Everywhere you look, there are ads for incontinence products. No wonder: urinary incontinence affects more than 25 million people in the United States, according to the National Association for Continence. And while sales of adult diapers now outpace sales of baby diapers, incontinence is rarely discussed. UR Medicine urogynecologist Dr. Gunhilde Buchsbaum dispels myths about urinary incontinence and offers advice and tips for prevention.
MYTH: Incontinence is the same for everyone.
FACT: Incontinence affects every person differently; the problem can range from an occasional minor “leak” to leaving puddles on to way the bathroom. There are different types of incontinence: the two most common are:
- Stress incontinence, which occurs with pressure on the bladder from activity such as coughing, sneezing or running causes urine loss.
- Urge incontinence, also known as “overactive bladder,” which causes urine loss with a strong and sudden urge to urinate.
MYTH: Incontinence is a normal and inevitable part of old age.
FACT: Urinary incontinence is a common problem; the risk that you’ll experience it increases with age, but it is not an inevitable part of getting older. Women of any age, even high school cheerleaders exerting pressure on bladders with their gymnastics, can be affected. The good news is that much can be done to alleviate symptoms or eliminate the problem entirely. However, one size does not fit all and treatment should be individualized.
MYTH: Incontinence is just a nuisance and not a health problem.
FACT: Urinary incontinence has serious health and social consequences. It’s linked with depression, decreased activity and social withdrawal. Older women with incontinence who frequently get up at night to urinate are at higher risk of falls that can result in hip fracture, which may have serious long-term health effects. The workplace can be a challenge for women who are incontinent; undergarments address leaking but not odors, and some professions with regimented work breaks (manufacturing assembly lines, etc.) may present problems for incontinent workers.
MYTH: We should all drink at least eight glasses of water a day.
FACT: A recent New York Times article exploding this myth has gotten lots of buzz. The truth is, excessive fluid intake offers no health benefits and can make incontinence worse. Caffeine, alcohol and artificial sweeteners in diet sodas work as diuretics—in other words, they cause the body to produce more urine—and also make bladder issues worse.
MYTH: Medications are the best treatment.
FACT: Medications to treat overactive bladder or urge incontinence alone are not effective for treating urine leakage in the long run. Most people with overactive bladder do not require medication. Behavior modification, such as decreasing intake of fluids and following a schedule for urination, can help those with urge incontinence. Medications for overactive bladder should only be used together with behavioral management and preferably under the care of a qualified health care provider. Common side effects of these medications include dry mouth and constipation.
MYTH: Only women have this problem.
FACT: Incontinence is more common in women but it does affect men, especially those who have been treated for prostate cancer.
MYTH: Incontinence is caused by childbirth.
FACT: Childbirth may bring incontinence on sooner. However, not all women who have given birth will develop incontinence, and women who have never been pregnant may become incontinent. There are likely many factors resulting in urinary incontinence such as genetics, lifestyle or aging. A University of Rochester Medical Center study showed the same prevalence in nuns suffering from incontinence and their biological sisters who had given birth.
Gunhilde Buchsbaum, M.D.,is director of the Division of Urogynecology at the University of Rochester Medical Center. She founded and directs UR Medicine’s Pelvic Health and Continence Specialties practice at the Women’s Health Pavilion.