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Global incontinence set to rise

13 August 2012

A study spanning five continents estimates that by the year 2018, almost half of the world population over the age of 20 (approximately 2.3 billion people) will experience at least one lower urinary tract symptom, an increase of 18 per cent in just one decade. Incontinence will also increase, particularly in Africa, South America and Asia.

The study of more than 19,000 people, co-ordinated by the Department of Epidemiology at the University of North Carolina, USA, and published in the British Journal of Urology International, predicted that between 2008 and 2018:

  • the worldwide prevalence of lower urinary tract symptoms will rise to just under 46 per cent (47 per cent women and 45 per cent men);
  • overactive bladder will increase by 20 per cent, affecting approximately 546 million people worldwide; and
  • urinary incontinence will have risen by 22 per cent, affecting about 423 million individuals.

Lead author Dr Debra Irwin said the study underlined a “clear and urgent need to improve the awareness, prevention, diagnosis and management of these conditions”. 



Choosing the right continence product

If your family member has been assessed as needing continence supplies, these are provided FREE in New Zealand. But there is so much more you need to know.

Carers New Zealand remains concerned about the number of carers who are unaware their sick or disabled family member may qualify for free continence supplies. (For more information on Carers NZ see www.carers.net.nz )

Manage your continence needs

Continence assessments are undertaken by trained professionals (often nurses), ideally after someone with disabilities or a chronic condition has consulted a GP to rule out treatable causes for urinary and/or bowel incontinence.

Incontinence can be highly treatable but for some this can become a short-term or lifetime issue that must be managed.

Many people with disabilities are able to monitor and manage their own continence needs. Others need support from paid care workers and their families and whanau.

Like so many bodily functions, continence is an area of embarrassment and high emotion -- it can be hard to raise the issue with GPs, health professionals, and even family members.

But "making do" -- the option chosen by a surprising number of carers who are unaware of the considerable support (advice and products) available in New Zealand -- has serious risks for you and your family member.

We recall quite a few calls from carers who have ripped up the carpet in their homes, choosing to clean up after "accidents" because they are too embarrassed to discuss alternatives with their family GP.

Often carers put up with endless laundry, again because they can't bring themselves to discuss incontinence with others (even other family members) or just aren't aware there are great products available to help them manage this challenge.

The secret to accessing this service -- and so many others funded by our public health system -- is needs assessment.

Seek practical help and manage your continence

Don't risk burning out or erosion of your relationship with your sick or disabled family member ... seek practical help and manage continence as you would other ordinary body functions such as sex (condoms) and menstruation (tampons, liners, and pads).

Start by arranging an appointment with your family member's GP, who will investigate whether incontinence is caused by treatable conditions such as a urinary tract infection. If not, you will be referred to your local continence assessor, who will meet with your family member and you to explore your needs and recommend appropriate continence products.

These can include pads that fit neatly into underwear or special panties designed to hold pads in place ... diaper-style pads for heavy needs ... or special products for men such as uridomes, which are slipped onto the penis like a condom then attached to plastic urine storage bags (these can be emptied and discarded after one use for maximum hygiene, or disinfected in bleach solution and used several times before they are thrown away). There are also ergomically designed plastic urine bottles for men and women, disposable or washable bed pads -- many, many different kinds of continence aids that can help your family member and you avoid discomfort, health risks, mess, and stress.

Many carers complain that they don't receive enough free state-funded continence pads to meet their family member's need, or that District Health Boards (which administer continence programmes in regions across the country) have an unhelpful "we buy the cheapest and one size fits all" approach to continence.

The system is not perfect, we agree, but at least we do live in a country that TRIES to meet continence needs and will hopefully continue to improve its services for New Zealanders who -- through no fault of their own -- need to use these often expensive products.

Shopping around before buying large quantities of a throw-away (disposable) product can save money. Some companies sell trial packs of disposable pads, and you may be able to borrow some products through your local continence service - things like urinals, for example. If your family member receives free state-funded pads, these will be regularly delivered to you.

Do not be put off if one product does not work well for you: be prepared to try others. Newer and better products are being constantly introduced.

Some items are available in high street pharmacies and (increasingly) in supermarkets - for example, absorbent pads for light incontinence. Most people who need to buy products, however, use mail order services offered by manufacturers or distributors.

Women buying absorbent products from retailers should resist the temptation to use sanitary towels to cope with incontinence: they are made to a quite different specification and have far less absorbency than continence pads - typically they can cope with only one tenth the leakage of the proper article. Although incontinence pads are more expensive they are far better value.

Absorbent products and some others can be safely used without medical supervision - although we always recommend getting a professional assessment of your problem - but some devices should be used only if proposed or prescribed by a doctor, nurse or qualified health professional (such as an assessor).

Which products best suit your family member will depend not just on their condition or disability, but also to some extent on your lifestyle (do you frequently commute or travel ... does your family member play sport etc).Consider mixing and matching products, from day to night, or according to your activities, or if your needs vary.

Some products are easier to use than others. If you have difficulty using your hands, dressing or undressing, or your eyesight is not good, think about how you are going to apply, use and remove the product.

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