Involuntary loss of urine is embarrassing, inconvenient and distressing, but the one thing I have always assured my patients is that it is not a life-threatening condition. Recently, my perspective on that has changed.
One of my patients mentioned to me that she had just recovered from a hip fracture that required a lengthy hospitalization and surgery. I asked her how she broke her hip and she replied, “I fell down at home.” That’s not unusual. In fact, most hip fractures occur from falls at home. She then said, “Actually, I never told anyone else, but I will admit to you that I was rushing to get to the bathroom and didn’t quite make it. I slipped on my urine and fell.”
I wondered how many other home falls were due to incontinence and did a little digging.
I found a number of studies that confirmed the association between urinary urgency, incontinence and falls that result in fracture including a 2013 article in the Journal of Clinical Nursing that showed that these often occur in elderly women living at home. It’s impossible to know exactly how many women fracture their hip running to get to the bathroom. Just as my patient didn’t report the reason for her fall, many women probably don’t report the reason for their fall to medical providers. Millions of women, especially older women, live with urinary incontinence. While we can’t know for sure how many falls every year result from rushing to the bathroom, the numbers are likely very high.
This is no small issue. There are 54 million people with osteoporosis in the United States. About one in three people who fracture their hip will die within a year of the fracture. In spite of the prevalence of the problem, most women do not report their incontinence. The reasons vary from embarrassment to assuming that a leaky bladder is a “normal consequence of aging.” Unfortunately, about half of women that do report leakage to a health-care provider are inadequately treated. Pads and diapers are commonly recommended, but they should be thought of as a means to manage–not treat–incontinence.
Know that there are many options available for treating your incontinence. You can have relief now, whether it’s with surgery, medication, pelvic-floor physical therapy, or an electrical stimulation biofeedback device, without waiting until you are older to do so. If your primary-care doctor or gynecologist does not offer options, consider seeing a urogynecologist.
While it is important to prevent and treat bone loss, preventing falls is equally important. If you are one of those women that gets that sudden “gotta go” feeling and then dashes, make sure there is a clear path between the bed and the bathroom. And then make an appointment to see your doctor.