Female Urology, Incontinence

Incontinence, simply defined, is the involuntary loss of urine. That means that a woman leaks urine into pads or underwear. It might just dampen the underwear or it might soak it. It is a persistent medical and social problem for millions of women of all ages. I have this embarrassing problem, am I stuck with it? The good news is that with proper treatment, the overwhelming majority of women who experience this problem can be cured or dramatically improved.

Who can help me get better?

Finding the right doctor can be a challenge. Traditionally, women with urinary tract problems have sought help from both urologists and gynecologists, and doctors of both specialties can offer helpful advice and treatment for these conditions.

Recently, a new sub-specialty has emerged that combines the expertise of urology and gynecology. It is called urogynecology by gynecologists and female urology by urologists. Most of the time, a urogynecologist or female urologist will know more about your problem than a doctor who does not specialize in women's urinary problems.

{mosbanner:id=1:right:0}A doctor with interest and expertise will know how to determine the likely causes of your symptoms. Not all incontinence is the same. For example, if you leak urine when you cough, laugh, or sneeze, you probably have what is called stress (sphincteric) incontinence. If you feel a strong urge to urinate and have to rush to the bathroom but can't get there in time, you probably suffer from an overactive bladder. The treatments for these two conditions are very different so it's important that you obtain an accurate diagnosis. Choosing the right doctor is the first step towards obtaining an accurate diagnosis.

So, how do I find the right doctor?

First, ask people who know, other doctors, doctors in training, nurses or friends who have incontinence.

Second, check the doctor's credentials. He or she should be board certified in urology or gynecology. A fellowship in female urology or urogynecology is a plus. As a general rule, the younger the doctor, the less experienced he or she is.

Third, ask a lot of questions.

Whether you choose a urologist, a gynecologist, or a practice that includes both kinds of doctors is a personal choice, but whatever you decide, you should be confident that your physician has the knowledge and experience to help you get better, and that he or she is familiar with the wide variety of tests and treatments that can help you conquer your problem.

What should I ask the doctor?

Ask the doctor:

  • how many patients he/she treats for incontinence;
  • how he/she evaluates the patient;
  • what possible treatment options there are;
  • how often or how many patients he/she operates on for incontinence; and
  • what the likelihood of a successful outcome there is for each treatment option.

What should the doctor do?

Doctors should:

  • Spend enough time with you.
  • Take a detailed history
  • Do a careful physical examination, (including an examination with a full bladder so the incontinence can be observed)
  • Do a urinalysis
  • Ask you to complete a diary (record the time and amount of each urination and describe any episodes of incontinence).
  • Ask you to do a "pad test," (wear your pads for a 24-hour period and bring them back to the doctor's office the next day so that he can determine how much urine you lost).
  • Based on these results, your doctor may recommend more advanced tests, such as urodynamics and cystoscopy, which involve the direct measurements and visual observations of your bladder.
  • Arrive at an accurate diagnosis and recommend treatment.

What kinds of treatments are there?

Treatments range from simple, non-invasive medical therapies, such as medication, to surgery, depending upon the particulars of your case.

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