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also known as incontinence, the inability to prevent the release of urine or feces affects almost four million canadians — a number that is growing along with our aging population — not only impacting quality of life, but also emotional health.
a 2020 population representative epidemiology survey published in the canadian journal of urology found there is a lack of awareness of the available treatments despite the acknowledgement that urinary incontinence is a significant medical condition. few people had actively engaged with treatments, and men remain less aware and less likely to seek help than women.
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there are several types of incontinence, according to the national institute on aging , with stress incontinence being the most common, particularly among middle-aged women.
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studies have also linked urinary incontinence to obesity. a u.k. paper published in critical care obstetrics and gynecology concluded that, while a direct cause-effect relationship between obesity and incontinence has not yet been established, there is evidence that weight reduction can be beneficial to obese incontinent women.
fecal incontinence is the involuntary loss of stool from the bowel, ranging from occasional leakage when you pass gas to the complete loss of bowel control. it can be caused by chronic constipation, which may damage the walls of the rectum as well as the nerves that control bowel movements. constipation affects about 15 to 30 per cent of canadians.
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other reasons for fecal incontinence include diarrhea (because loose stool is harder to control), muscle damage from vaginal childbirth and age-related weakening of pelvic floor muscles or the anal sphincter, and nerve damage from stroke, spinal cord injury, diabetes or multiple sclerosis, for example. about one per cent of people under the age of 65 and four to seven per cent of people over 65 have fecal incontinence .
promising new therapies include a water-based gel delivered by small injections into the urethral wall to add bulk and strength to prevent urinary incontinence . the gel is similar to cosmetic facial fillers that remain in the body over time.
for women, there are non-surgical vaginal devices that can be inserted in the same location as a tampon or diaphragm without hormones or drugs to provide bowel control for fecal incontinence. patients use a detached pump to inflate and deflate a balloon on the insert that controls the rectum and prevents stool from passing before a trip to the bathroom. after a bowel movement, you inflate the balloon again.
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