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AKUH 'Signs, Symptoms and Care' Programme |
50% Women Have Urinary Incontinence and Prolapse
"Problems of urinary incontinence and genital prolapse are common
in the community - nearly 50 per cent of women who have had children
experience prolapse or incontinence."
This was stated by Dr Raheela Mohsin, Assistant Professor, Department
of Obstetrics and Gynaecology, Aga Khan University (AKU), while giving
a presentation on 'Female Urinary Incontinence and Genital Prolapse'.
Dr Mohsin was speaking at 'Signs, Symptoms and Care', a public health
awareness programme organised by Aga Khan University Hospital (AKUH)
in Karachi on June 4, 2005.
Urinary incontinence is the term used to describe the involuntary
loss of urine from the bladder. "Urinary incontinence is never
normal. It is always a symptom or sign of an underlying problem,"
said Dr. Mohsin. She added that urinary incontinence "affects
3 in 10 women worldwide." This condition, she continued, is more
prevalent than diabetes and hypertension but many women conceal these
symptoms out of embarrassment, and therefore face difficulty accessing
medical resources for help. In western countries, such types of patients
are referred to Pelvic Floor Units, but in developing countries these
patients are looked after by general gynaecologists who have with
a good background of surgical experience.
'Prolapse is named after the tissue or organ that has lost its support
and is protruding into the vagina. "For example, when the urethra
protrudes into the vagina, it is called urethrocele. If the bladder
prolapses this is called cystocele. Genital prolapse has many similarities
to hernias. They both occur due to weakness of supporting tissues.
Genital prolapse is due to weakness of pelvic floor. The pelvic floor
is composed of muscles, collagen, connective tissue and fascia. A
weakness of these supporting tissues allows the tissues and the organs
surrounding the vagina to herniate into the vagina resulting in prolapse."
Dr Mohsin observed that 50 per cent of women who have had children
complain of some vaginal prolapse but only 10 to 20 per cent of these
seek medical attention. Over 10 per cent women undergo pelvic floor
surgery for the management of genital prolapse or urinary incontinence,
and up to one-third of these women will undergo repeat surgery. Post
natal exercises and pelvic physiotherapy have a proven role in the
prevention of prolapse. Moreover, women are advised to avoid heavy
weightlifting. "In my own study in Australia, 6 kg was found
as an upper limit to affect the urinary continence and pelvic organ
support." Disclosed Dr Mohsin. The incidence of surgery for prolapse
seems to increase with age. The peak age group for women undergoing
urinary incontinence surgery is the 40-50 year-old group. As the average
age for females in Pakistan is 62 years, often doctors see these patients
even at younger age. AKUH offers a special clinic titled 'Urogynaecology
Clinic' for patients with these complaints.
As part of its outreach programme and societal commitment of creating
awareness of early diagnosis and timely treatment, AKUH has organised
over 180 'Signs, Symptoms and Care' programmes in Karachi, Hyderabad
and the UAE, reaching out to more than 35,000 people.
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