Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

Urinary Incontinence: A Taboo Subject?

Urinary incontinence affects millions of women – 38% of women over the age of 60 – yet only 45% ever seek help for it. Men suffer from the problem too but at about half the rate. Only 22% of men seek help.

Why is this a taboo subject? One reason is that it’s an embarrassing – even infantilizing – problem. But patients’ shame is, well, a shame. Because urinary incontinence – the involuntary leakage of urine – can often be treated quite successfully. The first step is to make a proper diagnosis. One common type is “urge incontinence” – the bladder contracting when a person isn’t ready to urinate and can’t get to the toilet fast enough. Another common type, especially after childbirth or in athletes, is “stress incontinence.” It happens when there is a weakness in the pelvic muscles supporting the bladder and urethra (the structure through which urine exits the bladder), causing the urethra to lose its seal and allowing urine to escape when there is increased pressure on the bladder (e.g. coughing, sneezing, laughing, lifting, or exercise). As women get older, it’s more likely they will develop urge rather than stress incontinence. A very simple three question test has been created to help with the diagnosis.

It’s important to get a complete, head to toe medical evaluation because urinary incontinence may be a symptom of an underlying condition (e.g., neurological problem, diabetes, urinary tract infection, chronic bladder inflammation, or even a tumor) or may be a result of medication. Talk to your primary health provider and/or gynecologist. If needed, a specialist (e.g., urologist or urogynecologist) can be consulted.

Treatments for urge incontinence include bladder retraining and pelvic muscle exercises, medications to relax the bladder, and decreasing fluid intake. Approaches to stress incontinence include weight loss if obesity is present, a vaginal pessary, and surgery.

In today’s segment of CBS Doc Dot Com, Dr. Lori Warren and Dr. Jody Blanco, gynecologists with expertise in urinary incontinence, discuss the problem. You’ll meet a woman who overcame her embarrassment, sought help from Dr. Blanco, and is now symptom free after surgery.

There are several online resources on the subject, listed at the end of an excellent discussion in the online medical database,

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »

Commented - Most Popular Articles