Adult diapers may be a $16 billion industry, but aging baby boomers are looking for better ways to address the very common problem of incontinence.
And medicine isn't letting them down. With simple exercises, medication and surgery, many people are overcoming incontinence.
More than 15 million Americans have incontinence. About 85 percent are women -- and not just elderly women. In younger women, incontinence can be a problem after childbirth. Men tend to have incontinence associated with prostate problems.
More than half of all U.S. women will suffer from incontinence at some point in their lives, but only one in five will seek help, according to the American Urological Association. On average, a woman with incontinence will wait eight years before seeking help.
Half of all nursing home admissions are because of incontinence.
"It's a significant problem, but most of the effort goes into diapers and so forth, and not enough goes into proper treatment," says Dr. Michael Tahery, a Beverly Hills urogynecologist who has pioneered one of the new surgical treatments.
It's never too late to address the problem, experts say. Lucile Toole, 86, had struggled with incontinence for years. In 1997, she almost backed out of a cruise vacation. She survived the trip without accident, but her worry clouded the experience so she decided to do something about the problem. Toole made weekly visits to a urogynecologist and learned exercises, along with biofeedback, to retrain her pelvic muscles. Her problems abated, and it changed her life.
"I take classes and go to lectures," she says. "I'm not completely cured, but last week I was in a crowd, and I knew I couldn't get to a bathroom for at least an hour. And I could wait."
Recent developments in incontinence:
* A recent study in the Journal of the American Medical Association suggested that many women could be helped by simple, noninvasive exercises and biofeedback. An accompanying editorial called on doctors to redouble their efforts at diagnosis and treatment.
* Two new alternatives in drug therapy have become available within the last year: A new medication called Detrol received federal approval; it is an improvement over older drugs because it is less likely to cause side effects, such as dry mouth and constipation. And the popular medication oxybutynin chloride (the brand name is Ditropan) has just been released in a new formulation (called Ditropan XL), which allows for a once-a-day dose instead of taking the medication every few hours.
* A major research effort is under way to explore surgical techniques to cure female urinary incontinence. Surgery is also successful at treating stress incontinence, in which urine is leaked when the abdomen is under physical stress.
Guidelines from the Agency for Health Care Policy and Research and the National Institutes of Health have advised doctors to try the least invasive treatments first.
