Wednesday, March 22, 2017

Overactive Bladder doesn't necessarily have to be treated with drugs!


Urinary incontinence is certainly not a new medical problem, but it's messy and inconvenient and can be socially very limiting.

The term "over-active bladder" is a descriptive marketing term for urge incontinence.  This means that there is urinary leakage or loss of bladder control due to the sudden urge, or need to urinate.  This is different than stress incontinence where external pressure or stress on the bladder (such as by coughing, laughing or standing up) can cause leakage of urine.

There are quite a few prescription medications that can treat urinary incontinence, and I'm sure some of them are advertised on TV.  However, it is often not necessary to take medications to improve the incontinence!  Prescription drugs for incontinence can offer some improvement, but generally not completely.  Also, side-effects are not uncommon.

Losing weight and stopping smoking can help.  Using fiber supplements (such as Benefiber) and stool softners (such as Colace) may help, since constipation is pretty common and it can cause urinary problems since the rectum is next to the bladder.

Moderating alcohol, caffeine and carbonated drinks can help, since these can be irritating to the bladder and cause the need to urinate to come on suddenly.

Kegel exercises can also help, and are useful for both women (with illustrations) and men.

If you still have urge incontinence after several months of trying these suggestions, you may want to see me to consider adding a prescription medication to what you are already doing.  Long-acting (also known as extended-release) oxybutynin is a good choice:  it's generic, once a day and works as well as anything newer. The long-acting form is more expensive than the twice a day regular form, but it is also a lot less likely to cause any side effects and may be worth the extra cost.

For stress incontinence, seeing a urologist to discuss surgical procedures can be useful.  You don't have to go forward with surgery if you'd rather not, but if the symptoms are not responding to some of the above suggestions you may at least want to see what surgery would have to offer.



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