The First Step is Admitting You Have a Problem Urinary incontinence is rarely talked about, and when it is mentioned, it's often the tagline for a joke among friends, coworkers, or the cast of Saturday Night Live. But having a weak bladder and being unable to control when you urinate is not a laughing matter. As a private practicing urologist, in practice for 15 years I have seen the direct impact that urinary incontinence has had on my patient's lives. I have treated and have had the privilege to know several women who have suffered through the humiliation and embarrassment that this condition has brought them. They often wear dark clothing, and have to be very careful about how far they travel from home. These women have to change major aspects of their lives simply to counteract their urinary incontinence. They also have to spend a lot of extra money. Many of my patients who are already strapped for cash, have to add yet another expense to their monthly allotment in the form of costly pads, and in some cases, even diapers. Pretty soon their whole life seems to revolve around their urinary incontinence, dictating what they can or cannot do in order to just avoid an embarrassing situation. Urinary incontinence and bladder weakening doesn't happen all at once, it is usually a degenerative disease that gets worse over time. Many of my patients have delayed getting checked out by a physician because they are either too embarrassed or are not aware of what can be done to treat their condition. Often enough, it is only when they reach their absolute breaking point that they come and pay us a visit. They are fearful, worried and sometimes even ashamed of a condition that they have no control over. But after they leave their doctor's appointment and find out how they can be treated or maybe even cured, their fear turns to pure joy. I can't tell you how many times I have gotten hugs in the office after I've cured someone of urinary incontinence. This is no exaggeration on my part, it happens on a daily basis. And one of the most common things that a patient has said to me when they realize what can be done to treat their UI, is invariably, "Why did I wait so long?" They just don't realize the options that are available. The first step in treating most individuals is just to get them into the office for a checkup in the first place. This is why I wrote this book. For those of you that are having issues with urinary incontinence yet are hesitant or afraid to seek treatment, I hope that what you read here encourages you to make an appointment and get yourself checked out. My name is Nicole Eisenbrown, I am a private practicing urologist, and I hope to see you soon. Understanding the problem Now that we have acknowledged that we have a problem, we need understand that not all incontinence is the same. This is a big misconception I see with people who come into see me in the office. Even many physicians do not really appreciate that incontinence can be the result of various pathologies. The end result may be unwanted leakage of urine, but knowing what is causing the leakage is critical in determining what treatment options are available to treat the problem. I will briefly describe each of them for you here and then go into much greater depth on each one later on. This way you can jump right to the problems you think you have. The most common ones that were going to talk about our stress urinary incontinence, urge urinary incontinence, mixed incontinence, overflow incontinence and functional incontinence.