Talking About Incontinence
In "When You Gotta Go" [Sept. 14], Jennifer Huget bravely brings to light the hush-hush mentality many Americans associate with incontinence. As the executive director of a not-for-profit consumer advocacy organization dedicated to educating people with bladder control problems, I applaud her for sharing her personal story and encouraging readers with symptoms to seek medical attention.
To help men and women with involuntary leakage of urine understand the condition and initiate a dialogue about appropriate management options and treatments, we have developed a bladder health self-assessment tool. I encourage your readers to access this tool online by visiting www.nafc.org.
Nancy Muller
Executive Director,
National Association For Continence
Charleston, S.C.
Drugs or surgery are inappropriate first-line treatments for incontinence. The most effective, safest and cost-effective therapies for treating urinary incontinence are pelvic floor muscle exercises, biofeedback and/or behavioral therapies (also called bladder retraining).
Many randomized controlled trials have demonstrated the effectiveness of these therapies in diverse populations, including homebound elders, women who have just given birth and female soldiers with exercise-induced incontinence. These therapies work for both stress incontinence and urge incontinence and, in a direct comparison, biofeedback-assisted behavioral therapy was superior to the most popular drug treatment.
Additionally, the belief that estrogen helps incontinence, although popular among physicians, is a myth. Randomized controlled trials consistently show no benefit of estrogen over placebo.
Adriane Fugh-Berman, MD
