If you're one of the many women who experience bladder control problems, don't let embarrassment keep you from getting the help you need. Leaking urine, having to urinate frequently and experiencing other symptoms of urinary incontinence aren't trivial consequences of childbirth or a natural part of aging.
Not all doctors routinely ask about urinary function during an exam. It's up to you to take the first step. If you have bladder control problems, tell your doctor about them and ask for help.
Why to seek help
Bladder control problems require medical attention for several reasons. Reduced bladder control may, for instance:
- Indicate a serious underlying medical condition, such as diabetes or kidney problems
- Cause you to restrict your physical activities
- Lead you to withdraw from social interactions
- Increase your risk of falling if you have balance problems and you often rush to the bathroom to avoid leaking urine
When to seek help
A few isolated incidents of urinary incontinence don't necessarily require medical attention. But if the problem continues or affects your quality of life, consider getting these symptoms evaluated.
Make an appointment with your primary care provider if:
- You're embarrassed by urine leakage, and you avoid important activities because of it.
- You often feel urgency to urinate and rush to a bathroom, but sometimes don't make it in time.
- You urinate much more frequently than you used to, such as at night, even when you don't have a bladder infection.
- You often feel the need to urinate, but you're unable to pass urine.
- You notice that your urine stream is getting progressively weaker, or you feel as if you can't empty your bladder well.
In most circumstances, symptoms can be improved.
When to seek a specialist
Many health care providers can treat bladder control problems without referring you to a specialist. But not all have the necessary training or experience. In spite of better understanding and treatment of urinary incontinence, some providers consider it an inevitable consequence of childbearing, menopause or normal aging — a belief that makes them unlikely to consider you for evaluation or treatment.
If your doctor dismisses significant symptoms or seems uninformed about the many possible treatments, ask for referral to a specialist. Doctors who specialize in urinary disorders include:
- Urogynecologist. This is an obstetrician-gynecologist with additional training in problems that affect a woman's pelvic floor — the network of muscles, ligaments, connective tissue and nerves that helps support and control the bladder and other pelvic organs.
- Urologist. A urologist specializes in male and female urinary disorders, as well as the male reproductive system.
- Geriatrician. This medical doctor specializes in the care of older adults, often with emphasis on problems related to common quality-of-life issues, such as urinary incontinence.
Bladder diary: A detailed symptom record
Before your visit, ask your doctor's office for a bladder diary and how to use it so you can track information for several days in a row. This diary is a detailed, day-to-day record of your symptoms and other information related to your urinary habits. It can help you and your doctor determine the causes of bladder control problems.
To determine the amount of urine you pass, you can use any collection device that allows you to measure ounces or milliliters. There are special measuring devices that fit over the toilet rim, but any measuring cup will do.
Medical history review
Your visit will be more productive if you provide a good medical history. Make a list of:
- Any surgeries, childbirths, illnesses, injuries and medical procedures, along with approximate dates
- Current health problems, such as diabetes or any condition that affects your ability to walk or rise rapidly to a standing position
- Past and current problems with your urinary system
- Medications you're taking, including each drug's brand or generic name, dosage, when you take it, and what you take it for
Medications can be associated with bladder control problems, so list everything — prescriptions, over-the-counter drugs, vitamins, minerals, herbs and other supplements. If you're not sure whether something counts as a medication, put it on the list.
What to expect from treatment
Treatments for bladder control problems start with learning how to improve your bladder symptoms and typically include exercises. Some people will need medications, while others might need surgery. What's best for you depends on the type and severity of your bladder control problem — nearly all women can be helped through some form of treatment.
Your bladder function may greatly improve after treatment. Any improvement, however, counts as a success, as long as it frees you to do what you like and enhances your quality of life.