How urology can boost confidence and access for incontinence care

In this video, Aleece Fosnight, MSPAS, PA-C, CSC-S, CSE, IF, MSCP, HAES, founder of the Fosnight Center for Sexual Health and medical advisor for Aeroflow Urology, emphasizes that reducing stigma around urinary incontinence begins with changing the cultural narrative.

Fosnight argues that incontinence must be understood as a common, treatable medical condition rather than a personal failure or an inevitable part of aging. Public health campaigns, social media messaging, and partnerships with primary care, geriatrics, and women’s and men’s health groups can help normalize discussion and encourage individuals to seek care. Fosnight stresses that language matters: shifting from negatively charged terms like “accidents” to more neutral, affirming phrases such as “bladder leakage” can reduce shame and open the door for honest conversations.

Clinicians, she notes, also need stronger training. Routine screening questions—simple prompts that ask whether patients ever leak urine unintentionally—help create consistent opportunities for disclosure. Fosnight recommends communication models such as PLISSIT and motivational interviewing to build trust and invite patient engagement. She advocates for cross-specialty education so that primary care, OB/GYN, urology, and urogynecology all feel empowered to ask about incontinence. Repetition across providers, she says, signals importance and reassures patients that help is available.

A clear “treatment ladder” is another key component of patient confidence. Fosnight describes offering stepwise plans that outline current strategies while also showing there are additional options if one approach fails. This helps reduce fear and keeps patients motivated. She describes her approach as “cautiously aggressive”—allowing adequate time for treatments to work but moving on promptly when they do not.

Finally, Fosnight highlights the value of celebrating small wins and setting functional, meaningful goals. Success is not only fewer leaks but also improved quality of life—such as traveling comfortably or returning to the gym. Celebrating progress reinforces positive behavior and strengthens the provider-patient partnership, ultimately improving outcomes across age groups.