As a practicing urologist who is double board certified in urology and female pelvic medicine and reconstructive surgery, I see a lot of patients with urinary incontinence. And while it is extremely common, many myths surround the topic. Sadly, even though more patients in the U.S. suffer from overactive bladder than diabetes, there is very little education surrounding incontinence and other pelvic floor disorders.
One common misconception I hear is “you have to drink eight glasses of water.” Says who? Was it your doctor? Maybe. There are a few medical conditions where you need to drink extra water, kidney stones being one of them. However, the more you drink, the more you urinate. So, if you are having urinary issues, the first step is likely to cut back on fluids and simply drink when you are thirsty.
It is also important to note that some bladder medications can be dangerous. Anticholinergics are the most prescribed group of medications for urinary leakage with urgency and overactive bladder. Recent studies have shown an association between these drugs and dementia. If you take these drugs, you may be up to 50 percent more likely to get dementia. The risk increases with age and with longer medication use. The good news is there are newer, safer medications available, which are often covered by your insurance. Be sure to review your medication list with your doctor and confirm if the medications you are taking are right for you.
Additionally, not all bladder leakage is the same. There are several types, and they are treated differently. If you leak with activity, like coughing, laughing, sneezing or exercise, a simple office procedure or same day surgery may be appropriate. On the other hand, if you are making constant trips to the bathroom or having leakage with a strong urge to urinate, a medication, Botox injection or implantable bladder pacemaker may be the answer. Keeping a bladder diary of how much you drink, when you urinate, and what you are doing at the time of leakage can be a tool to help determine which type of leakage you have. Bladder diaries are free and available online or may be provided by your doctor.
Lastly, I wish more people knew that incontinence is not normal. It is not a part of aging that must be accepted, or a consequence of childbirth that cannot be helped. If you or someone you know suffers from urinary incontinence or other pelvic floor disorders, please talk to your urologist. There are many treatments available to help you improve your quality of life.
Richard P. Holm, MD passed away in March 2020 after a battle with pancreatic cancer. He is founder of The Prairie Doc®. For free and easy access to the entire Prairie Doc® ® library, visit www.prairiedoc.org and follow Prairie Doc® on Facebook. Lauren Wood Thum, M.D. is a contributing Prairie Doc® columnist. She is double board certified in urology and female pelvic medicine and reconstructive surgery with a practice based in Sioux Falls, South Dakota.
