Urinary Incontinence

5 Signs That You Need to See a Urologist
toilet paper roll

Some symptoms of incontinence are obvious: Urine leaks out inappropriately, or you simply can't "hold it" long enough to reach a commode. But many adults with incontinence may be oblivious to bladder problems or in denial about how serious the underlying issue may be -- that is, if their behaviors are any indication, says urologist Adam Tierney of Dean Clinic in Madison, Wisconsin.

Here are five lifestyle signs that you should see a doctor. You might be then referred to a urologist (a doctor specializing in the urinary system) or a gynecologist (a doctor specializing in the female reproductive system, who also manages certain urinary problems).

Sign #1: You routinely wear sanitary pads -- and you're not menstruating.

Some women turn to sanitary pads intended for menstruation to absorb the occasional uncontrollable leakage that seeps out when they cough, laugh too hard, lift something, or exercise -- or for leakage that appears seemingly at random.

Why it's unnecessary: "It's very common to leak urine, but that doesn't mean it's normal -- or shameful," says Jill Rabin, coauthor of Mind Over Bladder and chief of ambulatory care and urogynecology at the Albert Einstein College of Medicine in Hyde Park, New York.

If you're postmenopausal and still buying pads, or if you've taken to wearing sanitary pads routinely even after your period to "catch" bursts of wetness, it may be urine and warrants checking out.

What you can do: Stress incontinence (when urine leaks due to a physical stressor, such as laughing or moving a certain way) can be fixed in many ways without surgery. These include physical therapy to strengthen the pelvic muscles, nerve stimulation, and biofeedback.

Losing weight has also been shown to slash stress incontinence symptoms in women who are overweight or obese to begin with. Shedding just 10 or 20 pounds can cut symptom frequency in half.

Sign #2: You keep a change of clothing stashed in your car or bag.

Preparing for disasters is one thing. But if your disaster-worry centers on the possibility that you might wet your pants or skirt, and it's no random nightmare -- it's actually happened to you before -- you needn't live in fear.

Why it's unnecessary: These random acts of incontinence aren't a normal part of aging. A doctor can help discover the underlying cause. Overflow incontinence, for example, is when something blocks normal urinary flow, making it harder to control output. (It's more common in men.) Urge incontinence is the sudden overwhelming need to empty your bladder. In some cases nothing is produced, or you can make it to a bathroom in time. But sometimes the urge comes too fast or with almost no warning. (Both men and women can experience this.)

What you can do: If a kidney stone or tumor is behind the blockage causing overflow incontinence, it can be removed. Urge incontinence treatments include medications, dietary changes, bladder retraining programs, biofeedback and electrical stimulation, and surgery. While treatments are underway, modern absorbent products also help you avoid costume changes.

More signs that you need to see a urologist

Sign #3: Your social life has shrunk to the size of your home.

"It's very common to have your circle of interactions with others grow smaller and smaller because you're afraid of incontinence episodes," says Rabin. "Plenty of people become a prisoner of their own home." As someone with bladder symptoms grows wary of social outings, he or she starts turning down invitations; this snowballs over time into receiving fewer invites, because the person is perceived as not wanting others' company-- when the real cause for going Greta Garbo is a bad bladder, not a rude personality.

Variation on this theme: Planning your day around bathroom opportunities or feeling unable to relax in a new setting until you've first scoped out the location of the loo.

Why it's unnecessary: Avoiding life to avoid embarrassment is a drastic lifestyle cost, Tierney says. Ultimately, getting your body to a specialist is easier than adapting your lifestyle to your body.

What you can do: A thorough workup can usually pinpoint the cause of your incontinence episodes. Once you understand the cause, it's possible to live normally with a leaky bladder. Management tactics include monitoring fluid intake, avoiding foods that irritate the bladder, avoiding mental triggers for urination, and learning how to strengthen the pelvic floor.

Sign #4: You avoid sexual intercourse.

Obviously couples say, "Not tonight, dear" for many reasons, including those that originate in the head and heart, not just the body. But one physical reason that can embarrass both men and women to the point of avoidance is the inopportune appearance of urine.

Why it's unnecessary: The following common sex-stealers aren't normal.

For women, stress incontinence can cause small leakages at any time during sex play, especially during orgasm. Urge incontinence, the need to urinate immediately, can also be triggered by orgasm. Net result: inhibition.

For men, the need to urinate urgently and frequently -- known as overactive bladder -- can hamper what happens postarousal. According to a recent Pfizer study of 12,000 men, reported by the National Association for Continence, only half of men with overactive bladder are sexually active (compared to eight out of ten men with no urinary symptoms) -- and of these, one in four reported that their OAB symptoms were why they stopped having sex.

What you can do: All these forms of incontinence can be lessened with therapy, medication, or other interventions. Behavior modification techniques can help both men and women.

Sign #5: You lie down to relieve a constant, heavy pressure.

Urinary system troubles aren't always flagged by visible urine. A persistent heaviness or an annoying sensation of pressure near your plumbing -- urethra, vagina, vulva, kidneys -- is always worth having checked out, Rabin says. The discomfort often lifts when you lie down.

