Suffer No More In Silence – Urinary Incontinence
by Ngozi Osuagwu, MD | October 1st, 2017
“Every time I cough or sneeze, I wet my under wear, I have to wear a pad every day”
“I hate the fact that when I need to use the bathroom, I wet myself before I get to the bathroom”
“Ever since I had my baby, I find that I cannot hold my urine”
“Everywhere I go, I have to locate the nearest bathroom”
When we have no control over urinating, it is called urinary incontinence. It is a common condition in women that can occur at any age. Unfortunately, many women are embarrassed to talk about it and would rather suffer in silence. I always tell women, if your quality of life is not good and you have reached a point where it is affecting your life and limiting your activity, then it is time to get help. TALK WITH YOUR PHYSICIAN.
Urinary incontinence can be divided into three broad categories and depending on the cause, the treatment options are different.
- Stress urinary incontinence – losing urine when coughing, sneezing, laughing or exercising.
- Urge incontinence – when you cannot hold your urine in time to get to the bathroom.
- Mixed incontinence – a combination of both.
The work up for urinary incontinence often starts with a thorough history. Your doctor will want to know when the problem started and how it is affecting your life. They will want to know about your medical history especially all the medications that you are taking. Some types of medicines can cause urinary incontinence. For example, if you are on a diuretic for high blood pressure, you might notice that you are urinating a lot. Your physician might need to adjust the dosage or the time that you are taking the medication.
After a history, a physical exam will be done. Sometimes the condition may be related to the tone of your vagina especially after a vaginal delivery. If this is the case, your doctor may recommend pelvic floor physical therapy. Your doctor might have you do a voiding diary for 2 -3 days to get an idea of what you are drinking and how that may play a role in your symptoms. After reviewing your diary, the doctor may suggest that you stop drinking after a certain hour. Your doctor may even suggest timed voiding where you are encouraged to void every few hours whether you feel like urinating or not. Losing weight may also be a treatment option. Your doctor will send your urine for analysis to make sure that you do not have an infection.
If conservative methods do not help, you will be referred to an urogynecologist. An urogynecologist is a physician that has finished an OB/GYN residency and has done additional training to take care of women with urinary problems. For some women, they may need complex testing called urodynamic testing, they may need medication or they may need surgery.
Bottom Line: If you have urinary incontinence, talk with your physician. Get the necessary work up and do know that if your primary care physician or gynecologist cannot help you with the problem, you can be referred to an urogynecologist. DO NOT SUFFER IN SILENCE.
