No Need to Be Embarassed by Incontinence
If you experience symptoms of incontinence, don’t be ashamed—you’re not alone! Nineteen percent (19%) of women under 45 and nearly 80% of those over age 80 have some form of incontinence. The numbers for men are somewhat lower, but at least 5% of younger men and 21% of men over 65 also experience it. Those are big numbers. And less than half of the patients who have concerns about incontinence actually bring it up in a medical visit. You don’t have to be embarrassed! Don’t let incontinence keep you at home or limit your social activities. Let’s talk about this common and very treatable problem.
In addition to age and gender, other risk factors include obesity, history of constipation, neuropsychiatric conditions (multiple sclerosis or dementia), and history of trauma (anything from normal childbirth to radiation for cancer or prostate surgery in men).
I ask incontinent patients to keep a “voiding diary” for three days. That is, they record when they go to the bathroom, when they have an accident (and approximately how much), and any kind of triggers (such as drinking a lot of liquid). It’s great if they can work on this before coming in for a visit so we can go over it together and understand what’s going on.
The good news is that some of the best treatment approaches are non-invasive and don’t cost a thing. Often, “kegel” exercises, which strengthen the pelvic floor, are very effective for women. Like any form of exercise, the key is to do it consistently over a long period of time to strengthen the muscles that support the bladder. Another simple solution is referred to as “timed voiding,” or bladder training. With this exercise, you train yourself to hold the urine for a specified period of time, then increase the intervals to train the bladder, along with the related muscles and nerves, to hold on until you are actually ready to go. You can work on both of these approaches at any time on your own.
There are many good, effective medications, especially for men who may have symptoms of frequency, urgency, and incontinence related to prostate issues. It takes about a month before you’ll know for sure whether or not a particular drug is effective for you, so be patient.
The last mainstay of treatment is surgery, and it’s only effective for certain kinds of incontinence. If you’re wondering whether surgery is an option for you, ask your medical provider. S/he can perform certain tests to determine the root cause of the problem, which will indicate whether you’re a good surgical candidate.
Protective undergarments, while they may seem embarrassing, are used by a large number of people. Even if you experience incontinence symptoms infrequently, you may want to try them when you go out in public or on trips just for peace of mind, to make you feel more confident and comfortable.
Get symptoms checked out right away--you’ll want your clinician to quickly rule out infections or other complications. You can make the situation worse by delaying diagnosis and treatment.
Incontinence is common and treatable! So don’t let embarrassment stop you from talking to your medical provider about it today.