Question: I have become a hermit in my home because I cannot control my bladder. I lose urine when I laugh or sneeze. And those aren’t the only situations where it happens. Is there a medicine to take for this? What can I do?

Answer: “Incontinence” is the word for the loss of urine control. There are two different kinds: stress incontinence and urge incontinence (overactive bladder). You have the stress variety. You lose urine when abdominal pressure is transferred to the bladder, and you cannot hold the urine. Pushing a heavy piece of furniture, laughing, coughing and sneezing are examples of when stress incontinence strikes.

Treatments can help you gain bladder control. An important one is the Kegel exercises.

You can do them while standing, seated or lying. First you have to learn which muscles to contract. You learn by deliberately stopping the flow of urine. When you have learned what to do, begin the exercises when you’re not urinating. Contract those muscles tightly, hold that contraction for three seconds, relax and rest for three seconds, and then perform another 11 consecutive contractions and relaxations. Do these exercises many times during the day. In a week or so, lengthen the contractions until you are eventually squeezing the muscles for 10 seconds. If you stick with it, you ought to see enough improvement to restart your social life.

No medicines work for stress incontinence.

Surgical procedures also are a possibility. A urologist can put bulking material around the end of the urethra, the tube draining urine from the bladder to the outside. If you have a dropped bladder, then fixing that can restore control. Sometimes, it can be propped up with a pessary, a doughnut-shaped device that’s inserted into the vagina.

Surgery is another way of restoring the bladder to its normal position. Many other procedures for stress incontinence exist. One is a technique where needles position a mesh strip under the urethra to keep urine from leaking. A urologist or a urogynecologist will decide which procedure suits you best.


Question: My son is 32. I failed to get him any childhood vaccinations. He has been married for five years. He and his wife want children, but they haven’t been able to have any. When he was 4, he caught mumps. Could the mumps have settled in his testicles and made him sterile? I am sick to think I might have been the reason why he can’t have children.

Answer: Mumps can spread to the testicles. When this happens to boys before puberty, which is the time your son caught mumps, infertility does not result. When it happens to males after puberty, if only one testicle is infected, fertility is maintained. If both testicles are infected, infertility, as a result, is extremely rare.

Your son can get the immunizations he needs as an adult right now. He should have them. His family doctor will provide a schedule for him.


Question: I have a salty taste in my mouth constantly. I’ve tried five mouthwashes, but none works. What else can I try?

Answer: Stop the mouthwashes. Rinse your mouth many times during the day with plain water and spit it out.

Sugarless gum will stimulate saliva to keep your mouth moist. A dry mouth can generate funny taste sensations. Above all, see your dentist. Gum infections produce a salty taste. So does mucus dripping into your mouth and throat from the sinuses and nose.

I don’t know if you use them, but many denture adhesives frequently leave a salty taste.


Question: My brother says he has AIDS. He doesn’t look the least bit sick. He talks about his T-cells. What’s he talking about?

Answer: T-cells are part of the body’s defense against infections. The HIV virus (human immunodeficiency virus) decimates the ranks of T-cells. When their number drops, all sorts of difficult-to-treat infections spring up.

By the way, your brother is infected with the HIV virus. He doesn’t have AIDS. AIDS occurs when the complications of HIV infection appear.



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