Incontinence was one of those secret, hidden, embarrassing problems, the kind we were more likely to talk around than talk about.
But when 10 million adult Americans are suffering -- many of them afraid to leave their homes lest they lose control of their bladders in public -- the story needed to be told.
That happened with a little book titled "Staying Dry: A Practical Guide to Bladder Control," published by the Johns Hopkins University Press last November and recommended recently by Ann Landers in her column.
One women in two has some degree of bladder leakage after childbirth, one woman in three has it after menopause, and one man in five has it in the older years, according to Dr. Angelo Lucco, one of the co-authors (with Kathryn Burgio and K. Lynette Pearce).
About half the people in nursing homes are incontinent. In fact, Dr. Lucco says, bladder incontinence is often cited as "the straw that broke the camel's back," when families talk about why they opted for a nursing home.
Actually, the problem has been peeking out of the closet for years, as those ubiquitous commercials for adult diapers have saturated the airwaves with this once-hidden topic. According to some experts, however, if you assume life in a diaper is the inevitable outcome of incontinence you may be short-changing yourself.
"It's a shame, because that [the ads] is usually the only information most people get," says Dr. Lucco, who is medical director of the specialty hospital at the Levindale Hebrew Geriatric Center in Baltimore.
"The information people should be getting is that this isn't normal for anyone, just as losing your eyesight isn't normal. It's a legitimate problem, and people should be diagnosed and treated for it. Diapers are good in that they make life more bearable if all else fails; but they're the last line of treatment, not the first."
The first line of treatment, according to the book, is to describe the problem precisely. To do that, the authors say, you should keep a diary, listing the times you urinate deliberately or accidentally.
With your doctor's help, you can then figure out what kind of incontinence you have: In "stress" incontinence, urine leaks when you laugh, sneeze, cough or exercise; in "urge" incontinence, your bladder contracts and urine passes before you get to the bathroom; in "overflow" incontinence, neurological impairment might have left you unable to recognize when the bladder is full.
