Doctor’s advice and help:

Dear ladies,

I am well aware that questions regarding sexuality and problems connected with incontinence present rather sensitive and intimate topics, which are difficult to discuss. For many of you, therefore, it may be easier to consult said topics through slightly more viable and anonymous way. I believe a discussion will be started that will allow you to share your problems openly with other like-minded women.

It is my duty, however, to inform you that without an expert medical examination, my advice to your problems can be only partial. I can rather provide more information connected to products we offer.

My recommendation is that you should always consult and visit a physician in case of experiencing serious health problems.

I will be happy to answer any of your questions.
Sincerely, Soňa Hlavová, urologist

E-mail:	nepovinné
Question:

Good morning, can you give me some information about incontinence and your type of treatment? Thank you. Jarka 36

A problem discussed: INCONTINENCE

Incontinence = involuntary loss of urine

It affects 20% of women around the age of 45. Incontinence increases to 30% after the age of 50 and up to 40% after 65. In general, an involuntary loss of urine affects about 50% of women (from which 30% suffer from depression due to a reduced quality of life). Women going through menopause represent the high-risk group. Incontinence is one of the frequent health problems of our times.

Incontinence has 4 basic types, of which the most common is called Stress Urinary Incontinence. Said type is the result of dysfunction of the pelvic floor. Other consequences of such a dysfunction are pelvic pain and constipation. By stress incontinence it is understood that only the bladder is under pressure and not, as many women wrongly think, the whole body or the psyche. Psychological stress is the result of incontinence. The stress of the bladder is understood as an accidental leak of urine during physical activities (e.g. laughter, coughing, jumping, walking up the stairs, lifting weights) where the pressure is shifted from the stomach to the bladder.

It depends on the quality of the smooth muscle tissue – the sphincter, and also on the position of the junction – a place where the bladder passes into urethra (which cannot be controlled by will). It also depends on the quality and functionality of striated muscle tissue (ligaments and facies). The pelvic floor consists of ligaments and a group of muscles controlled by will. The most important of said muscles is called levator ani. The entire complex can be pictured as a suspension bridge, where the arch of the bridge corresponds with the vaginal vault, anchored on one side by the pubic bone, and sacrum on the other. Hanging ropes are represented by ligaments and muscles - if the rope loosens, the vaginal vault including the bladder collapses down.

Two types of treatment:

l) Surgical treatment – Colposuspension (according to Burch) - Invasive

laparotomy must be performed – an open surgery with 85% success rate, after 5 years the success rate decreases to 70%

2 types of slings:

• TVT (tension-free vaginal tape – retropubic)
• TOT (transobturator tape)

The advantage of such a treatment is less invasiveness compared to an open surgery. The surgery is performed under general aenesthesia, followed by short recovery time. The success rate reaches 95% even after a 5 years period.

The disadvantage is the high price of the sling, which must be cut before childbirth, therefore losing its function.

2) Conservative treatment

Change of daily habits/cessation of smoking. Nicotine irritates the bladder. Alcohol, sleep deprivation, unhealthy sleeping habits and chronic constipation all contribute to the leakage of urine. The important thing is to keep hydrated and avoid postponing urination (retention of a portion of urine in the bladder contributes to an increase of bacteria). Reduction of weight by 10% leads up to 60% decrease of urine leakage.

Physiotherapy involves a variety of methods, such as electrical stimulation, biofeedback and training of contractions of the pelvic floor muscles (many women are not aware of the position of their pelvic floor and how to use it). Proper physiotherapeutic approach takes into consideration other disorders, such as bad posture (postural stabilization of the trunk) with abdominal obesity and a muscle weakness of the lower back and abdomen.

From the medical point of view, the prevention is always better than the treatment of already developed problem. /p>

The selective, conscious contraction of the pelvic floor muscles is acquired by:

• Daily Kegel exercises – such exercises need to be performed 3 times per day for 20 minutes to guarantee their effectiveness. Few women, however, can meet such requirements.
• Active exercise using a vaginal body (vaginal balls) with a hinge, which is inserted into the vagina and the weights are added to the hinge. Gradually, the weight is increased. It is sufficient to perform the exercise for 3 minutes per day, at least every third day. (Striated muscle “forgets” the past load after 3 days and can set back the training process)

With the help of our product Violet, which was designed to actively strengthen the pelvic floor muscles according to the aforementioned treatment, 90 women in the Czech Republic began their exercises. The youngest of them being 23 years old and the oldest 85.

First results indicate that with a regular exercise (minimally 3 times per week) the weight load can be increased up to 200g per month. The amount of the weight is to some extent indicative of the condition of the pelvic floor muscle.

Each one of the 90 women reports a decline in the involuntary leakage of urine, and an improvement of their sexual experiences (although they do not reveal the method of their exercising to their partners).

In conclusion, our product reduces problems with urinary stress incontinence and contributes to improved psychological well-being and an increase of self-confidence.

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