Following the birth of her second child three years ago, the 36-year-old mother of two attempted a jump while exercising to a video. Unfortunately, she ended up wetting herself. Several months later, she made a second attempt and the same thing happened. It was at that point that she realized that something was amiss. She realized she needed to find some self-care tips and treatment options for incontinence.
However, that was just the beginning of her troubles. After the incident, she went to the bathroom to clean herself up, expecting that her urinary issues would subside. But to her surprise, she ended up passing more urine.
Madam T, a designer who prefers to remain anonymous, discovered she had developed fecal incontinence months after she began eating apples in the morning. She is one of a growing number of Singaporeans seeking help for urinary and fecal incontinence.
Dr Tricia Kuo, a consultant with the Department of Urology at Singapore General Hospital (SGH), defines urinary incontinence as the involuntary leakage of urine. Meanwhile, Dr Cherylin Fu, a consultant at SGH’s Colorectal Surgery Department, describes fecal incontinence as the inability to control bowel movements, which can lead to feces leaking unexpectedly from the rectum. The number of incontinent patients seen by SGH’s pelvic floor disorders service has more than doubled since its inception in 2008, with over 100 patients seeking treatment so far this year.
Various factors contribute to the increase in incontinence cases, such as greater awareness of available treatments and less stigma. Patients are now more willing to discuss their conditions with their doctors, and more elderly patients seek treatment to maintain an active lifestyle. According to Dr Fu, incontinence becomes more common as one ages.
Although most women develop incontinence later in life, after menopause, the damage to their pelvic floor muscles usually happens much earlier, due to pregnancy and childbirth. The pelvic floor and sphincter muscles may have been strong enough to compensate for the deficiencies in younger years, but as women age and their pelvic floor weakens, symptoms begin to appear.
Pelvic floor disorders can vary, including incontinence due to pelvic floor weakness, difficulty in passing urine and stools due to tight pelvic muscles, or prolapse. Habitually straining while passing motion or lifting heavy loads constantly could also cause the pelvic floor to prolapse. Patients with connective tissue disorders that predispose them to weakening of the pelvic floor ligaments and muscles may also be affected.
Dr Fu emphasizes that the longer a pelvic floor disorder is left unattended, the more severe the symptoms are likely to be. The good news is that most conditions can be addressed even after they have become longstanding. Medical therapy, such as dietary adjustments, avoiding triggers that might result in loose stools, medications such as anti-diarrhea pills, and biofeedback therapy, could be prescribed to help manage the condition. The management of each case involves discussions between the medical specialities involved, including colorectal surgery, urology, and gynecology, to determine the best course of treatment.
For Madam T, surgery is not an option yet. She has tried Kegel exercises and physiotherapy to no avail. In June, she visited Dr Fu, who recommended biofeedback therapy to train her pelvic floor muscles to work properly again. Biofeedback therapy involves a series of exercises such as squeezing, holding, and relaxing of the anal muscles, which are coordinated with one’s breathing and abdominal contractions. After three sessions, Madam TC reported that she could control her bowels better, allowing her to finish her meal before walking to the toilet to relieve herself, as opposed to having to drop everything and run to the toilet immediately.
Incontinence is a challenging condition that can significantly impact a person’s quality of life. It is essential to seek medical attention if you experience symptoms of urinary or fecal incontinence. With the right treatment, it is possible to manage the condition effectively and lead a fulfilling life. If you are struggling with incontinence, consider seeking medical advice today.
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