Q: I'm a 21 year-old woman, in decent health, disease-free and concerned about good hygiene. For several years, I have had difficulty urinating fully and there is a constant state of "drip" after urination. This naturally results in annoying stains and a bad odor. Are there any home remedies for this condition so I won't have to resort to a trip to the doctor's office?
-- M.M., Springfield, Mo.
A: I'm a little concerned that you haven't done something about this embarrassing and frustrating condition before now, but many women are the same way.
People often associate urinary incontinence with older people, especially women. Indeed, the incidence does go up with age, but there are different forms of incontinence that can affect people of any age and either gender.
For example, as many as 10 million North Americans have a condition known as urge urinary incontinence. Symptoms usually include the "urge" to urinate frequently, the need to urinate immediately and incontinence.
If you experience your "leakage" more often when you sneeze, laugh, exercise, etc., you may have another form of incontinence -- stress incontinence, the most common urinary incontinence problem in women. This is caused by increased physical strain or pressure on the bladder.
Incontinence in general can be caused by certain drugs, urinary tract infections and even psychological problems. Also, excessive intake of caffeine or alcohol can result in incontinence.
Short-term incontinence is commonly caused by a bladder infection. The incontinence disappears when the infection is treated.
Long-term, persistent incontinence such as you describe may be due to medical or physical problems with the bladder or urethra. It may also be the result of problems with the nerve network controlling urine flow, either in the brain or the nerves supplying the urinary tract.
There are steps you can take to limit your incontinence problems. You can control intake of fluids and empty your bladder before going out or doing anything strenuous. If the quantity of leakage warrants it, you can use incontinence pads when you know you will be out for a while.
You may want to try over-the-counter drugs that tighten the sphincter muscles, like phenylpropanolamine or pseudoephedrine.
I'm not sure I understand your reluctance to see a doctor. You're clearly concerned about this condition and presumably have tried to treat it yourself without success. Getting help from a professional would seem to be the next step.
Your doctor can prescribe effective medications for you. Also, your doctor can recommend exercises to strengthen sphincter muscles.
Finally, surgery will usually correct the problem if nothing else works.
However, as with any medical problem, treatment success is predicated on finding the cause of the condition and evaluating the options for treatment.
Dr. Allen Douma welcomes questions from readers.