March 15, 2018
Bladder control is a widespread issue among adults. According to the National Association for Continence, one in five individuals older than 40 years of age suffers from urinary incontinence.
Urinary incontinence isn’t just a physical condition. It can also affect a patient’s quality of life. It causes many people to avoid activities, limit social interactions, become depressed and even struggle to get a good night’s sleep.
A challenge for sufferers
Even though it’s common and can cause problems, patients find the subject difficult to bring up with their doctors. According to the Agency for Healthcare Research and Quality, more than 50 percent of women never get treatment for their stress incontinence. Physicians can start the conversation by simply adding a question to their standard review of systems and expanding them as needed: Do you have any trouble holding your urine?
If yes:
- When do you notice leaking (exercise, coughing, after urinating)?
- Is there urgency associated with the leaking?
- Do you have any issues emptying your bladder (incomplete, takes too long, pain?)
- How often do you empty your bladder at night? During the day?
- Do you have pain when you urinate?
- Have you noticed a change in color/smell/appearance/volume of your urine?
- How impactful are your urinary issues to your daily life?
For men, all the same questions, plus:
- Is there any change in stream?
- Any sexual dysfunction (new, historical, or changing)?
Treatment options
After a diagnosis is made, available courses of treatment include:
- Behavioral therapy: Usually the first line of treatment is behavioral therapy. Treatments can include bladder training, scheduled bathroom trips, pelvic floor muscle exercises, and fluid and diet management.
- Medications: These are frequently used in combination with behavioral therapies and include anticholinergic or antispasmodic drugs, and/or topical hormonal therapy for females.
- Medical devices: Women can be prescribed devices such as urethral inserts, and pessaries or intra-vaginal devices, which are similar to diaphragms and support the bladder.
With your help, urinary incontinence doesn’t have to take over the lives of your patients. Start the discussion and tell them about the variety of treatments that can help them enjoy life without the worry of leakage.