Urinary incontinence, fecal incontinence, and pelvic organ prolapse awareness is lacking among most women. Knowing the signs and symptoms of these conditions can help start the treatment sooner, but unfortunately, many women are unfamiliar with these conditions and their symptoms, so treatment is often delayed. This lack of knowledge was seen to be more common among women of color.
These conditions are most common pelvic floor disorders, and insufficient knowledge is one of the greatest barriers when it comes to receiving proper care. Corresponding author Dr. Marsha K. Guess explained, “If we can improve knowledge about pelvic floor disorders, we may be able to improve outcomes for all women.”
Roughly 25 percent of women over the age of 20 suffer from pelvic floor disorders, and the number of cases is expected to rise in the next 40 years. Annually in the U.S., over $12 billion is spent on treating just urinary incontinence alone, and the cost is expected to rise as well.
The researchers conducted a cross-sectional study consisting of 431 women. They uncovered that just over 71 percent of the women lacked knowledge regarding urinary incontinence and 48 percent lacked knowledge regarding prolapsed organs. Women of color were found to have much less awareness about these disorders, compared to white women.
First author Charisse Mandimika added, “Improving knowledge about health problems has proven effective in promoting behavioral change, reducing levels of disease symptoms, and improving compliance with treatment for other chronic diseases. This study shows that African American women and non-white groups in general are not benefiting from this knowledge.”
Dr. Guess concluded, “Another very concerning finding is that the majority of women who experienced urinary incontinence had not received treatment. Culturally sensitive educational interventions are urgently needed to raise awareness, and address these disparities in knowledge head on.”
Common treatments for pelvic floor disorders
There are different urinary incontinence treatments depending on what led to urinary incontinence in the first place. In many situations, behavioral remedies such as bladder retraining and Kegel exercises can help. Bladder retraining is simply using the washroom at regular timed intervals. This is also referred to as “timed voiding”. Kegel exercises are movements to strengthen the muscles that help hold in urine.
Lifestyle changes play a big role in treatment for some people who struggle with UI. You may try cutting down on caffeine consumption, consuming less fluid or more fluids, or losing weight, and find improvement.
Some people are prescribed urinary incontinence medication in combination with exercises, but it is important to know that there can be side effects, including dry mouth. There is also topical estrogen for the skin that comes as a ring, patch, or vaginal cream. It reinforces the tissue in the urethra and vaginal areas. Medical devices, including urethral and vaginal inserts, have been known to help women with incontinence, particularly during times of physical activity.
Although less common, radiofrequency therapy, which can firm up tissue in the lower urinary tract, botox injected into the bladder muscle, bulking agents injected into the tissue around the urethra, as well as the sacral nerve stimulator – a device implanted under the skin to stimulate the nerve that controls the bladder – are also possible treatment options.
Unfortunately, there are situations where urinary incontinence surgery is required. The three most common procedures are: sling, colposuspension, and artificial sphincter. Sling involves inserting something into the neck of the bladder to support the urethra in order to stop the leaking.
Colposuspension is a bladder neck lift. It is more invasive as it requires an incision in the lower abdomen and stitches through the walls of the bladder neck. Artificial sphincter is an artificial valve inserted to control the flow of urine from the bladder into the urethra. This is only recommended when nothing else works, because it comes with some serious risks.
Treatment for fecal incontinence involves lifestyle and dietary changes to relieve diarrhea or constipation, exercise programs to strengthen the muscles that control the bowel, medications to control diarrhea or constipation, and surgery.
Fecal incontinence products available include anal plugs and disposable pads. Your doctor will also want to treat the underlying condition that is causing fecal incontinence.
One of the treatment options for prolapsed bladder is not taking any course of action at all if there are no symptoms present. Other common forms of treatment include behavior therapy, Kegel exercises, pelvic floor physical therapy, use of a vaginal support device, or drug therapy, which may involve estrogen replacement.
Surgery is another option for a prolapsed bladder. Surgery options include open surgery, minimally invasive surgery, laparoscopic surgery, and robot-assisted laparoscopic surgery.
The goal of the surgery is to repair any damaged muscles or tissue, and augment the bladder with a surgical material.