Dr. Ernest Levister Jr.

Dear R.R. An estimated 25 million American adults suffer the inconvenience and embarrassment of incontinence - the unintended loss of urine or feces that is significant enough to make it difficult for them to maintain good hygiene and carry on ordinary social and work lives.

Sometimes incontinence is minor, and all you need is an occasional absorbent pad to keep enjoying your normal activities. But when you begin organizing your life around easy access to a bathroom or start giving up the activities that are important to you - your daily walk, travel, career, or sex - because you can't control leakage, it may be time to take action.

Besides disrupting daily activities and nighttime sleep, incontinence can also chip away at your health. If you have stopped exercising, for example, you are giving up one of the most effective strategies for maintaining a healthy heart and bones. Getting up several times a night can lead to sleep deprivation, which makes it difficult to function normally during the day. Nighttime trips to the toilet can also be dangerous for those with mobility impairment. And incontinence that causes withdrawal from social interactions can result in depression.

Did you know that you might be teaching your bladder some bad habits? For example, if you routinely urinate before your bladder is full it learns to signal the need to go when less volume is present. That can set up a vicious cycle. You respond to the new urges and teach your bladder to cry "run" when less and less urine is present.

Bladder training is a program of urinating on schedule. It is a mainstay of treatment for urinary frequency and urge incontinence in both women and men, alone or in conjunction with medications or other techniques. It's something you can try on your own or with the guidance and support of your doctor or a health professional.

Luckily, old bladders can learn new tricks. With bladder retraining, you gradually increase the amount of urine you can comfortably hold. Because bladder training is low cost and low risk, your healthcare clinician may encourage you to try it first, even before specific diagnostic tests are performed.