Urinary incontinence, defined as “any complained loss of urine”, affects more than 5 million citizens in Italy: 20-30% of women and 2-11% of males in adulthood. This percentage in women rises to 32-64% during pregnancy and to 55% in the elderly population of both sexes. And the National Day of Urology promoted today by the Italian Society of Urology (SIU) is dedicated to this pathology that has a strong impact on the quality of life of patients. Objective: to inform and raise public awareness on a condition that represents a serious loss of ability both in terms of limitation of activity and restriction of participation in social life.
The costs of urinary incontinence – a Siu note reports – are important both from a psycho-social point of view, due to the level of suffering of the individual and family members, and from a socioeconomic point of view. Despite the spread of the problem, the latest national data shows that only 43% of affected patients ask for an opinion from a professional, confirming that this problem was and still is a taboo that is accompanied by shame leading to the isolation of affected subjects. For these reasons, the Italian Society of Urology has always been involved in awareness campaigns regarding urinary incontinence. Unfortunately – it is written – from the interaction with patient associations one cannot help but take note of how the issue does not receive the attention it should, and recently also in the European context the project ‘An Urge to Act’ was proposed by the European Society of Urology, which will be presented in Italy in conjunction with the National Day.
Italian urology, through this day – they say from Siu – hopes for a substantial change also in active policies related to incontinence, knowing full well that the pathology is not only a disease, but could be a symptom of further clinical situations that need to be investigated and treated. “It is necessary to know that urine loss is not only a physiological process linked exclusively to age and the so-called ‘protections’ must not represent the only solution to the problem of incontinence, but the moment of transition between the diagnostic and therapeutic phase – says Giuseppe Carrieri, national president of Siu – The availability of clinics and dedicated staff, who direct and follow the patient in every phase of treatment, from advice on lifestyle (such as nutrition, weight loss, intestinal regularity), to pelvic floor rehabilitation, from pharmacological therapy to surgery, is essential to allow the recovery of continence”.
For this reason, the ‘SIU Risponde’ service has been activated, which provides answers to questions on urinary incontinence and the recommendations of urologists within a decalogue presented this morning, as part of the day, in Rome in the presence of Giuseppina Castiello, Undersecretary to the Presidency of the Council, Francesco Zaffini, President of the 10th Health Commission of the Senate, and Ugo Cappellacci, President of the 12th Health Commission of the Chamber.
Through the Decalogue, Italian urologists reiterate how lifestyle changes (for example, eliminating smoking, diet and maintaining a healthy weight) are extremely beneficial for those who suffer from urinary incontinence, since nicotine is a known bladder irritant and obesity weakens the pelvic floor.
The ’10 rules’ to best deal with urinary incontinence: 1. Do not consider it only as a disease, because it could be a symptom of a pathology that needs to be investigated and treated; 2. Losing urine is not a physiological process related only to age; 3. Protections must not represent a solution to the problem of incontinence, but the moment of transition between the diagnostic and therapeutic phase; 4. Maintaining regular intestinal function, fighting constipation, is useful for reducing the load on the muscular structures and pelvic organs; 5. Regular physical activity with walking and swimming helps to stay healthy, without excessive physical efforts that involve the abdominal muscles and the pelvic floor.
And again: 6. Stop smoking because nicotine is a known bladder irritant, as are foods such as chocolate, coffee, tea, carbonated or alcoholic drinks; 7. Control your weight: obesity weakens the pelvic floor and increases pressure on the bladder; 8. Urinating before intercourse can be useful to reduce losses during sexual intercourse; 9. If incontinence occurs, it is advisable to fill out a urination diary to bring to the urological visit to objectify the number of daily urinations, the amount of urine emitted spontaneously or lost; 10.i In case of incontinence, contact a urologist and do not hide behind the problem, but face it to solve it.
Thanks to ‘SIU Risponde’ – the note concludes – ample space will be given to the perception of the psychological discomfort of the population affected by incontinence when they realize they are affected by the pathology, in fact dealing with fears and shames that can be overcome even with the alliance of the specialist. Furthermore, Italian urologists will be available through this platform present on the portal www.siu.it to offer further information related to the theme of incontinence, knowing that they are not only health allies when they propose taking charge, having attention to the aspects related to the humanization of care and the best doctor/patient communication.
Among the many initiatives of the National Day there is also the training course for caregivers, in order to make them able to independently and correctly assist the affected person, and the mobilization in Italian municipalities with the invitation to municipalities for better management and greater availability of ‘bathrooms’ in Italian cities, as essential support structures for the management of the problem, especially in public spaces.
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