Why it's unnecessary: The cause of the discomfort may be prolapse, in which muscle weakness causes one or more organs to slip out of their usual positions. Common after childbirth or menopause, vaginal prolapse can also affect the bladder, urethra, uterus, bowel, and rectum. A heavy sensation may be the clue of a mass in the area that should be evaluated.

What you can do: The first line of defense is to strengthen the pelvic floor muscles through therapies and other measures, including vaginal weights and pessaries (devices worn in the vagina to strengthen musculature). Surgery is sometimes needed to correct prolapse.

If the source of the heaviness is found to be a mass or other blockage, you may need to have it removed surgically or biopsied for further evaluation.

Paula Spencer Scott

Paula Spencer Scott is the author of Surviving Alzheimer's: Practical Tips and Soul-Saving Wisdom for Caregivers and much of the Alzheimer's and caregiving content on Caring. See full bio

about 1 year ago, said...

Amazing information about stress. Nice article Thanks for sharing

over 1 year ago, said...

Thanks for pointing out some of the signs that might indicate it is time to see a urologist. You make some good points about how a problem with your bladder shouldn't take over your life. I would think that once it starts affecting your daily routine, it is time to seek medical help. http://www.advuro.com/

almost 2 years ago, said...

Cool post! Thank you for helping me understand when it is time to see a Urologist. I like how you said that "Some symptoms of incontinence are obvious: Urine leaks out inappropriately, or you simply can't "hold it" long enough to reach a commode." I have never had bladder or urination problems but I can imagine how helpful a Urologist can be when it comes to fixing problems with your bladder and urination.

almost 5 years ago, said...

I am very happy to read your articles it's very useful for me,  and I am completely satisfied with your website.  All comments and articles are very useful and very good. Your blog is very attention-grabbing. I am loving all of the in. turn you are sharing with each one!"¦. Urologist in indore

over 5 years ago, said...

Comments from men seem to be ignored or we are kicked off the site.

over 5 years ago, said...

There is little attention to men's health problems.

over 5 years ago, said...

This article was geared to women. Thanks for nothing.

over 5 years ago, said...

I tried to leave a comment requesting help in finding a urologist who will treat a male patient with the same respect for privacy and dignity that is provided to female patients. I had a totally humilate and inappropriate transrectal sonogram which has left me unwilling to viait a urologiat.

over 5 years ago, said...

I am starting to have urinary problems, so am reading as much as I can find about it.

about 6 years ago, said...

It helped me solve my vaginal problems! Thanks guys! PS. Love you long time.

about 6 years ago, said...

if its totally prevented before you know it!

about 6 years ago, said...


about 6 years ago, said...

I got kidney problem before but it was cured after a medication was made.then I got a stone in my gall bladder , itwas seen in ultra sound... but the pain was felt later part of year may be 1992 ..then the pain was lost. anoter pain came continouslly then i only se a Doctor and give me a medication then later it was diagnose and had seen in ultra sound A gall bladder since 2008 until now i am not be able ,to see aDoctor because of finacial needs . But I ,sometimes let God heal all our sickness.By God graces he will help and protect and save us . But i also accept any help and advices regarding any sickness. God bless thank you.

about 6 years ago, said...

The article is titled "5 Signs" etc. and they only show 2 signs. Where are the other 3?

about 6 years ago, said...

well i wouldnt say this isnt some thing too do with witch's hangin about''

about 6 years ago, said...

The article answered a lot of questions.

about 6 years ago, said...

I piss with a double stream..one hits the toilet the other hits my toe! .<==uu . . . . forgive me LOL . . . .

about 6 years ago, said...

Hello partial/radi­cal ?, Thank you very much for your question. If you'd like, you can post it in our Ask & Answer section, here: ( http://www.caring.com/ask ). I hope that helps! -- Emily | Community Manager

about 6 years ago, said...

Need information on partial bladder cysto. What are complications , etc

about 6 years ago, said...

Oh, and on the bladder article--needs more description. I recently had a UTI that wouldn't not rescind its presence, so I saw a urologist who performed a procedure involving a small camera and tube in his office. This allowed him to see to what degree the bladder had slipped down causing pressure and discomfort. Now, a pressure test will be done to see how much I tolerate. In my case surgery is not necessary, but a pill to alleviate the pressure feeling will be used. So, a prolapsed bladder may be the cause of incontinence, pain, pressure, etc. Hope that helps. Now I gotta go find a communicative method to reach Reader's Digest!

about 6 years ago, said...

Actually, I was trying to find a way to communicate with Reader's Digest on another matter when I started investigating articles. Cleaning methods were direct and to the point without advising the use of expensive materials was pleasant. It was a refreshing method of telling me that I've been doing most things properly! This type of article should be given more exposure.

over 6 years ago, said...

1. you work for him 2. he just graduated from college 3. he doesn't have a wife 4. he doesn't have any children 5. you can turn the snake into domesticated mammal

over 6 years ago, said...

The Albert Einstein College of Medicine is located in NEW Hyde Park, not Hyde Park. Two very different towns, though both are located in NY State.