Urinary Incontinence: Starting the Conversation
Since discussing urinary incontinence is usually the biggest hurdle for people, some doctors have found ways to integrate it into the conversation.
“I’ve made asking whether women are leaking urine a part of my routine history that’s taken when they come in,” says Greg Kitagawa, MD, assistant professor in the department of reproductive biology at Case Western Reserve University and an ob-gyn at MetroHealth Medical Center in Cleveland. “That way I’ve already opened the door for them to discuss these things with me.” As a result, Kitagawa says, the topic is less threatening and patients are more open to talking about it.
So when should you talk about it with your doctor? Stepp says there's no amount of leaking that is too little to discuss. “A woman should speak to her doctor if it bothers her," he tells WebMD.
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.