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Don’t Suffer in Silence

Don’t Suffer in Silence
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More than one in five people suffer significant bladder problems such as leaking urine, disturbed sleep due to the need to pass urine or difficulty with bladder emptying. Dr Robert Jones explains more here

BY Mr Robert Jones, BMedSci, Bm BS, DM, FRCS (Urol) consultant urologist at Nuffield Health Taunton Hospital and Musgrove Park Hospital, Taunton and Somerset NHS Foundation Trust.

More than one in five people suffer significant bladder problems such as leaking urine, disturbed sleep due to the need to pass urine or difficulty with bladder emptying. These symptoms occur in both men and women and, although not life-threatening, can be highly intrusive, embarrassing and restrictive (people often feel “my life revolves around my bladder”).

Yet despite their impact on quality of life , it is surprising how commonly these symptoms are just accepted and many people suffer in silence. Recent large epidemiological studies have
identified a ‘silent epidemic’ of men and women with untreated yet bothersome bladder symptoms, who have never mentioned these problems to their doctor. This reluctance to seek treatment may be due to embarrassment or the (mistaken) belief that such problems are an expected consequence of childbirth, or an inevitable part of normal aging.

In fact these problems are usually treatable with simple measures and quality of life can often be improved dramatically. Where surgery is indicated, recent developments have led to the
availability of less in vasive treatments.

  • Stress incontinence: Leaking urine on coughing, sneezing or activity is most commonly noticed by women who have had children and is often self-limiting with pelvic floor exercises. When problems persist despite physiotherapy , minimally invasive modern urethral sling procedures (e .g. tension-free vaginal tapes) are highly effective and avoid the prolonged recovery associated with traditional open surgery . Urethral bulking agent injection has a role in some patients and can be performed under local anaesthesia.
  • Overactive bladder: Having to drop everything to rush to the loo for fear of not making it in time (or indeed sometimes not making it in time!), occurs in both men and women. 2013 has seen the launch of a new overactive bladder medication (Mirabegron), the first new class of drug in around 20 years. Where tablets aren’t enough, Botox bladder injections are a highly effective, minimally invasive alternative to traditional major surgery.
  • Prostate obstruction: Benign enlargement of the prostate in men often causes a mixture of voiding symptoms (weak or intermittent urinary stream, difficulty starting off or trickling at the end) and storage symptoms (going too often both day and night). If medication can’t control these adequately and prostate obstruction is confirmed, telescopic prostate removal (transurethral prostatectomy, TURP) is highly effective. This procedure has been further refined recently through new laser techniques (such as Holmium laser enulcleation of the prostate, HoLEP) to limit bleeding and reduce hospital stay.

These modern, minimally invasive, effective treatments are increasingly performed as a day case and offer new hope for those suffering these common and miserable symptoms. So don’t
become part of the ‘silent epidemic’ – take control of your bladder rather than letting it take control of you! For further information or to book an appointment with one of our urology consultants, please phone 01823-250612 or e-mail us.