Seeking Treatment for Incontinence: It’s All About Your Expectations!

  • I am sure this has happened to many people, but it always happens to me! A new movie will come out with all kinds of hype, and the trailer looks great, and you can't wait to see it. Often, that is followed with huge disappointment because of your expectations. You expect the movie to be amazing, and when it doesn't stand up to your expectations, you are disappointed. Going to the doctor to discuss incontinence and treatments for the condition can be the same way. It's all about perspective and expectations.


    I have many patients who are appropriately very frustrated with their incontinence and come looking for help. All doctors do the best they can to make their patients better, but often there is only so much we can do. I find people want to "take a pill" and fix the problem 100%. Or people don't want to take anything and still want their incontinence to be fixed.

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    I wish I had a magic wand to wave that would make problems go away. Wouldn't that be great?


    I think we all need to have realistic expectations about what can be done medically to treat incontinence -- and to what extent, as well. If your expectations about incontience treatments are too high, you will be disappointed. I am not saying you should have low expectations from your doctor, just some realistic ones.


    For example, I have a very nice gentleman who had his prostate removed for cancer. A year later, he was cancer free, but had some urinary leakage with activity. He was wetting three to four pads a day. He found this rather bothersome and came to see me. After an appropriate work-up, we decided together that having a male urethral sling would be a good option for him to regain continence.


    It is now one month since the surgery, and he is minimally dampening one pad a day. I was very pleased with this result, but he is still unhappy because he wanted to be 100% improved and instead reports he is only 90% improved. I am sure that many of you reading this would be delighted with that result because you know how bad incontinence is.


    I blame myself for not discussing realistic expectations of the surgery with him, and I try to remind him that he is not only virtually dry, but also cancer free!! We had a long heart to heart about that, and I think he feels much better about all of it now. It was just a matter of changing his perspective.


    Here's another example: I have a very pleasant lady as a patient who came to me about eight months ago completely wet, having very little bladder control. She was unable to leave her house due to extreme social embarrassment.


    We did a full work up on her and found she had both stress incontinence from intrinsic sphincter deficiency (ISD) and overactive bladder (OAB). She had a collagen injection into her urethra for the ISD and we started pills for her OAB.


    I just saw her last week, and she seemed rather down. She told me that she was still wearing a pad and felt like all the treatments had failed. I then re-read my notes to her from our first visit 8 months ago and reminded her that she had been soaking 8-10 pads a day, she wasn't leaving her house, and she was very depressed.


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    She said "Really? I totally forgot how bad it was. I remember now. I guess I am doing really well, huh?" I told her I agreed that I thought she was doing fantastic. I asked her to write that down, too, in order to remind herself of how well she is doing and how far she has come.


    It made me think of how easily we forget how bad things were and how we all lose perspective. I think it is a great idea that if you have chronic medical issue that you should keep a journal recording your symptoms and your thoughts and feelings. That way, as you get better you can look back and see how far you have come with your treatments. It will help keep your expectations and perspectives realistic and lead you to success.

Published On: October 04, 2007