Why We Need To Smash Stigma Around This â€˜Embarrassingâ€™ Illness That Affects Millions
Life came to a standstill for 35-year-old Lavanya Giri five years ago, post her pregnancy. After giving birth to her son, Giri lost control of her bladder. The condition called urinary incontinence affected Giri dramatically. She stopped going out and started avoiding meeting friends. Simple things like going to the movies became impossible. The fear of wetting always lurked at the back of her head.
Giri isnâ€™t the only one suffering from incontinence. Nearly 24 million Indians suffer from it. But, the embarrassment associated with the disease ensures most choose to suffer from it in silence. Like most, it also took Giri a lot of time to confront her condition and see a doctor. Through dietary interventions and exercise, Giri now feels much more in control.
To get to know more about incontinence, we decided to speak with Dr Anurag Khaitan, Head of Urology at Delhiâ€™s Paras hospital. In the interview that lasted for more than an hour, Dr Khaitan told YKA about various kinds of incontinence, just how pervasive the condition is and why patients shouldnâ€™t think twice before approaching a doctor.
Shikha Sharma (SS): What is urinary incontinence and just how common is it in India?
Dr Anurag Khaitan (AK):Â â€“ Urinary incontinence is the involuntary leakage of urine; in simple terms, it means a person urinates when they do not want to. It is a much more common problem than most people realise, and can occur due to a variety of reasons. It is very common during old age, but can happen to youngsters. Women are more prone to it than men.
Millions of adults in Asia suffer from urinary incontinence or its milder form called bladder weakness or an over-active bladder (OAB). In my office, I receive 5-7 people who suffer from this every day. These are people from different backgrounds and professions, so yes, there is no rule as to who it can afflict. It can happen to anyone.
SS: What are the causes of incontinence. Any particular reason why women are more prone to incontinence?
AK: There are many causes of urinary incontinence. This could be weak bladder muscles, pregnancy, child birth, forceps delivery, removal of uterus, complications from surgery, stroke, or chronic diseases like diabetes, multiple sclerosis (MS), and Parkinsonâ€™s disease. Those suffering from Urinary Tract infections (UTI) or prostate infections can also get incontinence. Even stress can be a contributor.
Women are more prone to incontinence because of physical changes in the body that occur due to things like pregnancy and menopause. UTIs are also more common in females, making them more susceptible to suffering from incontinence.
SS: You say this condition is very common. Yet, there is very little conversation around incontinence. Why is this the case?
AK: Having incontinence can be a source of huge embarrassment to those who suffer from it. Because they have little or no control over peeing, people who suffer from it fear wetting themselves in public places. As a result, they donâ€™t go out, they donâ€™t even like to talk about it fearing they would be viewed unfavourably. That is why there is little conversation around it. In fact, most who suffer from the condition are extremely reluctant in stepping out of their homes, only going to places where they know there will be a washroom available.
SS: Psychologically, what is a patient going through? Can you tell us a bit about his/her frame of mind?
AK: Like I was saying, the first thing that happens to a person who suffers from incontinence is that they stop going out completely. Cutting off social interaction is never a good idea, and this obviously has a negative effect on their psychological well-being. Because they canâ€™t talk about it, the embarrassment and shame builds up. In extreme cases, this can even lead to depression. Patients may not even step out of their rooms. In old age, especially, if this is not treated, it can increase the risk of infections, that only compounds the problem.
SS: As a doctor, what would you advise people who suffer from this condition?
AK: My advice to all those who suffer from incontinence would be simple. If you suffer from the condition, just go to the doctor. Incontinence is easily treatable through medicines. In cases where medicines may not work, one can opt for surgery. It takes a day to complete and is totally safe. The person can even go to the gym a day after the surgery. If you leak while you laugh or cough, donâ€™t dismiss it. Go see a doctor and be assured that there is treatment available for your condition. Not talking about it only makes things worse.
SS: What about patients for whom surgery may not be an option or the surgery isnâ€™t successful?
AK: Yes, there may be cases where the patient may be too old, or bedridden, or the leak still continues post-surgery. Or those who donâ€™t respond to any kind of treatment. Even then, there is no need to lock yourself up. One can always use products like adult diapers that are available in the market, which one can wear when they go out. A personâ€™s life doesnâ€™t have to stop just because they suffer from this condition.
Yet, thousands of Indians continue to do just that, silently suffering from the condition. This is hardly fair. Everyone should be able to talk about incontinence and seek qualified medical help without fearing judgement over it. It is time we stopped brushing this issue under the carpet, and started discussing this more openly within our families and social circles.