Imagine not being able to sit through a movie or a meeting without having to take a bathroom break. Or not being able to pick up your grandchildren or exercise without risk of urinary leakage. 13% of men and 37% of women may be affected by some form of urinary incontinence. And a survey of people sitting in GP waiting rooms found that 65% of women and 30% of men report some type of urinary incontinence, yet only 31% of report having sought help from a health professional. Urinary Incontinence (UI) is a disorder that is often so distressing that it causes sufferers to choose to stop some of life's most pleasurable activities rather than seek help. UI is surprisingly widespread, and while the chances of it increase with ageing, it is not inevitable.
There are many conditions that can cause incontinence, including stroke, diabetes, and changes associated with growing older - though UI can happen at any age. And there are different types of incontinence. If activities like sneezing, laughing, coughing or carrying heavy objects result in leakage, it may be stress incontinence. People who have a strong need to urinate and don't reach the bathroom in time are experiencing urge incontinence. It is not uncommon for some people to experience both types of UI.
One of life's more difficult conversations comes if you believe someone you love has UI but is too embarrassed to seek help. Why has grandma stopped coming to visit? No matter what excuse she gives, bladder problems may be the real issue. And it isn't just grandma — why did you stop finding time for tennis or aerobics? Progressive social isolation and restriction of physical activities are coping behaviours that can minimise UI in the short term but are not good for physical or mental health.
The time to seek help is sooner, not later. Visit a healthcare professional armed with information that will help with diagnosis. Keep a "bladder diary": record trips to the bathroom and episodes of UI, as well as volume and type of fluids consumed, for at least a day or two prior to the visit. Be prepared to honestly describe how the UI is affecting your life. Most importantly, don't be ashamed to ask for help and don't accept that UI just comes with getting older or having had children. The first step in helping someone with UI is to help them understand they are not alone and that UI is treatable — often without surgery or taking a medication. Healthcare professionals can advise on both surgical and nonsurgical treatment options. In many cases, preventing and alleviating UI comes down to lifestyle changes.
- Obesity is linked to UI — still another reason to try and maintain a healthy weight.
- Some foods and beverages, including caffeine, carbonated beverages and foods with artificial sweeteners, may provoke bladder urgency or increase the amount of urine produced.
- Exercises called "Kegels" are easy to do and can help strengthen the pelvic floor muscles that are critical for keeping urine in the bladder.
As a physician, I know that dealing with incontinence is hard. As a caregiver, I know this can be an even more difficult subject to talk about with your loved one. But if you or someone you care for is experiencing frequent UI, it's time to start some important conversations, including one with your doctor or nurse, about ways to tackle the issue.
- 1. RACGP. Guidelines for preventive activities in general practice 9th edition. Accessed 6/2/2017.