Unintentional loss of urine can often be remedied with pelvic floor therapy
Urologist Erich Taubert too often sees patients in his office who have been wearing ‘a wipe’ for decades or who have not even left the door. Unnecessary, because with the right training, unwanted urine loss can often be remedied.
That there are women who have been walking around with urinary complaints for decades – urologist Erich Taubert continues to be amazed. Recently, a 70-year-old patient came to his office. It turned out that she had suffered from light urine loss when coughing and lifting heavy items for forty years. And that while these complaints are often easy to remedy, while they only get worse if you don’t do anything about it.
Why are you concerned about this?
“Urine leakage has a huge impact on quality of life. You can lose urine when lifting shopping bags, but also during intercourse. It can mean that a couple stops having sex because of this.
The urine leakage often starts after the second delivery. At first it’s just a few drops when coughing or sneezing, but slowly it gets worse. We call this stress incontinence or stress incontinence. It usually gets worse if you don’t do anything about it. I see that young women do go to the doctor, for example if they lose urine while running. But the older generation does not. It can happen that women have this problem for decades, until they eventually end up at the urologist.”
Why don’t they see a doctor sooner?
“Many women think it’s part of it. They get to work with it themselves and wear a panty liner, sanitary napkin or incontinence material just to be safe. That’s a shame, because the problem can often be solved. The worst thing is that these women often get stuck in care system. Care providers pay too little attention to the seriousness of urine leakage. As a patient, you are told that you just have to learn to live with it. I find that unacceptable. These women organize their entire lives around urine loss. They start drinking less water , which is very unhealthy. And if their bladder is only a quarter full, they often already urinate. But with that they ‘teach’ the bladder that they urinate every half hour. And so they sleep less well, going out for the day becomes difficult.
Many people live in loneliness due to urine leakage. They are very afraid that someone will smell or see something. Much loneliness among seniors is self-imposed by incontinence.”
Why is incontinence material not a good solution?
“Incontinence material can help, but it is used too much and for too long. At least 480,000 adults in our country use it – that is a lot. From the health insurance alone, 150 million euros are reimbursed annually for incontinence material. With good pelvic floor therapy, 80 percent of patients get rid of stress incontinence; this is the most common form of incontinence. It gives much more freedom and comfort.”
You break a lance for pelvic floor therapy.
“Certainly. In fact: I only operate on a patient if he or she has first been to the pelvic floor therapist. Often an operation is no longer necessary. Furthermore, the result of the operation is better if you have had pelvic floor therapy first. Pelvic floor therapy is also necessary, by the way; you have to keep training.”
Why does not everyone with urinary complaints go to a pelvic floor therapist?
“The exercises do take effort, of course. I often speak to patients who say: ‘I have already done these exercises.’ Usually it turns out that they have been to a regular physiotherapist. That is quite different. A recognized pelvic floor therapist has followed a special two-year training. Pelvic floor therapy is reimbursed when it comes to urinary incontinence. The first nine treatments are covered by the basic insurance and you don’t need a referral from your GP.”
Does urinary incontinence also occur in men?
“Men are almost never incontinent for urine, except for a small percentage, for example due to an overactive bladder or prostate surgery involving the sphincter. Yet many men use incontinence materials. They have difficulty urinating due to prostate problems. When the pants are back on, they leak. a few drops after. Many men use incontinence material or ‘a wipe’ as they often call it for years. Often this is unnecessary, because with medication or training they are dry again. And a wipe is not healthy for the bladder. You give the bladder the signal that it is ‘set’. As a result, it works less well. It is better to only use the cloth at a concert evening or the card club and continue to train your bladder at home. Both men and women make their bladder lazy.”
What is that: a ‘lazy bladder’?
“The bladder is similar to a pump, just like the heart. A healthy bladder can contain half a liter of urine. You should empty the bladder four times a day. But if you always go to the toilet with a little filled bladder, your bladder is lazy and he can no longer handle that half liter. Step one is discovering what is going wrong. A good diagnosis of the urination problem is very important. To gain more insight into this, it is best to keep a record of how much you drink for three days and On the website of Thuisarts.nl there is a ‘urine diary’ that you can print and fill in. On the basis of this, the urologist or gynaecologist gets a good picture of the nature of the complaints.”
You have developed an app that allows patients to map their urinary problems.
“The app is called iP pee list and is made to digitally keep track of your daily fluid intake and when you urinated. With an iPod or iPhone you can download it for less than a dollar. When filling out the app, many women see that they drink too little. Men are more likely to realize they have a prostate problem and seek help.”
What do you expect from the new technology in urology?
“There are already special underpants with a sensor. When moisture gets on them, you get a signal on your mobile. That can work very well as a trainer for the bladder. I expect that in a few years many incontinence materials will have such a sensor. A good development, because with technology we can improve an incredible amount for people with urinary complaints.”
Erich Taubert is a urologist at the Slingeland Hospital in Doetinchem. He is also founder and director of Synappz, a company that develops apps and software for healthcare.
Read our tips against unwanted urine loss here
Sources):
- Plus Magazine
