My mother is 76 years old. She is having problems with her kidneys. She is unable to make it to the bathroom without wetting. Is there some kind of treatment available?

-- Judy

Your mother is suffering from incontinence. There are many different types of incontinence and many different reasons for it. Sometimes, if the bladder and the urethra have dropped, urine will leak if one coughs or sneezes -- this is called stress incontinence. If the bladder becomes overdistended, urine may leak spontaneously (overflow incontinence). If the bladder muscle contracts spontaneously, leakage may occur (detrusor instability). Medical problems like diabetes or Alzheimer's may be a factor as well.

Incontinence can be treated. First an appropriate diagnosis must be made. It helps if you keep a diary of fluid intake, times leakage occurs and circumstances surrounding the episodes (for example, on way to bathroom, when getting up from a chair, during sleep, or when laughing); bring this diary to the doctor's appointment. Your mother's primary care doctor or gynecologist would be good places to start. Sometimes referral to a urologist is necessary.

Once a diagnosis is made, your mother can start appropriate treatment. This could be something as simple as better bladder habits, such as emptying the bladder regularly, cutting down on caffeine, and limiting fluids in the evening. Medications are available to treat the bladder spasms that are responsible for leakage in detrusor instability. Sometimes surgery is recommended for stress incontinence. A complete evaluation is the first step.