I honestly don’t know how it came up in conversation, but recently I had two separate conversations with groups of female friends about peeing your pants. Yep, there I said it, in public no less – peeing your pants, wetting your self, urinary incontinence. The things you can talk about over a few glasses of wine, or a good cup of tea and a brownie! And now, another admission: This is a problem that I’ve struggled with.

Talking with my friends about urinary incontinence I was shocked. I knew the figures, a third of women suffer from urinary incontinence, (some numbers put it as high as 45%) but I figured I just had early onset, that the majority of that third of women were sixty-five plus. If these two separate groups of women were anything to go by, the problem is much bigger than one-third of women. Close to two-thirds of these groups, n =12, aged between 30-45, admitted that peeing their pants was or had been a concern in the past, but the numbers who had sought treatment for urinary incontinence was tiny. That lack of seeking help with in these two small groups is reflective of the behavior of the larger population where it is estimated that only one in twelve women suffering with UI seek help. The thing is you don’t have to suffer in silence and you shouldn’t let UI go untreated. As my gynecologist said, when I finally summed up the courage to talk to her about my own issues postpartum, buying pads and liners doesn’t have to be an inevitable part of the aging process or a result of pregnancy and childbirth. For the majority of sufferers there is no need to experience this embarrassment, there is treatment.

How to get help

Talk with your primary care physician or gynecologist. For me getting treatment started with a good friend, with whom I’d shared my tale of woe. She harassed me for months about making an appointment with my gynecologist. I’d receive emails with subject lines like “Call the Pee Doctor NOW”. Apparently, I respond to pressure because eventually I relented and set up an appointment with my gynecologist. Just as my friend said, my doctor was not surprised and was supportive. She referred me to a urologist.

Meeting the Urologist

The doctor isn’t going to be shocked by a grown woman having UI, they deal with this issue every day. They are there to help.

One of the first things you can expect when you talk to a urologist or pelvic floor physical therapist about urinary incontinence is to be asked to fill out a bladder diary for a few days or a week. When you have accidents, what and how much you drink, whether it is a sudden urge, a constant leak, a sudden outpouring in conjunction with physical exertion are all indicators of what type of incontinence you’re suffering with, there are several forms (see the chart below.) You can also expect to have a physical exam.Through a physical exam, the doctor can assess whether you have a physical blockage or growth, if you have vaginal or bladder prolapse and the general state of your pelvic floor structure. Don’t let the physical exam deter you from seeking medical help. Getting over our embarrassment and being evaluated and receiving help is much more rewarding that standing in a line at the supermarket hiding the liners, pads and diapers beneath your groceries for the rest of your life.

The Types of Urinary Incontinence

Stress Leakage of small amounts of urine during physical movement (coughing, sneezing, exercising).
Urge Leakage of large amounts of urine at unexpected times, including during sleep.
Overactive Bladder Urinary frequency and urgency, with or without urge incontinence.
Functional Untimely urination because of physical disability, external obstacles, or problems in thinking or communicating that prevent a person from reaching a toilet.
Overflow Unexpected leakage of small amounts of urine because of a full bladder.
Mixed Usually the occurrence of stress and urge incontinence together.
Transient Leakage that occurs temporarily because of a situation that will pass (infection, taking a new medication, colds with coughing).

From the National Kidney and Urological Diseases Information Clearing House. Downloaded on July 3, 2012

Getting a diagnosis
Like many women, my incontinence was classified as “Mixed Incontinence” – A mixture of stress and urge incontinence. Jumping jacks should be called “pee jacks” and my chronic winter cough does not help and a rollicking good laugh…well I almost peed my pants, but occasionally it happened when it wasn’t associated with some physical exertion. Now I had a diagnosis we had to investigate the triggers and that would lead, hopefully, to a solution.

Next time: Chocolate, periods, heels and a wee accident. What’s the connection?

Information on this blog does not constitute medical advice. Please seek the help of a medical professional if you experience issues with urinary incontinence.