Dr. Jennifer Berman – Sexual Health Expert in Los Angeles

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Seven Things to Tell Your Doctor on Your First Appointment Related to Urinary Tract Health and/or Bladder Leakage

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Going to the doctor can be a challenging process. Due to the limited time in our hectic lives, we often don’t make our routine health a priority until something goes wrong. Even when we do take the time to go in, it is very challenging to communicate with the doctor due to the “15 min slot of time”, and it is especially difficult to talk about subjects that are embarrassing to speak with our close friends about much less our doctors.

One of the most common subjects that women struggle with talking about is incontinence—the unintentional leakage of urine that is sufficient in amount and frequency to cause physical and/or emotional distress. Incontinence is a hard subject to talk about, but when it turns into something that debilitates your quality of life, it is time to ask for help.

Bladder leakage is not something to be embarrassed about, and you are absolutely not alone. It is a medical problem, and your doctor or nurse can help you find a solution. When it comes to incontinence or bladder leakage here are some recommendations:

  1. Talk to your doctor about when your symptoms started and for how long you have been experiencing them.

There are many types of incontinence, so this is incredibly important. Talking about your specific urination pattern with your doctor will help you figure out what kind you have and will also help your doctor figure out what is the best way to treat it. As I mentioned earlier, there are many types of incontinence: Stress, Urge, Overactive Bladder, Functional, Overflow, Mixed, Transient, etc., so it is very important to observe as much as possible about your urinary incontinence so you and your doctor can develop the right treatment for you.

  1. Let your doctor know how the problem is affecting you and your life.

This is your body and your life, so don’t under-exaggerate! Like I said before, this is a real medical problem, and it is nothing to be embarrassed about. Be thorough when talking about your symptoms. Don’t let shame or embarrassment be the reason you don’t get the treatment you need. Talk about what activities it inhibits you from doing or interferes with. You do not have to redefine yourself or feel like you plan your life around the bathroom.

  1. Be clear and truthful about your lifestyle and behavioral patterns

Sometimes your behavioral patterns can actually be a primary cause of your urinary incontinence. For example, the amount of fluids you drink, certain foods you may be eating, and your voiding patterns can all affect urinary tract health and bladder function and control. There are also many prescription drugs as well as common supplements that have been found to make incontinence worse. Some of the common triggers for urinary incontinence are caffeine, alcohol and nicotine, spicy foods and even chocolate—so if any of these are a staple in your life cutting them out could potentially be the solution! But whether solutions are achieved through lifestyle and behavioral changes, medication, products from companies such as Depend®, surgery, or a combination of treatments, talking honestly and openly with your doctor can get you on the right track.

  1. Tell your doctor if urinating is painful, if you have pelvic pain, if there is blood in your urine, or if you have symptoms that come on very fast or dramatically.

Although this is not commonly the case, sometimes urinary incontinence can be a sign of a larger or more urgent problem. If you are experiencing any or all of the symptoms above, it is even more important to honestly discuss the situation with a medical professional.

  1. Tell your doctor if you are also having trouble with your bowel movements

There are two reasons to talk about this: first, constipation can put pressure on the bladder, and second, patients with bowel problems often have urinary problems and vice versa. Nerves that control the bladder also control the sigmoid colon, which causes some people to leak both stool and urine.

  1. Tell your doctor if you experience any pain or discomfort during intercourse

Patients rarely volunteer information about how their sex lives are negatively affected by urinary incontinence. Women with incontinence are often afraid of leakage or pain during sex, and, as a result, they avoid intimate situations. It is important to talk to your doctor about pain during intercourse because it can be a sign of hormone imbalance. In some cases, women will leak with penetration due to pressure on the bladder, and in other cases, women may leak during orgasm. There are many methods and ways to cure or at least ease incontinence, so if you are experiencing any pain or fear of leakage during sex tell your doctor.

  1. Ask about the symptoms associated with vulvovaginal atrophy

Many women with incontinence and symptoms of dryness, irritation, soreness and urinary urgency and frequency have vulvovaginal atrophy, yet women frequently do not report symptoms and thus it goes untreated. It is very important to talk to your doctor about this, because it can be very easily treated with topical vaginal estrogen.

You don’t have to live with urinary incontinence. It is extremely common and there are a lot of options that are easy, low risk, and non-surgical. Many people live with urinary incontinence, and, as a result, may withdraw socially or become depressed because they never get diagnosed or treated for it. Many are embarrassed to bring it up with their doctors, or simply believe that there is nothing that can be done. Don’t be one of those people! Talk to your doctor, get your life back, and start getting the relief you want and deserve.

Questions:

I’m trying to resolve my own incontinence by changing my diet and losing weight. While I leak less, it’s not completely gone. How will I know when to give up and just go to the doctor?

If your attempts to change your lifestyle don’t work, then it is time to go to the doctor. Many people feel that it is a problem that they have to live with, that it comes with age and that there is nothing to do about it. However, most people who have urinary incontinence can be helped. If you cannot solve the problem yourself, you should seek help from a medical professional.

The doctor tells me I need a bladder suspension. What’s involved in this surgery?

Bladder suspension refers to surgery that helps place a sagging bladder back into its normal position. In a traditional bladder sling surgery, the doctor uses strips of tissue to create a sling around the neck of the bladder and the urethra. The sling provides support to your urethra when pressure is placed on the bladder.

Do Kegels work for men?

Kegel exercises, much like lifting weights, help you strengthen muscles. The exercises target the muscles of the pelvic floor, which are medically termed the pubococcygeus. Both men and women have these muscles, which provide support to pelvic organs. With that being said, some research does suggest that Kegels may help restore bladder control after prostate surgery, improve erectile dysfunction, delay premature ejaculation, and perhaps even boost libido in men.

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