Nuffield Health Hospitals: putting you in the know

Mr Ayman Fouad, consultant Urogynaecologist, & Siân Moulder, physiotherapist at the Nuffield Brighton Hospital, offer a range of treatments for urinary incontinence in women

Urinary incontinence (UI) is a sudden loss of bladder control that causes you to release urine when you don’t want to. It may happen when you cough, sneeze, laugh, or when you exercise. This is called stress incontinence (SI), however it has nothing to do with emotional stress. SI usually occurs when the pelvic floor muscles that support the bladder are weakened.

UI may also happen when you have a strong urge to pass urine and you can not get the toilet in time, this is what we call Overactive Bladder Syndrome (OAB). In OAB the bladder muscle becomes irritable, it may contract at inappropriate times causing a strong desire to pass urine, resulting in frequent urination and may even result in urine being passed involuntarily.

UI is a very common condition, and it affects women twice as much as men. Around one in three ladies will experience a urinary problem at some stage of their life. Unfortunately many ladies do not seek professional help due to lack of knowledge about their condition or embarrassment. However the majority of these women can be cured.

Pelvic floor exercise (PFE) should be the first line of treatment for SI, and it is highly effective in treating OAB. Women’s Health specialist physiotherapist Siân Moulder comprehensively explores the history of the condition with the client and carries out a detailed pelvic floor examination. She will then advise on, and implement, a PFE regime to strengthen the muscles that support the bladder. Siân will supervise PFE and progress treatment using a range of techniques tailored to the needs of the individual. Treatment of OAB and urge incontinence mainly focuses on lifestyle advice and bladder training. Some women find electrical stimulation and biofeedback very helpful.

Physiotherapy treatment is successful in resolving or dramatically improving symptoms in the majority of Women with stress incontinence or OAB, enabling the individual to regain control of their bladder.

Surgical treatment is the second option if the symptoms of UI continue to persist after physiotherapy treatment. Medication may be prescribed by Mr Fouad to compliment the treatment of OAB.

Currently the surgery for SI is minimally invasive – most women can be treated as a day case. Surgery can be performed under local anaesthetic or general anaesthetic and does not normally take longer than 20 minutes. The success rate of surgery for SI in keeping you dry on coughing or sneezing is up to 90 per cent.

Surgical treatment is either in the form of a synthetic sling to support the bladder neck or injection at the level of bladder opening. During your consultation, Mr Fouad will discuss with you both options and you will decide on which one suits you the most.

If you are experiencing problems with your bladder, do not suffer in silence, remember you are not alone and your condition can be treated with tremendous success. Speak to your GP or contact Nuffield Health today for further information and take control.

For direct referrals to Physiotherapy please call 08450454845 and ask for a consultation with Siân Moulder. Nuffield Health Brighton Hospital, Warren Road, Wodingdean, 01273 627008, www.nuffieldhealth.com/brighton

Mr Fouad, consultant at Brighton and Sussex University hospitals consults weekly at the Nuffield Health Brighton Hospital and the Nuffiled Health Haywards Heath Hospital. Siân Moulder, holds a Women’s Health Physiotherapy clinic once a fortnight in Brighton and weekly in Crawley at Nuffield Health Fitness and Wellbeing centre.