HomeBladder HealthUrinary Incontinence Often Goes Undiagnosed

Urinary Incontinence Often Goes Undiagnosed

By Dave Gilmartin

Urinary incontinence (UI) is so uncomfortable for some women to talk about that only 40 percent seek treatment, some waiting years before discussing it with a primary care provider, says Kendra Roloff, DNP, WHNP-C, CUNP, who specializes in pelvic health and continence.

Even though one in two women in this country will have UI at some point and treatment is available, many don’t reach out for help.

“These women feel as if they are suffering in silence,” Roloff said. “And that feeling of isolation stems from the fact that UI is difficult to discuss.”

She notes that one study found some women can take as long as 19 years to bring up UI with their healthcare provider.

Three kinds of UI

Urinary incontinence in women can take three forms. The Patient-Centered Outcomes Research Institute outlines the circumstances when UI can occur during:

  • Stress UI when you cough, laugh, sneeze or strain.
  • Urgency UI when you have a sudden and unexpected urge to urinate and can’t make it to the bathroom in time. This is also known as an overactive bladder.
  • Mixed UI which is a combination of the two.

There are nonsurgical treatments for all three types, PCORI says in a systemic review update published in Sept. 2019. These include Kegel exercises, bladder training, medications, nerve stimulation or a combination of any of those.

Almost three-quarters of the women who used Kegel exercises for Stress UI improved their symptoms as did three-quarters of the women who used bladder training for Urgency UI. More than half of those who tried medications for either condition saw improvements in symptoms.

Urine leakage in women not tied to age

While urine leakage does tend to happen more often with age, it has been seen in younger women athletes and is never normal and not inevitable.

Roloff urges women with UI to talk with their primary care provider.

“This is nothing to be ashamed of. This is nothing to be embarrassed about. It is very common and treatment is available,” said Roloff, who also wrote an October CE article on bladder pain.

She also urges nurse practitioners and other providers to “talk to your patients about UI so you can be the one to initiate the conversation.”