What will my doctor ask me if I bring up incontinence issues?
It depends on the physicians knowledge about incontinence. When I see a patient with leakage, my first questions center around trying to determine what type of leakage the patient has. Does he or she leak with stress; cough, laugh, sneeze? Or with urge; urge on the way to the toilet? I try to get a sense of how severe the leakage is, how many pads a patient wears, how often the patient gets up at night. So a lot of the questions involve characterizing the leakage. And then also I try to find out how aggressive the patient wants to be. I had a patient that said, "My doctor told me to see you because I have incontinence", and that patient, if she doesn't mind the leakage, I check her urinalysis, I also do a catheterization to make sure she's emptying completely, and there's not necessarily a need to anything if she doesn't mind the leakage. I do like to find out what the patients expectations are; how much do they want to be dry? Today I saw a patient who had pretty severe stress incontinence and I said, "Are you ready for surgery? 'Cause that's the best next step for you." So I think it's important to find out what the patient wants.
