Tips & Advice: Talking to Your Doctor

See Your Doctor to Treat Urinary Incontinence
Finding the Right Doctor for Incontinence
Before Seeing Your Doctor
Questions to Ask Your Doctor about Urinary Incontinence
Questions about Your Urinary Incontinence
During Your Appointment

See Your Doctor to Treat Urinary Incontinence

Urinary incontinence is a medical condition that affects more than 25 million people in the United States. It can often be treated or managed, but many people are reluctant to seek medical attention because they feel embarrassed or think that it's a normal part of aging. Seeing a doctor for your bladder control problems is important because you need to make sure that you're not suffering from a more serious issue, such as diabetes or a kidney infection. Incontinence is a sign that something isn't right with your body.

If the cause of your bladder problems is something as small as your medication or diet, incontinence treatment can be as simple as changing to a new medicine and changing what you eat. To successfully treat incontinence, you need to determine the cause. So if you're experiencing a loss of bladder control and its affecting your daily life, don't stay silent – contact your doctor! And while you're waiting to get treated, using protective absorbent products can help you stay dry and lead an active life.

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Finding the Right Doctor for Incontinence

Once you decide to get help for your bladder control problems, the first person you should contact is your primary care physician. He or she can easily treat you if the cause of your incontinence is due to an infection or medication. However, depending on the cause of your bladder issues, your doctor might refer you to a specialist who is trained to treat or manage urinary incontinence. You might also want to seek a second opinion if you don't agree with your doctor's suggestions or don't find him or her helpful. Below are a few types of specialists who can help you regain control over your bladder:

• Urologists are surgeons who specialize in the male and female systems and the male reproductive system.
• Gynecologists specialize in the woman's reproductive system.
• Urogynecologists are urologists or OB/GYNs who specialize in treating women experiencing pelvic floor disorders, such as uterine prolapse or urinary incontinence.
• Gastroenterologists are trained to treat digestive tract diseases, including those that result in bowel incontinence.
• Geriatricians specialize in treating elderly adults, who have a high risk of skin breakdown due to exposure to urine and stool.
• Physical therapists can help with pelvic strengthening exercises, which can help restore bladder control in individuals suffering from urinary incontinence.
• Neurologists specialize in diseases of the urinary system, several of which can affect bladder and urethral function and cause incontinence. These diseases include multiple sclerosis (MS), dementia, and Alzheimer's.

Depending on the severity of your incontinence, you might need to see more than one doctor or specialist. It's important that you find a doctor who is knowledgeable and whom you can trust and build a relationship with. It's also very important to have an open and honest discussion with all your doctors to get the most effective treatment. If you feel that your doctor is not adequate in treating you or is not taking you seriously, you have every right to contact one who will.

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Before Seeing Your Doctor

As you wait for your appointment day to arrive, get prepared by gathering information your doctor will need to properly diagnose and treat you. Keep a three-day voiding diary that lists all your symptoms when they appear, your urination habits, what you ate and drank, and any physical pain you experience.

Symptoms may include:

• difficulty urinating
• dribbling or urine leakage
• feeling like you can't completely empty your bladder
• weak urine flow

Urination habits include:

• when and how much you urinate
• any urinary leakage and what you were doing when it happened (ie. sneezing, running, or biking)
• how many times you felt a sudden urge to go but couldn't
• how often you woke up at night to use the bathroom

Below is an example of what your bladder journal may look like:

If you are using any incontinence products, note how many pads or briefs you use a day and how many times you have to change your clothes due to wetting accidents. Lastly, list all the medications and vitamin and herbal supplements you take as some can contribute to bladder control problems.

A bladder diary can help you and your doctor better understand the severity and cause of your incontinence problems.

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Questions to Ask Your Doctor about Urinary Incontinence

Being prepared for your doctor's appointment also means creating and bringing a list of questions to ask your physician. Oftentimes, people leave their doctor's office without asking all the questions they need. Here's a list to start you off:

1. What type of urinary incontinence do I have?
2. What is the cause(s) of my incontinence?
3. What kind of tests do you use to diagnose incontinence?
4. How can I treat my condition?
5. What are the risks or side effects of these treatments?
6. How long will it be before I stop leaking after these treatments?
7. How can I protect myself from wetting accidents?
8. If I leak while I exercise, should I stop exercising?
9. What lifestyle changes should I make to reduce incontinence symptoms?
10. Will I need surgery?

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Questions about Your Urinary Incontinence

When you seek treatment for urinary incontinence, your doctor or healthcare provider will need to ask you some questions. Here is a brief list:

1. Do you have trouble holding your urine?
2. Does your bladder feel empty after using the bathroom?
3. How often do you use the bathroom during the day?
4. How often do you wake up at night to use the bathroom?
5. What and how much fluid do you drink each day?
6. Are you constipated?
7. Do you have pain or a burning sensation when you urinate?
8. How much urine do you release?
9. Have you had any wetting accidents? What were you doing when it happened?
10. How has your problem affected your school and work life? Is it affecting your relationships with others, your sex life, or your emotional wellbeing?

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During Your Appointment

Discussing bladder control issues to a doctor is not an easy task. But in order to treat the problem, you have to understand the cause of the problem. Your doctor has seen it all and heard it all, so don't be embarrassed. Be as thorough as possible when describing your symptoms. For example, "leaking a little" may mean a few drops for one person, while it can mean soaking up one pad for another. Also make sure to tell your doctor if your urinary symptoms are interfering with your lifestyle, relationships (ie. family, friends, or romantic partner) or emotional wellbeing.

• Cystoscopy – Your doctor may insert a thin tube with a tiny camera into your urethra to look for any abnormalities in your urinary tract.
• Urodynamics – This test is used to measure bladder pressure and urine flow.
• Urinalysis – A sample of your urine will be taken to a lab to check for signs of infections or other abnormalities.
• Bladder Stress Test – With a full bladder, you will vigorously cough to see if any leakage occurs.

Once your doctor determines the cause of your incontinence, he or she will suggest treatment options, which may include bladder retraining, lifestyle changes, and pelvic exercises. Again, it is very important to see a doctor if you have bladder control problems, as it can be a sign of something more serious.

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