World Continence Week 2018: There Are Many Solutions

Leaking is no laughing matter, is what World Continence Week 2018 reminds us with the “Laugh Without Leaking” campaign. Incontinence affects people of all ages and genders and it’s not a normal part of aging or motherhood – that’s what the Continence Foundation of Australia wants us to know as well as to keep in mind that there are a lot of treatment options.

Bladder and bowel issues related to incontinence are not incurable, they are, however, underreported and swept under the rug far too often.

Because of the air of shame surrounding them, as well as some myths (the weakening of the pelvic floor muscles is not, in fact, just a natural consequence of pregnancy or aging) these issues often go untreated, no matter the amount of possibilities.

We at FindMeCure saw this week as an opportunity to spread the knowledge about innovative incontinence treatments. We hope that by informing people about the options available (or soon-to-be available) to them, we’ll encourage them to seek help from medical professionals.   

From slightly invasive procedures like botox injections and minor surgical procedures to conservative approaches like exercising the pelvic floor muscles and discreet external catheters, the options really are numerous and it depends entirely on your preferences which one you choose. There are, of course, clinical trials testing treatments in development and we’ll talk about these as well.

Strengthening the pelvic floor is one of the first solutions that spring to mind when thinking about treating incontinence. There is, however, more than one way to approach this and, mind you, it’s not just effective for women.

Setting an appointment with a specialist who can teach you how to do the appropriate exercises is a good first step. But don’t expect miracles to happen after the first few sessions – noticeable results that actually make a difference in your life are said to take up to a few weeks of consistent exercise.

You can do these exercises alone or you can add something extra to your routine with a device that stimulates the muscles further. Whichever you choose, consult a medical professional as you want to make sure you’re doing the optimal amount of stimulation needed. 

Slightly more invasive and thus, reserved for more persistent cases of incontinence, are implants like Coaptite, made to be injected in the female urethra near the bladder neck. It works by augmenting the tissue in order to increase resistance to the loss of urine.

Another more permanent, but also invasive and not to be taken lightly solution for incontinence in women can be surgery. Also called spiral sling procedure, it’s a type of surgery that puts a kind of a sling made from biologic tissue of synthetic material to support the urethra and bladder neck. However, the procedure carries its risks and, like most treatments, is not always successful. It’s most often used as a kind of a last resort after all other options like bladder retraining and medicine have been exhausted.

Botox is not just used for wrinkles. A botox injection is shown to reduce urinary incontinence in 75% of women and its effect typically lasts from six to nine months, so it’s a semi-permanent solution when other treatments don’t show great improvement.

The procedure is pretty simple and usually takes only five minutes to perform, but it is, afterall, a surgery that requires general anaesthetic. During these five minutes botox is injected into twenty specific sites of the bladder wall through a tube inserted there and attached to a camera.

Undergoing research is also a procedure that consists of injecting adipose tissue extracted from the patient into the area of the urethral sphincter. The clinical trial targets women with stress urinary incontinence and is currently recruiting, though the phase is not provided and it’s hard to tell how far into the future to look for this procedure or how promising it seems now.

A device called Pelvital is also in clinical trials against placebo or in this case – a placebo procedure. The device is similar to others on the market designed to strengthen and possibly heal the pelvic floor muscles by mechanotherapy.

Under investigation are also some drugs, of course. TAS-303 is in a phase II trial against placebo and what it does is inhibit the transmission of certain neurons so as to help continence. It works similar to another drug on the market, Duloxetine, that can also be used to treat depression and anxiety. How it helps incontinence is by relaxing the urethral phincter.