Regional
(2009-10-04)
Listen Now:
GREELEY, CO
(KUNC) -
It's a sensitive medical issue that most don't want to talk about - including KUNC commentator Dr. Marc Ringel. That is until now.
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I'm sitting on the floor of my friend Bobby's living room, playing with his new train set. I have to pee. Lynn, Bobby's older sister, is in the apartment's only bathroom. So I wait and wait and wait. Finally, unwilling to announce my need to a girl and unable to hold it any longer, I decide just to wet my pants, discretely. The warmth spreads in my shorts as I sit there, pretending to pay attention to the toy train. I stand up to leave a while later with Jay, the other friend who's been there, figuring I've gotten away with it. Then Bobby picks up the instruction booklet for the train set, which I've inadvertently been sitting on, holds the document at arm's length and shakes it violently, spraying cold drops of urine on the three of us. I dash out the door, humiliated.
That incident happened when I was about five years old. Such was my shame that the scene is indelibly printed on my memory. Yet this is the first time I've spoken of it, ever. Which is the point of telling my story now. I want to underline just how embarrassing it can be to pee in your pants. That feeling sticks with us, no matter what our age.
That's where I want to start the discussion of urinary incontinence in adults, with the sense of shame that people feel when they lose control of their bladder. With great embarrassment, they purchase pads or disposable pants, horrified at the thought that they're back in diapers. They may even quarantine themselves in their home so as to avoid the disgrace of wetting their pants in public.
Seen as an inevitable, unfortunate, untreatable result of aging, many people with urinary incontinence will never even bring it up to their doctors, which is too bad because often something can be done about the problem.
First you have to tell your physician about it, though. She will start out by trying to determine the cause. Is it an infection that irritates the urinary tract? A weak bladder that doesn't empty well and so overflows? A spastic bladder that contracts and dumps out a bucket of urine without warning? An extra passage that dribbles pee to the outside?
That's just a beginning list of kinds of incontinence. And each of these types has unique therapeutic approaches. As you can see, it's a complex problem. Often, though, solutions are as simple as: a regular toileting schedule; a course of antibiotics for an infection; a drug to relax a spastic bladder or a different medication to loosen a tight valve; or exercises to strengthen pelvic muscles. And sometimes surgery, as easy as dilating the urethra by inserting a smooth blunt metal instrument or as complex as reconstructing the pelvis, may be called for to reconfigure the plumbing.
If your primary care provider doesn't have an answer to your incontinence problem, it may well be worth consulting a doctor who specializes in urology, the field that deals with problems of the urinary tract. Just remember that the first step is to speak up about your trouble.
If it turns out that there's not a fix for this very, very common problem, do what it takes emotionally to accept it, manage it, and get on with your life. Don't wait almost six decades to air it out, as I've done.
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