Who Has the Help you Need?
Navigating the Health Care System
by Karen Laforet RN, MClSc-WH, CNHC(c), VA-BC, CVAA(C)
Incontinence is a widespread condition that ranges in severity from 'just a small leak' to complete loss of bladder or bowel control. Over 10 percent of all Canadians—adults and children, have bladder or bowel control problems for a whole lot of different reasons.
If you’re one of the many Canadians experiencing incontinence, the good news is that it can be treated and managed, and, in some cases cured. Despite how common this condition is, folks struggle to get the help they need because of the stigma and embarrassment. While there are many healthcare professionals who specialize in the area of incontinence, it may be confusing to work out who would be best for you to see.
The following information explains the various healthcare professionals specializing in incontinence and provides tips on how to approach your appointments.
The most important thing you need to do is find healthcare professionals who are knowledgeable AND interested in incontinence. It may take time and effort to find the right person(s) for you, however doing so will help you take charge of your health.
First, let’s start with the physician group:
Family Doctor (General Practitioner)
Embarrassed to start the conversation regarding your incontinence? One option is to speak to your family doctor (GP) during your regular health check up, pap smear or prostate exam. It is important to discuss the management of other conditions such as asthma, diabetes, obesity and arthritis to reduce their impact on your incontinence at the same time.
Ask your GP if s/he has an interest and experience in assessing and treating incontinence. They may not—and that is OK. Remind yourself not everyone specializes in this field. Ask for a referral. We recommend printing out this blog and bringing it with you to your GP appointment. This list will help your GP refer you to the continence professionals that best meet your needs.
Once you start seeing a continence specialist, continue to keep your GP informed and involved as their role as your health history and current medical care cannot be overstated.
Urologists are qualified surgeons who have specialized in caring for men's sexual and reproductive health and treating women and men’s kidney, bladder and urinary problems.
A urogynecologist is a fully trained gynecologist who has undertaken further advanced specialist training to deal with the complexities of women’s pelvic problems such as vaginal prolapse, bladder dysfunction and urinary incontinence. Some women may prefer a doctor that focuses solely on women’s health. Don’t be afraid to ask if there is a Urogynecologist in your area.
A gynecologist is a doctor specializing female reproductive health. You will need to ask to confirm if they specialize in urinary incontinence. If they don’t, this is not the specialist for you.
Geriatricians are doctors who specialize in care of the elderly using a holistic model for all aspects of an elderly person’s health including urinary or fecal incontinence.
Gastroenterologists specialise in gut and bowel diseases and are able to investigate the causes and contributing factors to bowel dysfunction & incontinence.
Colorectal surgeons correct mechanical bowel dysfunction that causes constipation, chronic diarrhea or rectal leakage. If investigations suggest a diagnosis of severe rectal dysfunction your physician or specialist may refer your to this type of surgeon.
Nurses Specialized in Wound, Ostomy, and Continence (NSWOC) and Nurse Continence Advisor (NCA)
An NSWOC, and more specifically an NCA, is a registered nurse who has received post-graduate training and certification incontinence care. The Nurse will complete a detailed assessment and work with you to develop a management plan best suited to your needs and lifestyle. Continence nurse advisors may visit you at home or see you in a clinic setting. A doctor’s referral is not usually required.
Lastly Allied health professionals:
Physiotherapist specializing incontinence and women's health or pelvic floor
Physiotherapist specializing in women’s health and pelvic floor hold post-graduate qualifications specializing in pelvic floor muscle training. They can assess your pelvic floor function and tailor an exercise program to meet your specific needs. They can also prescribe other treatment options such as biofeedback and discuss relevant lifestyle factors with you. Depending on your insurance plan you may need a medical order.
Physiotherapist with an interest in continence and women's health or pelvic floor
Physiotherapists with an interest in continence and women's health or pelvic floor may work exclusively in this area however they do not have postgraduate qualifications. They can assess your pelvic floor function and tailor an exercise program to meet your specific needs. Depending on your insurance plan you may need a medical order.
Dietitians hold post-graduate qualifications in nutrition and dietary advice. They know about food and how different foods impact certain health conditions. They can help you with a food plan as well as provide accurate nutritional information. A Doctor’s order is not needed unless specified by your insurance plan.
Occupational therapists specialize in maximizing your safety and independence at work and at home. They work with other health professionals and caregivers to provide assistance with your activities of daily living. Depending on your insurance plan you may need a medical order.
Pharmacists are the best health professional to offer advice on medications that may cause or aggravate incontinence. They can also complete a medication check to ensure your medications are right for you, provide you with continence product advice, and free information resources.
As you can see, there are a number of healthcare professionals with unique specialization to help you manage and possibly cure incontinence. While it may take time and a bit of effort to find the right professional(s) for you, doing so will help you or someone you care for live life to the fullest.
Links to more information:
What is pelvic floor physical therapy? https://www.issm.info/sexual-health-qa/what-is-pelvic-floor-physical-therapy/