Incontinence is the unintentional passage of urine and is a condition affecting approximately 34% of women in the UK. It is also a condition that is rarely discussed. The perceived taboo may have prevented more women from coming forward so the actual number affected may be higher. For women suffering in silence, not seeking treatment, their problems will only continue. Men also experience incontinence, but as pregnancy, childbirth and menopause are leading contributors, incontinence affects many more women than men.
The unpredictable nature of incontinence can make leading a normal lifestyle difficult. Women who suffer from incontinence can be affected at any moment. Some women feel unable to seek treatment and then incontinence can have an incredibly negative impact on their lives and their wellbeing as they may shy away from joining social and sports activities with a fear that they could have an accident and embarrass themselves.
Incontinence is recognised as a side-effect of childbirth and this may be perceived as the ‘acceptable’ or ‘understandable’ face of incontinence. However, it also affects women who have not had children, and this is probably less widely appreciated by the general public. As a result, many childless women feel that they have to hide their incontinence as it is an embarrassment to them. This is what Elaine Miller is seeking to change.
A physiotherapist specialising in pelvic floor exercises, Elaine Miller has written a comedy show about incontinence called ‘Gusset Grippers’, which she has taken to the Edinburgh Fringe festival. Her technique is to use comedy to spark conversation amongst women and increase awareness of physiotherapy as a viable treatment for incontinence. In breaking the taboo around incontinence, she hopes to increase awareness of the available treatments so that women no longer feel that they have to suffer, seemingly endlessly, in silence.
Research is currently underway to discover whether stem cells have a place in incontinence treatment; some methods involve collecting stem cells from adipose tissue as a less invasive method than the more common bone marrow stem cells. The mesenchymal cells that are collected have the ability to differentiate into muscle cells and can therefore be used to repair the pelvic floor.
As incontinence is not a disease but a symptom of weak pelvic floor muscles, it is possible to treat it entirely. Physiotherapy is often the first treatment recommended by GPs, but patients can also be referred to a urogynaecologist for urodynamics, and further tests, to see if there is a surgical solution. Physiotherapy has increased in significance since ‘vaginal mesh’ treatment has been paused amid concerns that it creates alarming complications for women.
Alison Johnson, a partner in Penningtons Manches Cooper’s clinical negligence team, represents women with gynaecological and urological claims, whose symptoms often include incontinence. When this results from poor medical care, the team is able to investigate and then bring a clinical negligence claim to seek compensation for these women.
Alison says: “In many of the cases we have dealt with relating to urogynaecological surgery or treatment, the impact on our clients has been devastating. Frequently there has been a failure to explain properly the risks associated with surgery, meaning that they have been unable to give their full, informed consent. Negligent surgery may have left them with urinary incontinence, abdominal and pelvic pain or unable to have sexual intercourse. Some of my clients have told me about the taboo associated with incontinence and the considerable impact it has on their day to day lives, and I am very keen to help raise awareness and break that taboo.”