What can the Doctor do?
The first thing your general practitioner will do is finding out what kind of urinary incontinence you suffer from. This is determined by you telling about your nuisances and by you filling out a fluid and urination table for three days. Furthermore, the doctor will examine your urine, perform a gynaecological examination and possibly take some blood samples.
The doctor’s further treatment will depend on which kind of urinary incontinence you suffer from.
1) Overactive bladder
Sudden strong urge to urinate where you do not reach the toilet in time.
An overactive bladder is that form of urinary incontinence that is hardest to treat.
The doctor’s treatment depends on what is the cause of your overactive bladder. Whether it is an inflammation in the bladder, stone in the bladder or a tumour in your abdomen, the doctor’s treatment will be directed at what is the cause. However, with many there is – even after a thorough examination – no obvious explanation for why exactly you have an overactive bladder.
The doctor will encourage you to exercise your bladder, exercising your pelvic floor and possibly give you medication. Exercising your bladder and your pelvic floor has been described earlier – look under the section ‘What can I do Myself?’
The doctor can write a prescription on several different kinds of medication – here the female hormone oestrogen and medication that counteracts involuntary contractions of the musculature of the bladder should be mentioned.
It is known that especially women after menopause are bothered by an overactive bladder. Therefore, it has been tried giving these women supplements of oestrogen – but the results are not that convincing.
There are several different kinds of medication that can have a relaxing effect on an overactive bladder. The results with the new medication show that many can be helped without the troublesome side effects that used to be. The new medication also has some side effects but they are often passing.
The doctor also looks at the medication you use and will be able to help you if you suffer from constipation or overweight.
If your doctor cannot help you satisfactorily enough, you can be referred to a specialist with a particular interest for urinary incontinence.
2) Stress-triggered urinary incontinence
Urination in connection with physical activity like coughing, sneezing, laughter or running.
Stress-triggered urinary incontinence is the form that is easiest to treat.
The doctor’s treatment depends on what is the cause of your stress-triggered urinary incontinence. Whether it is an inflammation of the bladder or prolapse of the uterus, the treatment is directed against the cause.
The doctor will encourage you to exercise your pelvic floor. The doctor will be able to check if you squeeze properly when doing your exercises by inserting two fingers in your vagina. Exercising of the pelvis is described under the section ‘What can I do Myself?’
The doctor can give you a prescription for the female hormone oestrogen that can strengthen the muscles of your pelvic floor. Oestrogen can be given as a suppository or a ring that is inserted in the vagina.
Your doctor can tell you which aid you will benefit the most from. The doctor also looks at what kind of medication you use and can help you if you suffer from constipation or overweight.
If your doctor cannot help you satisfactorily enough, you can be referred to a specialist with a particular interest for urinary incontinence.
A mixture of the two first
Both overactive bladder and stress-triggered urinary incontinence.
The treatment depends on which kind you are most bothered by. Most often, the overactive bladder bothers the most.