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YOUR HEALTH When You Have To Go by Ihor Magun, M.D., F.A.C..P Millions of people suffer some form of in continence. Frequently, they suffer in silence be cause this is a topic that is not openly discussed. Of ten, in fact, it is not even brought to the attention of a physician. Clearly, the problem is often under diagnosed and untreated. About 85% of individuals diagnosed with incontinence are women. There is a misconception that the problem is a natural progression of aging or a consequence of pregnancy. These ideas are not necessarily true because incontinence has many dif ferent causes and manifestations. Each type of in continence is treated differently, and the number of individuals helped by treatment far outweighs the number of individuals who cannot be helped. Women under the age of 60 primarily suffer from stress incontinence, which is defined as a loss of urine provoked by certain physical stresses such as coughing or sneezing. Treatment of stress incon tinence usually involves pelvic muscle exercises (Kegel exercises), biofeedback, and a change in diet. Dietary recommendations include limiting the intake of spicy food, alcohol, and caffeine. For these mo dalities to be successful, considerable commitment is necessary. Unfortunately, the self-discipline re quired is often difficult to maintain and treatment often fails because the regimen is not complied with. Certain individuals may benefit from devices called pessaries, which help correct anatomically caused incontinence. Estrogen cream can also be helpful in some cases. Errata. In the list of donations to the New York Firefighters Memorial Fund which was published on page 17 of the Feb ruary 2001 issue of Our Life, UNWLA Branch 66 was inadvertently “relocated” to Hartford, Connecticut. Please note that Branch 66 is in New Haven, Connecticut. We apologize for the error. An Invitation. We are currently planning our April and May issues and invite our readers to submit articles, with or without photographs. We are especially interested in stories with an Easter or Mother’s Day’s focus at this time, but arti cles on branch activities and letters to the editor are always welcome. Please forward manuscripts directly to Tamara Stadnychenko, English Language Editor, 2180 Woodland Road, Abington, PA 19001. Urge incontinence, generally associated with women over the age of 60, is the desire to pass urine at inappropriate frequent intervals. This condi tion is also referred to as overactive bladder. Treat ment of urge incontinence includes bladder retrain ing, biofeedback, and oral medications. Since they were first introduced, anti-incontinence medications have been markedly improved and they are now ex tremely effective in controlling the problem. Functional incontinence refers to a failure to recognize the necessity of having to void, that is, not being able to reach a toilet in time. Overflow incon tinence is caused by some form of obstruction, such as an enlarged prostrate in males or some pelvic or gan abnormality. Functional incontinence is treated with regularly scheduled toilet visits. Overflow in continence can be treated surgically, with medica tions, or with mechanical tubes that permit proper voiding. In all cases, treatment of urinary inconti nence requires a complete physical examination, evaluation for infections, and evaluation of prescrip tion and non-prescription medications taken by the patient, which may be a contributing factor. Chronic constipation can also lead to urinary problems and must be addressed before any treatment program begins. While many forms of incontinence can be treated by your own physician, referral to a urologist may be necessary in more refractory or complicated cases. “НАШ Е Ж ИТТЯ”, БЕРЕЗЕН Ь 2002 17
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