Urinary Incontinence

Cheryle Gartley

How should I mention my "leaking problem" to my doctor? What if he or she dismisses by concerns?

Many people find it difficult to discuss incontinence. In addition to feeling embarrassed, two other major difficulties may occur. First, you may not know what vocabulary to use in describing the problem, and second, you may have no idea of the information the doctor needs.

It’s like asking directions in a foreign country: The first step is to use "their" language. Briefly, stress urinary incontinence refers to leakage when coughing, sneezing, laughing, or doing anything that causes the abdominal pressure to override the bladder’s closure mechanism. Urge incontinence describes the compelling desire to urinate and the inability to delay voiding long enough to get to a toilet. Mixed incontinence is a combination of stress and urge incontinence. Overactive bladder or OAB is defined by urgency, with or without urge incontinence, usually with frequency and the need to urinate more than is normal at night. Think about how the symptom of incontinence occurs in your own particular case and be prepared to define its characteristics as precisely as you can.

Before you see your doctor or nurse, write down a list of medications you currently take, and your medical history, including any surgeries. Just as important: Keep a record called a "bladder diary" which includes times of urination, amount of fluid urinated, amount of fluid consumed and when incontinence accidents occur. You may want to request that your doctor’s office mail you a bladder diary to use before your appointment so you’ll be giving the doctor this information in the exact format he or she is used to having.

Research has shown that one of the major irritations doctors report is having a patient say "oh, by the way" just as the doctor is about to leave the examining room. Be sure that incontinence is first on your list of items to discuss so you have plenty of time for this important topic.

The world of medicine is both a science and an art. With today’s ever accelerating technology, no physician, no matter how competent, can treat every physical problem. So if you’ve done your part regarding good physician/patient communications and still receive an unhelpful response, or your doctor dismisses your concerns, be prepared to take additional action. Gently remind the doctor or nurse that you really do need help and that incontinence is a significant health challenge in your life. Be respectful and understanding if incontinence is not his or her expertise. Then ask his or her commitment to help you find a referral to a specialist who is interested and knowledgeable about diagnosing and treating incontinence.

Cheryle Gartley
Founder and President, the Simon Foundation for Continence
www.simonfoundation.org