Urinary Incontinence: How to Talk to Your Doctor
Evaluating Urinary Incontinence
Once you broach the subject, your doctor will usually ask questions to help determine what kind of incontinence you may have. Tests may also be needed to rule out potential causes contributing to incontinence like infections, diabetes, or other medical issues.
Sometimes doctors ask people to track their urination pattern for a few days or more. This "bladder diary" can include information such as how much liquid you drink each day, any drugs you take, and symptoms such as straining that may occur with incontinence, as well as when and how often it happens. You can also keep a bladder diary before you see a doctor so you are prepared to answer common questions.
Stepp says it helps doctors to know how a woman has tried to treat the symptoms -- and what treatments she's willing to try. “Many women go online for information and try to do Kegels,” he says. “I find out what they’ve tried and where they’re looking to go. Are they saying, 'I want help, but I don’t want surgery'? Or are they saying, 'I’ve been dealing with this for so long. Just take me to the O.R. and fix it'?”
Letting Your Doctor Know How You Feel
Kathleen knew she wanted to get help for her leaky bladder. "Once you have a problem with incontinence, it becomes all you think about," she says. "Even something as simple as going to a store takes planning.” She sought help early on, learned about her options, knew what she wanted to try first, and communicated her desires to her doctor.
Kathleen decided to have surgery to implant a urethral sling at Duke University Hospital in Durham, NC. Changes in the pelvic floor muscles can cause the bladder to move out of it's normal position and a sling helps hold it back in. She was pleased with the results.
Fourteen years later, however, she noticed symptoms of stress incontinence again. “I was just leaking a little,” she says. “But I knew about physical therapy and felt that if I worked on developing those muscles now, before it got really bad, I wouldn’t need to have surgery again.” She also wanted to avoid taking medications, if possible.