One of the keys to success in treatment for bladder or bowel control problems is to first get accurately diagnosed. That's because there are different kinds of problems with different sets of causal factors and consequently different types of solutions. In a survey of over a thousand women ages 18 and older conducted by NAFC in recent years, we discovered that 20% of women with symptoms exclusively associated with stress urinary incontinence (SUI), or leakage when laughing, coughing or sneezing, reported they had been prescribed medication. Needless to say, the drugs didn't alleviate or eliminate symptoms of leakage because more than likely they were developed for overactive bladder, a condition associated with the neurogenic bladder, or abnormal frequency of urination and the sudden urge to urinate. We know the wrong medicine was prescribed because there is no FDA approved drug for SUI available in the U.S. The best explanation for such an occurrence is an incorrect diagnosis and a hurried one at that, acting on inaccurate or incomplete information from the patient describing her symptoms.
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For your doctor or nurse practitioner to nail your diagnosis, you have to start with communication. Not only do you have to initiate the dialogue, you have to be equipped with information about what you're experiencing. A BLADDER DIARY begins that process. What you do is record during waking hours over a two day period or more everything you eat and drink including how much and when you have a toileting accident including its severity. NAFC has a simple template to help you keep track of times and events. Print it from our web site and get started. On your visit to a provider, this document serves as the basis for your discussion about your experiences. You might discover more than one set of symptoms and thus face multiple solutions. The point is to create a record of all the symptoms in a context to be helpful to your doctor in reaching a diagnosis.
The majority of people take this information to their primary care provider. But often, a referral to more of an expert is needed. That may be a continence nurse to help with bladder retraining or a pessary fitting or a physical therapist to coach you on pelvic floor rehabilitation, possible with the guidance of biofeedback therapy. The team may be expanded to include a specialist such as a urologist to do a diagnostic urodynamics analysis of the bladder filling, storing, and emptying capabilities. Depending on severity, you may be a candidate for surgery. A third of women with SUI actually have such a level of severity and thus need a urologist specially trained in female pelvic surgery or a urogynecologist.
The point is you not only have to get educated and informed, you have to assume responsibility for playing a role in getting diagnosed correctly. This includes understanding your own anatomy so you can describe what's happening, knowing the difference between what is normal and abnormal. Once diagnosed correctly, such knowledge equips you to be able to ask meaningful questions prior to undergoing any procedure, comprehending the answers from your doctor but also understanding the risks associated with an intervention. This includes the side effects of prescribed medication.
Get in the know: Steer your doctor in the right direction!
Nancy Muller, Executive Director
National Association For Continence
Published On: March 30, 2010