Urinary Incontinence: What to Tell Your Doctor
Urinary Incontinence: What to Tell Your Doctor
Her doctor referred her to a urogynecologist, a specialist in urinary and associated pelvic floor problems. “I told him I wanted to try physical therapy first, unless it was something I couldn’t do because of prior surgery or other issues," Kathleen says.
The urogynecologist’s exam turned up two issues adding to her stress incontinence -- a weak urethra and a prolapsed, or dropped, bladder. He advised trying intensive pelvic floor physical therapy, including Kegel exercises, and referred her for nine weeks of treatment.
“He said that at the end of that time, if they sign off and say I’m doing great, I can do my therapy at home,” Kathleen says. “But if not, he wants to see me and we’ll discuss surgical options.”
When people are considering their treatment options, Kitegawa says, it’s important for doctors to make sure they have realistic expectations. “We know people want a ‘quick fix,’” he says. “That’s a possibility sometimes, but they need to know that physical therapy and lifestyle changes can have a much longer lasting impact.”
Your doctor may want you to start with these behavioral changes:
Urinary Incontinence: How to Talk to Your Doctor
Letting Your Doctor Know How You Feel continued...
Her doctor referred her to a urogynecologist, a specialist in urinary and associated pelvic floor problems. “I told him I wanted to try physical therapy first, unless it was something I couldn’t do because of prior surgery or other issues," Kathleen says.
The urogynecologist’s exam turned up two issues adding to her stress incontinence -- a weak urethra and a prolapsed, or dropped, bladder. He advised trying intensive pelvic floor physical therapy, including Kegel exercises, and referred her for nine weeks of treatment.
“He said that at the end of that time, if they sign off and say I’m doing great, I can do my therapy at home,” Kathleen says. “But if not, he wants to see me and we’ll discuss surgical options.”
Lifestyle Changes That Can Make a Big Difference
When people are considering their treatment options, Kitegawa says, it’s important for doctors to make sure they have realistic expectations. “We know people want a ‘quick fix,’” he says. “That’s a possibility sometimes, but they need to know that physical therapy and lifestyle changes can have a much longer lasting impact.”
Your doctor may want you to start with these behavioral changes:
- Cut caffeine, alcohol, and nicotine. Stepp and Kitagawa say this is critical. “If you cut your caffeine intake in half, you’ll notice a difference,” Stepp says. “If you eliminate it completely you’ll notice more of a difference.” Stepp calls alcohol the "double whammy": “Not only is it an irritant, it also makes you pee more. It increases the volume in the bladder.” And he is adamant about eliminating nicotine. “If you want to tackle bladder symptoms, you have to stop smoking,” Stepp says. “Nicotine stimulates urgency.” And coughing associated with smoking aggravates stress incontinence.
- Bladder retraining. In addition to eliminating caffeine, Kitagawa suggests restricting fluids prior to going to bed, if possible. "Timed voiding" -- going to the bathroom at regularly timed intervals -- is one way of retraining your bladder.
- Kegel exercises. These can help strengthen the muscles that hold urine in.
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