Just because something is common does not mean it is normal. Many diseases are common nowadays, yet few would consider them normal. For example, while obesity and diabetes are rampant, none would argue that these conditions are normal or should go untreated. However, when it comes to problems of the urinary tract, this is often the case. Millions of individuals suffer from urinary incontinence – the involuntary loss of urine. Leakage can occur due to a strong “gotta go, gotta go” urge, activity such as coughing or laughing, or even without awareness. Few people seek treatment for these bothersome, yet very treatable, conditions.
On average, patients wait six years or more to bring these urinary complaints to their physicians. And some never do. Many are under the impression that incontinence is a normal part of aging, or something one must simply live with. This could not be further from the truth. Leakage itself is rarely dangerous, however serious consequences can arise from incontinence. Waking frequently at night or rushing to the bathroom can lead to falls, which in turn can result in injury and even the need for nursing home care.
These situations, while dangerous, are oftentimes completely preventable. The first step is a careful history and physical examination by a specialist. People leak for a multitude of reasons, and successful treatment depends upon correct diagnosis. Most types of leakage can be eliminated or cured. Depending on the cause, often a trial of simple behavioral modifications can do the trick. These may include limiting fluid intake, avoiding bladder irritants or urinating on a set schedule. Pelvic floor physical therapy may also be an option.
Some patients with a constant urge to urinate, frequent urination, or night waking may require the help of a medication. And not all medications have bothersome side effects. Fortunately, other options do exist. If medication does not work or is not appropriate, we have a multitude of office-based procedures in addition to minor surgical ones. For leakage with activity, a ten-minute procedure can cure leakage for years to come. Not every treatment option is appropriate for every patient, but the bottom line is that options do exist.
It saddens me to think of the number of individuals who suffer in silence with these and other very treatable complaints. And while these conditions affect up to half or more of all adults, they are not “normal.” If you are bothered by urinary complaints, be sure to let your doctor know and seek out the help of a urologist who specializes in pelvic medicine. Your quality of life could improve dramatically, and you will be glad you did.
Lauren Wood Thum, M.D. practicing urology in Sioux Falls, South Dakota, is a contributing Prairie Doc® columnist. 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.