What is urinary incontinence?
Urinary incontinence is a condition causing a struggle to resists the urge of urination and/or experience of involuntary leakage of urine. The disease is a frequent problem, especially in women as their risk of developing the condition is twice as high as in men. About 10 % of all women regularly experience incontinence, and the condition becomes more frequent with age. A notable risk factor of urinary incontinence is if the woman has undergone a natural birth. At least 50 % of all women experience incontinence at some point during their life, but the causes differ. The condition can be due to hereditary or environmental factors which contribute to the development of urinary incontinence.
Some suffer from stress-incontinence, where the sphincter – located under the bladder around the urethra – is weakened, preventing the bladder from withholding the urine when the pressure increases. Others suffer from urge-incontinence. This is characterised by a sudden, violent urination urge which is difficult to control. Currently, the treatment of urinary incontinence mostly focuses on training the muscles in the pelvic floor and the bladder muscle as well as lifestyle changes, herein weight loss and a reduced liquid intake.
New knowledge of the risk factors of urinary incontinence
Diseases, which concern the pelvic floor, greatly influence the patient’s life. This includes urinary incontinence but also faeces-incontinence and a prolapse of the pelvic floor. Based on this notable influence on the quality of life, and because the occurrence is relatively high, research into the causes and potential treatment options for patients with urinary incontinence has been of high priority.
A group of researchers from The Department of Epidemiology and Biostatistics and the Imperial College in London have discovered a very surprising connection between urinary incontinence and a well-known substance that can treat a number of different diseases. Researchers from the imperial college have conducted an extensive investigation of genetic material from almost 9,000 women from Finland and England. In the study, they scanned the genetic material for markers, which could be related to urinary incontinence. Earlier studies have failed to find any genetic causes to incontinence. The data collection was difficult as the researchers wanted data from a large group of women with the condition, and because it was difficult to obtain enough information about the condition of the study subject. It took the researchers as much as 5 years to collect and process the data.
The analysis of data in the English investigation showed that a specific area of our genetic material contributes to increasing and reducing the risk of incontinence. This area is located close to the gene for the substance called ‘endothelin’. Endothelin is a substance, which is involved in the bladder muscle’s ability to contract. There are several drugs that affect the function of endothelin. Currently, these drugs are used to treat elevated blood pressure in the pulmonary circulation and ‘Raynaud’s syndrome’. Raynaud’s syndrome is a condition characterised by spasms in the arteries – usually the arteries by the fingers – which reduces the blood flow. The investigations now suggest that the drugs may provide a beneficial effect to patients with incontinence.
Genetic screening can help pregnant women
As we are now aware of the fact that the genetic risk factors related to urinary incontinence are increasing, we may be able to offer a screening of the genetic material in the future. From there, we can determine the patient’s risk of developing the condition. This will especially be helpful in the advising of pregnant women about their likeliness of developing urinary incontinence as a result of natural birth. This way, they are better informed about their options and can decide between a natural birth or a C-section with the knowledge of the respective risk factors. A C-section protects against the development of urinary incontinence, but in Europe there is a lot of focus on limiting the number of C-sections as the procedure can cause other risks and complications for mother and child. Therefore, it is a topic that requires a debate about the benefits and drawbacks related to the choice of birth.
References:
1. https://www.sundhed.dk/borger/patienthaandbogen/nyrer-og-urinveje/illustrationer/animationer/urininkontinens/
2. https://www.news-medical.net/news/20170529/Drug-treatment-used-for-other-conditions-can-help-women-combat-urinary-incontinence.aspx
