. 
Sacral
Nerve Stimulation for Incontinence to Be Covered by Medicare: Health
and Human Services Secretary Tommy G. Thompson announced that Medicare
coverage will be extended to include a surgical treatment known
as sacral nerve stimulation for urinary incontinence. 
Bladder
Control Primer:
Bladder control
problems, sometimes called urinary incontinence, are an inability
to hold your urine until you get to a toilet. More than 13 million
people in the United States--male and female, young and old--experience
incontinence. It is often temporary, and it always results from
an underlying medical condition.
Women experience
incontinence two times more often than men. Pregnancy and childbirth,
menopause, and the structure of the female urinary tract account
for this difference. Older women, more often than younger women,
experience incontinence. But both women and men can become incontinent
from strokes, multiple sclerosis, and physical problems associated
with old age.
But incontinence
is not inevitable with age. Incontinence is treatable and often
curable at all ages. If you experience incontinence, you may feel
embarrassed. It may help you to remember that loss of bladder control
can be treated. You will need to overcome your embarrassment and
see a doctor to learn if you need treatment for an underlying medical
condition.
What Are the
Types of Incontinence?
- Overactive
Bladder or Urge Incontinence: If you lose urine for no apparent
reason while suddenly feeling the need or urge to urinate, you
may have urge incontinence. The most common cause of urge incontinence
is inappropriate bladder contractions. Medical professionals describe
such a bladder as "unstable," "spastic," or "overactive." Your
doctor might call your condition "reflex incontinence" if it results
from overactive nerves controlling the bladder. Urge incontinence
can mean that your bladder empties during sleep, after drinking
a small amount of water, or when you touch water or hear it running
(as when someone else is taking a shower or washing dishes).
- Stress Incontinence:
If coughing, laughing, sneezing, or other movements that put pressure
on the bladder cause you to leak urine, you may have stress incontinence.
Physical changes resulting from pregnancy, childbirth, and menopause
are common events that cause stress incontinence. It is the most
common form of incontinence in women and is treatable. Pelvic
floor muscles support your bladder. If these muscles weaken, your
bladder can move downward, pushing slightly out of the bottom
of the pelvis toward the vagina. This prevents muscles that ordinarily
force the urethra shut from squeezing as tightly as they should.
As a result, urine can leak into the urethra during moments of
physical stress. Stress incontinence also occurs if the muscles
that do the squeezing weaken. Stress incontinence can worsen during
the week before your menstrual period. At that time, lowered estrogen
levels might lead to lower muscular pressure around the urethra,
increasing chances of leakage. The incidence of stress incontinence
increases following menopause.
- Functional
Incontinence: People with functional incontinence may have problems
thinking, moving, or communicating that prevent them from reaching
a toilet. A person with Alzheimer's disease, for example, may
not think well enough to plan a timely trip to a restroom. A person
in a wheelchair may be blocked from getting to a toilet in time.
Conditions such as these are often associated with age and account
for some of the incontinence of elderly women in nursing homes.
- Overflow
Incontinence: If your bladder is always full so that it continually
leaks urine, you have overflow incontinence. Weak bladder muscles
or a blocked urethra can cause this type of incontinence. Nerve
damage from diabetes or other diseases can lead to weak bladder
muscles; tumors and urinary stones can block the urethra. Overflow
incontinence is rare in women.
The first step
toward relief is to see a doctor who is well acquainted with incontinence
to learn the type you have.
How Is Incontinence
Treated?
- Exercises:
Kegel exercises to strengthen or retrain pelvic floor muscles
and sphincter muscles can reduce or cure stress leakage. Women
of all ages can learn and practice these exercises, which are
taught by a health care professional. Most Kegel exercises do
not require equipment.
- Electrical
Stimulation: Brief doses of electrical stimulation can strengthen
muscles in the lower pelvis in a way similar to exercising the
muscles. Electrical stimulation can be used to reduce both stress
incontinence and urge incontinence.
- Biofeedback:
Biofeedback uses measuring devices to help you become aware of
your body's functioning. By using electronic devices or diaries
to track when your bladder and urethral muscles contract, you
can gain control over these muscles. Biofeedback can be used with
pelvic muscle exercises and electrical stimulation to relieve
stress and urge incontinence.
- Timed Voiding
or Bladder Training: Timed voiding (urinating) and bladder training
are techniques that use biofeedback. In timed voiding, you fill
in a chart of voiding and leaking. From the patterns that appear
in your chart, you can plan to empty your bladder before you would
otherwise leak. Biofeedback and muscle conditioning--known as
bladder training--can alter the bladder's schedule for storing
and emptying urine. These techniques are effective for urge and
overflow incontinence.
- Medications:
Medications can reduce many types of leakage. Some drugs inhibit
contractions of an overactive bladder. Others relax muscles, leading
to more complete bladder emptying during urination. Some drugs
tighten muscles at the bladder neck and urethra, preventing leakage.
And some, especially hormones such as estrogen, are believed to
cause muscles involved in urination to function normally. Some
of these medications can produce harmful side effects if used
for long periods.
- Pessaries:
A pessary is a stiff ring that is inserted by a doctor or nurse
into the vagina, where it presses against the wall of the vagina
and the nearby urethra. The pressure helps reposition the urethra,
leading to less stress leakage. If you use a pessary, you should
watch for possible vaginal and urinary tract infections and see
your doctor regularly.
- Implants:
Implants are substances injected into tissues around the urethra.
The implant adds bulk and helps to close the urethra to reduce
stress incontinence. Collagen (a fibrous natural tissue from cows)
and fat from the patient's body have been used. Implants can be
injected by a doctor in about half an hour using local anesthesia.
Implants have a partial success rate. Injections must be repeated
after a time because the body slowly eliminates the substances.
- Surgery:
Doctors usually suggest surgery to alleviate incontinence only
after other treatments have been tried. Many surgical options
have high rates of success. Most stress incontinence results from
the bladder dropping down toward the vagina. Therefore, common
surgery for stress incontinence involves pulling the bladder up
to a more normal position.
- Catheterization:
If you are incontinent because your bladder never empties completely
(overflow incontinence) or your bladder cannot empty because of
poor muscle tone, past surgery, or spinal cord injury, you might
use a catheter to empty your bladder. A catheter is a tube that
you can learn to insert through the urethra into the bladder to
drain urine. Catheters may be used once in a while or on a constant
basis, in which case the tube connects to a bag that you can attach
to your leg. If you use a long-term (or indwelling) catheter,
you should watch for possible urinary tract infections.
- Other Procedures:
Many women manage urinary incontinence with pads that catch slight
leakage during activities such as exercising. Also, you often
can reduce incontinence by restricting certain liquids, such as
coffee, tea, and alcohol. Finally, many women who could be treated
resort instead to wearing absorbent undergarments, or diapers--especially
elderly women in nursing homes. This is unfortunate, because diapering
can lead to diminished self-esteem, as well as skin irritation
and sores.
Background information
provided by: National Institute of Diabetes and Digestive and Kidney
Diseases, National Institutes of Health, Bethesda, MD 20892

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