Patient Education and Empowerment: Key Strategies for Managing Stress Urinary Incontinence in Clinical Practice
When it comes to stress urinary incontinence, there are plenty of opportunities for women to learn more about their condition, and how to manage and treat it.
Let’s examine the key strategies to educate patients about stress urinary incontinence.
1. Seek Diagnosis
Unfortunately, many women do not see a doctor when they have incontinence. In one study, 61% of women reported they did not seek treatment, citing reasons such as “it’s not bad enough,” “it’s a normal part of aging,” and “health care provider never asked.” The same study reported that 45% of mid-life women report urinary incontinence occurring at least a few times per month, and about 15% report it almost daily—which means there are far too many women not seeking treatment.7
Stress urinary incontinence is not a normal part of aging. There are certainly risk factors that seem to make it more prevalent as women age, such as pregnancy and childbirth, menopause, and uterine prolapse. But chronic coughing, diabetes, pelvic surgery and obesity are also risk factors.2 Women need to be encouraged to seek diagnosis and treatment, and not suffer in silence.
2. The Pelvic Floor Matters
Perhaps the key understanding for women with stress urinary incontinence is that their pelvic floor plays a vital role in managing their continence. The pelvic floor consists of the muscles and tissues that hold the pelvic organs in place, and also play a role in bodily functions like urination, defecation and sex. Weakened pelvic floor muscles can lead to stress incontinence.
As a result, exercises that strengthen these muscles can help prevent urine leakage. These pelvic floor exercises are commonly called “Kegel” exercises, named after the doctor who developed them. By toning and strengthening the pelvic floor muscles, these exercises can help prevent and treat urinary incontinence.
In fact, research has shown that pelvic floor exercises are an effective treatment for women suffering with stress urinary incontinence. They can also be used as a preventive measure to help keep pelvic floor muscles “fit.”
Teaching women the proper technique to perform Kegels is a vital part of patient education when it comes to managing stress urinary incontinence. Doctors may want to consider referral to a pelvic floor physical therapist to teach the proper technique. It can take 4-6 weeks of regular exercise to see symptoms improve.2
There are also products available to non-invasively treat incontinence. The INNOVO Urinary Incontinence Kit—cleared by the FDA—is a pair of “smart shorts” designed to strengthen pelvic floor muscles from the inside out. Using the kit, a patient can perform 180 perfect Kegels in 30 minutes.
A clinical study guided by the FDA had amazing results: 87% of women were defined as dry after just 12 weeks, and 90% of users would recommend the therapy to others.
3. Effective Treatment Options for Women with Stress Urinary Incontinence
Women can also be educated on various treatment options for incontinence. Education is empowerment, and can lead to better shared decision making with their health care provider.
The first step is the previously mentioned program of pelvic floor muscle exercises.
Behavioral changes like limiting fluid intake or scheduling regular bathroom breaks may help some women. There are also ways to manage the symptoms to allow women to return to active living using products like absorbent pads. A pelvic floor occupational therapist could supplement treatment with environmental strategies like adjusting toilet height or other bathroom modifications, to make it easier for an older patient to safely get to the bathroom.
There are also products and devices to manage leaks, such as a pessary, a vaginal insert designed to help SUI; or a urethral insert, a small tampon-like disposable device inserted into the urethra to act as a barrier to prevent leakage.
Medications are an option for treatment too, but patients must be properly educated about this decision. That’s because the choices for medication often include taking a chance with troublesome side effects. That leads many women to look to health care providers for treatment beyond medications.
If medication is chosen for the treatment plan, education is still important. While many of the pharmacologic options are associated with undesirable side effects, these can be managed through patient education and counseling, as patient adherence to medications is key in treating incontinence.8
Finally, surgery is an alternative to treating incontinence. The most common option is known as the sling procedure. A surgeon uses mesh to build a sling or hammock that supports the urethra. Caldera Medical offers a variety of slings for treating incontinence.
Patient education plays a role in choosing this surgery, which has become the most common type of surgery to correct SUI. It offers advantages such as completing the procedure in as little as 30 minutes; discharging most often on the same day; and short recovery time with minimal pain.9
Other surgeries are available too, like one that attaches ligaments along the pubic bone to lift and support tissues near the bladder neck. Injectable bulking agents can be injected into tissues around the upper portion of the urethra, bulking up the area to improve the ability of the sphincter to close.10
What’s key is that the patient is properly educated on the causes of incontinence, and treatment options available, many of which are non-invasive or minimally invasive, and don’t have to include lengthy regimens of medication.
Conclusion
Women suffering from stress urinary incontinence face quality of life consequences that can impact in their social life, work life and even sex life. It’s vital that women seek diagnosis from a health care provider, as treatment options are available.
Patient education plays a key role in a treatment plan. Communication, understanding, and shared decision-making between a patient and health care providers will improve outcomes for patients.
Women’s Pelvic Health issues in general are often not talked about due to embarrassment or lack of knowledge, leading women to believe they are alone with their condition. Whether you’re a woman suffering from stress urinary incontinence or you’re treating someone with this condition, it’s important to remember that you’re not the only one. Don’t go through this journey alone. Seek to understand the condition and what can be done.
There’s plenty of support, guidance and treatment options, including minimally invasive treatments offered by Caldera Medical, to help women regain confidence and live life to the fullest.