Urinary Incontinence Expectations

What Should My Expectations Be If I Have Urinary Incontinence?

We’re not telling you anything new when we say that many women do not like to talk about their bladder control problems. In a study by Burgio, only 25.5% of women who reported having urinary incontinence actually sought treatment. As part of our own research, we conducted numerous focus groups to ask incontinent women why they do not seek care for treatment. What keeps a woman from discussing a problem that impacts her life? Women believe they will be told one of the following:

· It is a normal part of aging, or a normal product of childbirth.

· It’s because I am overweight and I should just lose weight.

· There’s nothing that can be done for uncontrollable urine loss. I’ll be told to buy Depends.

· I will just be told to do Kegel exercises.

· I’ll be called a hypochondriac.

· I will be given medicine, and I don’t want to take more pills.

· Surgery is the only option, and the surgery isn’t very successful, or I’m afraid of surgery.

· The doctor will just tell me to come back when my symptoms are worse.

· I have done something in the past which has brought on this problem.

Did any of these statements keep you from care? Although common, none of the above statements are accurate.

In addition, many women do not view uncontrollable urine loss as a medical problem, like high blood pressure or diabetes. They believe they just have to learn to live with it because there is nothing they or their health care provider can do about it anyway. This concept is reinforced by data from the Centers for Disease Control and Prevention that found only about 23% of primary care physicians routinely ask their patients about problems related to bladder control. But uncontrollable urine loss is a medical problem that can be treated and cured in a majority of cases. Other women believe their uncontrollable urine loss has to get “really bad”, significantly impact their activities of daily living or significantly decrease their quality of life, before they should seek care. Younger incontinent women may feel hopeless and helpless because society stigmatizes urinary incontinence as a problem of aging that discourages them from seeking care.

By the time you come to our office, we recognize that you may have lived with your symptoms for many years without seeking treatment, or may have been frustrated or rebuffed in your attempts to get successful treatment. You may have received incorrect information and/or treatment in the past, and may still be angry or upset about that treatment. We believe our mission is to provide you with an accurate diagnosis, and educate you about this diagnosis and treatment options so that you can make the best possible decision about your treatment. We are partners in this process. Our knowledge and experience is based on sound, scientific medical evidence. We not only value your participation, but believe it is vital to the success of your treatment.

You may come to us feeling hopeless and helpless about your uncontrollable urine (or anal) loss. If you don’t think you have any control over your urine loss, don’t think you have the ability to what the physician might ask, or had a previous treatment that was not successful, who wouldn’t feel hopeless? Research studies have found that mastery, a person’s perception of control over the forces affecting her life, was the strongest determiner of quality of life for women with urine leakage. Several studies have demonstrated that self efficacy, a person’s belief that they are capable of performing what is required, provides a sense of control over the environment and motivates a person to follow through with recommended treatments. We want to provide you with information and encouragement so you can regain a sense of control, an increased ability to cope, and a renewed sense of hope about your options.

Our experience has shown that a woman is more likely to have her treatment expectations met if she better understands her diagnosis and treatment options. In a study of patients with rheumatoid arthritis, patient education increased compliance with treatment. An analysis of 47 studies demonstrated patient teaching has positive treatment outcomes for diabetic adults. On our website, www.mybladderdoctor.com, you will find a wealth of information about your condition. If you do not have access to a computer, we can print out any of the information for you. It is our hope that as you read the information, you will understand more about your condition, reasons for treatment recommendations, things you can do to improve your symptoms, and be excited about following through with the suggested treatment to obtain the best treatment outcomes possible.

Finally, we encourage you to explore your treatment expectations. Consider the following:

· Do you expect to be totally dry or totally cured?

· What is your concept of wellness? Do you have to be totally continent to believe you are “well” or “healthy”?

· How long do you think it should take to obtain positive results? After the first visit?

· Do you expect to receive a prescription and be cured?

· Do you expect to make some changes, or do you expect a physician to “fix” you?

· Are you willing to prioritize your concerns and work them on one at a time, or do you expect the physician to address all of your concerns at once? (An example might be: I leak urine, I’ve been constipated for 25 years, I’ve had vaginal dryness since my hysterectomy 15 years ago, and my gynecologist said I have a pelvic organ prolapse.) What do you want addressed first?

In a study of patients with low back pain, patient expectations influenced clinical outcomes independent of the treatment itself (acupuncture or massage). After adjusting for other variables, patients with higher expectations regarding treatment benefit had a five fold greater likelihood of substantial improvement after treatment. On the other hand, unrealistic expectations cause patients to become frustrated, unhappy with their care, and less likely to follow through with treatment recommendations because they simply did not hear what they expected or wanted to hear. We welcome proactive patients who are willing to discuss their expectations for their physician visit, diagnosis, and treatment. This provides us an opportunity to meet your expectations, which should have a positive effect on treatment outcomes. We can then formulate an agreeable “game plan” to attack your concerns and achieve success – together.

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