It's a problem that affects nearly one woman in five, but one that
carries such a stigma that few own up to it or contemplate seeking
medical advice.
But urinary or stress incontinence is now not only treatable, but
with a new procedure developed by Ethicon, a division of Johnson &
Johnson, it can be cured without resorting to major surgery.
Tension-free vaginal tape, or TVT, involves inserting a specially
designed Prolene tape around the urethra to support it during 'stress'
moments -- anything from coughing, sneezing and laughing through to
running or jumping.
The procedure, which takes around 30 minutes in the operating
theatre, can be performed while a patient is under local anaesthetic and
involves a minimal stay in hospital, often just overnight.
And, with a success rate of up to 95 per cent, it represents a major
step forward in treatment of one of the most common, but untreated,
women's problems.
Now available at several hospitals in the UAE, the procedure has
already changed the lives of many women.
A typical case is Wendy, a mother of two in her mid-30s who
discovered last year that she was suffering from stress incontinence all her life.
"I was told as a child that I had a small bladder and after that, I just
coped with it," she said. "I still kept going, visiting a gym three
times a week and cycling daily, for instance, although this involved
wearing incontinence pads -- termed by my children as 'mummy's nappies' --
but I just didn't know that a cure was available.
"However, it was the birth of my children which convinced me to seek
some form of treatment -- I wanted to enjoy life with them without any restrictions."
After seeing a poster advertising a lecture on the new procedure,
Wendy had a bladder test at a hospital in Dubai. The diagnosis of
stress incontinence qualified her for the new TVT treatment which she
underwent late last year.
"With the local anaesthetic, there was no sensation and certainly no
pain -- and I had no need for painkillers afterwards either," she said.
"During the first week that followed, I still leaked slightly and was
hesitant to sneeze or cough, but after this, there has been no problem
and I was given the all-clear after four weeks to gradually resume my
active life -- but without my former restrictions."
A fellow sufferer, Anne, is similarly enthusiastic about the TVT
procedure, which changed her life after a decade of incontinence problems.
"It started after the birth of my first child, 12 years ago, but was
not too bad at first," she said. "However, following a traumatic
delivery for my second child, it got progressively worse, causing me to
lose control even in social situations.
"And, when a friend who had a similar problem opted for surgery to
cure it, I began to look at the possibility."
Fortunately for both Anne and Wendy, the TVT procedure is now
becoming increasingly common in the region, offering a non-evasive,
cheaper and quicker treatment than traditional methods that involve
abdominal surgery.
Says Dr Rihab Awad of the American Hospital, "with invasive surgery, it can take up to six weeks for the patient to recover, but with TVT, we can schedule the treatment within a week of diagnosis, and the patient will only have to spend one night at the hospital."
"Using an epidural, there are no side-effects or risks associated
with general anaesthetics, and it is also suitable to older women who
might suffer more from the trauma of major surgery."
She says the success rate to date was between 85 and 95 per cent, and
new statistics tended to put this at the upper end of this range, while
the nature of the treatment meant it could be repeated if necessary.
"The tape simply becomes part of the body so there are no side
effects, and should it become necessary, it is simple to do the
procedure a second time."
Dr Awad stresses the TVT treatment was one of several options
available, depending on the nature of the problem: "In mild cases, we
would recommend physiotherapy for three months, while those suffering
from a weight problem - which can also cause stress incontinence - are
advised to deal with this first.
"But, for many women, it is the stretching of tissue during pregnancy
which aggravates stress incontinence, because after birth, this does not
revert to normal -- and it is here that TVT can help."
"The typical reaction is to ignore it," says Anne. "It's just an
embarrassment to be suffering from something usually associated with
elderly women."
But, as Wendy explains, once the subject is in the open, it's
surprising how many friends and relatives are also affected: "Since I
underwent the procedure and mentioned it to people, I found out that so
many other women had it too."
One problem in the region is the lack of a GP (general practitioner)
system, where patients can unburden themselves to a local doctor
familiar with their health history: "In the UAE, people have to identify
a problem first and then actively seek treatment," says Dr Awad.
Hopefully, with women such as Wendy and Anne prepared to speak out
about their experiences, more sufferers will acknowledge their problem --
and take steps to seek treatment.
The Stress of Incontinence
Gynecare met up with Lynda Benbow just as she was packing up to leave Dubai after almost twelve years. She was off to start a new life in Africa, where her husband had been posted.
Lynda, was well known here as a freelance journalist.
Lynda found the courage to discuss and share with us a problem that has severely affected both her social and working life for the last five years. She doesn't want other women to suffer in silence for as long as she did, and wants to tell us how she quite simply managed to radically improve the quality of her own life.
How did stress incontinence affect your life?
It was ruling my life. It was affecting what I wore, white was out for obvious reasons. My husband even complained that I wore frumpy clothes. Even playing golf was out of the question.
What did you do first?
Nothing, I was much too embarrassed even to confide in my husband at first. It wasn't until a friend admitted to the same problem that I realized I wasn't alone.
What happened to make you face the problem?
I saw an article in the newspaper that reported on a doctor in Dubai who had operated on a woman here, and as I was leaving it spurred me to do something about it.
What steps did you take?
At the Al Baraha Hospital I saw Dr. Al Husseini who I felt very comfortable with. He agreed to perform the operation and sent me to purchase TVT (tension free vaginal tape) from Johnson & Johnson at the Trade Centre.
How long did you have to wait for the operation?
Just a week later and it was during the school holidays (I was now working in a local school) so didn't need to tell anybody.
What did the operation involve?
I spent three nights in hospital. One before the operation to make sure I had nothing by mouth and give me antibiotics and the usual tests. The next day I had an epidural so was fully awake throughout but felt no pain whatsoever. There are just two small outer incisions and one internally. The operation supports the urethra and it has been proved over the years that in surgery the body does not reject this product.
How did you feel after the operation?
As though I had been set free. My first thought when I woke up was that I didn't need to go to the toilet. It was slightly uncomfortable to sit down at first but after a couple of days of warm salt baths I was fine.
What would you say to other women out there suffering as you did?
Don't feel as though you are on your own, this can happen to women of any age and one of the contributing factors is childbirth. Try to find other like-minded women to discuss this with and remember this is just one way to deal with the problem. It might not be the right choice for you, although it certainly was for me, it's changed my life.
For further information, mail us.
