DEAR DR. DONOHUE: 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? I am so isolated because of this. What can I do? — A.K.

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. You won’t meet with overnight success. 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 of the many available procedures suits you best.

DEAR DR. DONOHUE: My son is 32. I never had him get any childhood vaccinations. I feel terrible about that now. 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 know this can be a complication. I am sick to think that I might have been the reason why he can’t have children. — M.G.

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.

DEAR DR. DONOHUE: I have a salty taste in my mouth constantly. I have tried more than five different mouthwashes without any luck. What else can I try? — P.P.

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.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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