This may take a while. Luckily, I am patient (the use of this word to refer to a person receiving medical treatment must not be an etymologic accident, since patients spend so much of their time waiting).
Although there are solid, scientific reasons why the continence we learned so well as children may occasionally or even frequently elude us as we get older, urinary incontinence is not an inevitable part of aging. Millions of women worldwide have experienced urinary incontinence for a variety of reasons: women’s urethras are shorter than men’s, at about four centimeters (less than two inches); childbirth causes changes to pelvic organs and tissues; and women experience menopause, to name just a few. Unfortunately, it is currently estimated that fewer than half of incontinent women share their bladder control issues with their health care provider. The condition is not shameful and is treatable in almost every situation.
Do you know the location of each bathroom in every mall and public place? Do you leak when you cough, sneeze or exert yourself? Do you spend hours each week doing countless loads of laundry? Is your life ruled by your bladder? When you’re ready to address your incontinence head-on, there is no substitute for a thorough diagnostic workup. This starts with a full medical history shared with a physician (or other qualified health care provider) whom you trust, and who will listen carefully and seriously to your concerns. Explain in detail how the loss of bladder control is affecting your life physically, socially, and emotionally.
Once a diagnosis has been firmly established, you and your healthcare provider can discuss the various treatment options open to you. Often, in formulating your long-term treatment plan, several options are available and can be used either simultaneously or sequentially to maximize your continence margin (the combination of physical factors that keep you dry at any given point). Each person’s continence margin varies at different times in life. Generally, our margin is wider when we are young, and it may take many factors being “out of sync” to make us lose urine. As we age, our continence margin may be narrower, and a simple urinary tract infection may push us, possibly only temporarily, into the “leakage zone.”
Urinary incontinence plagues over half of all nursing home residents and is one of the most common reasons that women enter long-term care and nursing facilities. In the process of losing control of their bladders, they often lose control of their lives as well. Much has been written about the depression associated with untreated incontinence and how lives are negatively affected through the social isolation, emotional turmoil, and physical debilitation that this condition brings. Do not despair! Effective treatments to improve incontinence are currently available, and new treatments are continually being developed while older ones are refined.
Billions of taxpayer dollars — the current estimate is 62 billion — are spent on urinary incontinence in the United States each year. This money primarily funds the routine care associated with incontinence (such as diapers, skin breakdown care, home-health aides) and some of the inadvertent consequences that may be associated with incontinence (treatment of a hip fracture resulting from a fall on a puddle of leaked urine). Absorbent products (diapers and pads) are, overall, very useful, and their rightful place should not be underestimated. These products work best when utilized as part of an overall plan, however, and not viewed as a treatment, because they do not treat the condition. By comparison, little money is spent on diagnosis and treatment of urinary incontinence.
Now is the time to take charge of your condition in order to have control over your bladder for life.
Dr. Jill M. Rabin is an Associate Professor of Clinical Obstetrics, Gynecology & Women’s Health at the Albert Einstein College of Medicine, Bronx, New York, and Chief of the Division of Ambulatory Care and Head of Urogynecology at the Long Island Jewish Medical Center, North Shore-LIJ Health System, New Hyde Park, New York. Dr. Rabin and Gail Stein are co-authors of a new book entitled “Mind Over Bladder…I Never Met A Bathroom I Didn’t Like,” which can be purchased on Amazon.com and BarnesandNoble.com. For more information, go to www.mindoverbladderbooks. com. health.incontinence.cover
