Urinary incontinence or leaking is a common condition in women. It affects upwards of 16 million Americans and is more common in our population than diabetes or hypertension. Despite this fact, it is often unrecognized or unappreciated as a treatable condition. There may be many reasons for this but one of them is the embarrassing nature of this disease and people’s reluctance to discuss it with their doctors.
Most women manage it by wearing absorbent products. This is why there is more grocery store shelf space for adult diapers and absorbent products than for infant care. Others isolate themselves socially for fear of an embarrassing accident. These women are often doing themselves a disservice as there are many therapies available with excellent results in restoring continence and confidence.
Some myths about incontinence:
• MYTH: It is an inevitable process of getting older. REALITY: There is no doubt that the incidence of incontinence increases with age but that doesn’t make it normal or inevitable. Women over the age of 50 respond to therapy just as well as younger women and get satisfactory relief in the vast majority of cases. 
• MYTH: Surgery is the only treatment option. REALITY: Surgery plays a role in some forms of incontinence but most incontinence is treated with either behavioral therapy, pharmacotherapy with medications or physical therapy with pelvic floor muscle strengthening.
• MYTH: Nothing works in treating incontinence, my friend had surgery and it didn’t work. REALITY: There are multiple therapies for treating all types of incontinence. Yes all therapies are not 100% effective, but do improve symptoms in over 90% of patients who seek care. Surgical cure rates for certain types of incontinence are around 90% and surgical failures are uncommon in properly selected patients.
What should I do if I am experiencing incontinence?
• Talk to your doctor (Family doctor, Internist or Gynecologist) by setting up a visit to discuss your incontinence problem. Don’t try to talk about it at a visit where you are also addressing other problems.
• If your doctor is not comfortable managing urinary incontinence ask for a referral to a local physician who can help you with your concerns.
• If you are concerned about surgery ask your doctor for non-surgical options (there are always non-surgical options)
What can I do myself to help with incontinence?
This will depend to some extent on what type of incontinence you are experiencing but here are a few suggestions:
• Avoid caffeinated substances.
• Avoid drinking large volumes of fluids (like some diets suggest)
• Kegel’s exercises are often recommended but research suggests they are difficult to master without the help of a physical therapist and biofeedback. However, there is new evidence that Pilates exercises can mimic some aspects of Kegel’s exercises and help strengthen the pelvic floor which can reduce incontinence episodes.
• Urinate on a regular schedule at least every 2.5 to 3 hours.
by: Steve Swift, M.D.