Bladder control problems: How to seek treatment

If you have bladder control problems, don't let embarrassment keep you from getting the help you need. Leaking urine, having to urinate a lot, and other symptoms of urinary incontinence aren't just a natural part of aging.

Your health care provider might not ask about urinary problems during an exam. But if you have concerns, it's important to tell your provider about them and ask for help.

Problems with bladder control may cause you to:

• Be less active.
• Withdraw from social situations, having less contact with people. This could even lead to depression.
• Rush to the bathroom before urine leaks, putting you at a greater risk of falling.

Leaking urine only every so often may not mean you need medical care. It's also common as you get older to wake up to pass urine at night. But if your problem affects your quality of life, think about making an appointment to be evaluated.

Contact your primary care provider for a visit if:

• You're embarrassed by urine leakage, and you miss important activities because of it.
• You often rush to a bathroom, but can't make it in time.
• You often feel the need to pee but pass little or no urine.
• Your urine stream is getting weaker, or you feel as if you can't empty your bladder all the way.

In many cases, treatment can provide relief from your symptoms.

You may be able to have your bladder control problem checked without a trip to a specialist. But if your provider doesn't think your problems are serious or if treatment doesn't work, ask to see a specialist. Health care providers who specialize in urinary disorders include:

• Geriatrician. This is a doctor who specializes in the care of older adults, often dealing with quality-of-life issues, such as urinary incontinence.
• Urogynecologist. This is a doctor who specializes in conditions that affect the female reproductive system and urinary tract with extra training in problems that affect the pelvic floor. The pelvic floor is the network of muscles, ligaments, connective tissue, and nerves that helps support and control your bladder and other pelvic organs.
• Urologist. This type of doctor specializes in male and female urinary problems, and the male reproductive system.

Before your visit, your health care provider may ask you to fill out a bladder diary. A bladder diary is a complete, day-to-day record of your urinary habits. You track information for several days in a row.

To record how much urine you pass each day, you can use any collection container that allows you to measure ounces or milliliters.

A bladder diary may help your provider find the cause of your bladder control problem. Knowing the cause can lead to effective treatment.

You can get the most out of your visit with your health care provider if you can give details about your medical history. Make a list of:

• Any surgeries, childbirths, illnesses, injuries or medical tests you've had. Also note when they happened.
• Current health conditions you may have, such as diabetes or any condition that affects walking or getting up quickly to stand.
• Any problems you've had with your urinary system, now or in the past.
• Medicines you take. Note how much you take, when you take it and what you take it for.

Some medicines cause bladder control problems, so list everything. This includes prescription medicines, over-the-counter drugs, vitamins, minerals, herbs and other supplements. If you're not sure whether something counts as a medicine, put it on the list anyway.

As a first step, your health care provider may suggest lifestyle changes to "train" your bladder. These may include exercises, called Kegel exercises, that strengthen the pelvic floor muscles. You also may follow a schedule for when you drink fluids and use the bathroom.

For some people, medicines help. For others, surgery provides effective treatment. But these treatments both have side effects. Talk with your provider about possible side effects before deciding on a treatment option.

Your condition may get a lot better after treatment. Or it may get only a little bit better. But any improvement counts as a success, as long as it helps you keep doing the things you like to do and enhances your quality of life.