Urinary Incontinence: The Health Problem Women Won't Talk About

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Getting Help

Diagnosing stress incontinence usually isn't difficult if your physician does a thorough examination. "Many doctors don't take the time needed to identify your problem accurately," says G. Willy Davila, MD, chairman of gynecology at the Cleveland Clinic Florida in Weston. "They may recommend the wrong treatment."

Be especially wary if your doctor's first response is to write a prescription. The incontinence medications you hear about on TV are generally for urge incontinence and won't help stress incontinence.

If nondrug remedies don't work, there are prescription medications your doctor can try later in your treatment. If your problem is severe you may eventually need to see a urogynecologist, an ob-gyn who specializes in treating women with pelvic-floor dysfunction. For help finding one, go to the American Urogynecologic Society's Web site (www.augs.org) or visit www.mypelvichealth.org.

Therapies to treat stress incontinence range from simple and noninvasive to surgical repair. Start with the basic remedies and see if they give you some relief.

Cross Your Legs
This may be the universal posture of bladder distress, but it actually works, preventing embarrassing dribbles in 73 percent of women, researchers report. Whether you're standing or sitting, cross your legs and bend slightly forward whenever you feel a cough, sneeze, or hearty laugh coming on.

Train Your Pelvic-Floor Muscles
A 2004 study found that 49 percent of test subjects benefited from Kegel exercises. Most likely to be helped? Women with fewer than two leaking episodes a day. "Yet 99 percent of the women who walk into our center insist that Kegel exercises don't work," says Diane K. Newman, MSN, codirector of the Penn Center for Continence and Pelvic Health at the University of Pennsylvania Medical Center. "That's because most women do them incorrectly. Once a woman learns the right way to Kegel, the results can really be dramatic."

To find the right muscles to use, lie down, insert one or two fingers into your vagina, and contract your pelvic-floor muscles as if you were trying to stop urine flow; you should feel pressure on your fingers. One of the best ways to do Kegel exercises is to gradually contract these muscles for a count of four and then hold the contraction for another count of four. It takes about eight to 12 weeks of doing Kegels regularly (about five minutes, twice a day) to see results.

Continued on page 4:  More Treatments


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