Treating Incontinence

November/December 2005

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Treating Incontinence

Photo: Linda A. Cicero

On sabbatical visits to England, Denmark and Switzerland, urologist Chris Constantinou was intrigued by the work of so-called continence advisers.

“In Europe the concept of conservative treatment for incontinence is very much alive,” the associate professor of urology says. “The idea is that you can help people strengthen their pelvic floor and the muscles that hold the bladder.”

At a time when more than 11 million women in the United States are dealing with incontinence, Constantinou says the difficulty costs “billions of dollars” annually for protective devices like diapers, and for injuries that result when women get out of bed at night and take a bad fall.

“In addition to the monetary costs, there are social costs,” he adds. “Older women don’t leave their homes, and withdraw from society. And because retirement homes will not take an incontinent person, they have to go into a nursing home, which is a lot more expensive.”

The cause of incontinence most often is associated with childbirth; a woman’s risk increases with the number of children she bears (particularly via vaginal delivery) and the size of the infants. But measuring the extent of a woman’s incontinence—and identifying the muscles that are affected—has always been difficult.

With a $500,000 grant from the National Institutes of Health, Constantinou is now developing a diagnostic vaginal probe. “Instead of having one [physician’s] finger pressed against the muscles, the probe has four elements that can measure the force of muscle contractions from different directions in calibrated ways.” The probe can identify the strength and endurance of particular muscles, and physicians can work with patients to develop those muscles.

Constantinou is in the second year of clinical trials, working with women who serve as “educators” for medical school students, and with female volunteers from a local yoga class. He expects to ultimately manufacture two devices: one for physicians’ diagnostic uses and another that can be used in the privacy of one’s home.


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