Medicine For Stress Incontinence
If stress incontinence does not significantly improve with lifestyle changes or exercises, surgery will usually be recommended as the next step.
However, if you’re unsuitable for surgery or want to avoid an operation, you may benefit from an antidepressant medicine called duloxetine. This can help increase the muscle tone of the urethra, to help keep it closed.
You’ll need to take duloxetine tablets twice a day and will be assessed after 2 to 4 weeks to see if the medicine is beneficial or causing any side effects.
Possible side effects of duloxetine can include:
Do not suddenly stop taking duloxetine, as this can also cause unpleasant side effects. A GP will reduce your dose gradually.
Duloxetine is not suitable for everyone, however, so a GP will discuss any other medical conditions you have to determine if you can take it.
It Could Be A Sign Of An Underlying Condition
Naturally, later in life, people can experience incontinence because of increased production of urine related to aging kidneys. Bladder function is also heavily impacted by changing bladder capacity and chronic medical conditions like diabetes, says Fairchild. Chronic straining, coughing and/or constipation can all put stress on the bladder, she explains.
But leakage can also be sign of a more serious, underlying health condition, according to a 2018 National Poll on Healthy Aging.” For example, poor heart function could be the culprit behind frequent urination while sleeping.
If fluid is pooling in your legs during the day, when you lay down, that fluid redistributes and increases urine production, says Fairchild.
Although bladder leakage is common, discuss your particular symptoms with your doctor.
Incontinence In Alzheimer’s Disease
People in the later stages of Alzheimers disease often have problems with urinary incontinence. This can be a result of not realizing they need to urinate, forgetting to go to the bathroom, or not being able to find the toilet. These tips may help:
- Avoid drinks like caffeinated coffee, tea, and sodas, which may increase urination. But dont limit water.
- Keep hallways clear and the bathroom clutter-free, with a light on at all times.
- Provide regular bathroom breaks.
- Use underwear that is easy to get on and off, and absorbent briefs or underwear for trips away from home.
Visit Alzheimers Disease: Common Medical Problems for more tips.
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Other Bladder Control Medications
If symptoms of urinary incontinence are thought to be caused by an enlarged prostate, different medications can be offered to reduce these symptoms. The prostate gland wraps around the urethra , and if it is enlarged, it could squeeze the urinary passage tight, making the emptying of bladder more difficult and incomplete.
In brief, the following categories are available for the treatment of urinary symptoms caused by an enlarged prostate :
- Alpha-blockers, terazosin , doxyzosin , alfuzosin , silodosin , and tamsulosin , work by relaxing the muscles around the urethra and prostate, thus, making urination more comfortable and complete. These medications start to relieve symptoms within a few weeks, but they do not affect the prostate size.
- 5-alpha reductase inhibitors, finasteride and dutasteride , work by reducing the size of the prostate gland. They may take several months to become effective.
Can I Buy Medicines For Urinary Urgency And Incontinence
No – you cannot buy medicines for urinary urgency and incontinence. They are only available from your pharmacist, with a doctor’s prescription.
How to use the Yellow Card Scheme
If you think you have had a side-effect to one of your medicines you can report this on the Yellow Card Scheme. You can do this online at www.mhra.gov.uk/yellowcard.
The Yellow Card Scheme is used to make pharmacists, doctors and nurses aware of any new side-effects that medicines or any other healthcare products may have caused. If you wish to report a side-effect, you will need to provide basic information about:
- The side-effect.
- The name of the medicine which you think caused it.
- The person who had the side-effect.
- Your contact details as the reporter of the side-effect.
It is helpful if you have your medication – and/or the leaflet that came with it – with you while you fill out the report.
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Percutaneous Tibial Nerve Stimulation
Normal voiding depends not only on the normal function of organs and muscles, but also on nerves that deliver appropriate signals regarding urination. In urge incontinence, the nerves regulating the bladder can become hyper-reactive, sending strong signals to empty before the bladder is full. Nerve stimulation therapies “jam” the pathways that transmit these abnormal messages.
In PTNS, a small acupuncture needle is placed in the ankle along the tibial nerve. A handheld device connects to the needle to deliver mild electrical impulses to the nerve. These travel up the tibial nerve to the sacral nerve plexus, which regulates the bladder. PTNS sessions are painless, last 30 minutes and are repeated weekly for 12 weeks. All sessions take place in a medical office.
Extracorporeal Magnetic Resonance Therapy
Extracorporeal magnetic resonance therapy has been introduced as a therapy for stress incontinence. The NeoControl unit was approved by the Food and Drug Administration for this purpose in 2000. Resonating magnetic flux within a magnetic field induces electrical depolarization of targeted nerves and muscles. No probes are required. The patient simply sits on a chair containing the magnetic device.
A small study achieved an improvement rate of 77% after 8 weeks of therapy, with 56% of patients being completely dry. However, a 3-year follow-up study found that the benefits tend to be temporary: at 6 months, the recurrence rate was 53%.
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How To Talk About Urinary Incontinence
Bringing up the topic of urinary incontinence with your doctor or your spouse is never easy most people are at least a bit embarrassed. But open communication can help you find out about the causes of incontinence and whether your medications may be contributing.
One good opener might be something like this: “I have been having bladder troubles.”
If you will be visiting a new doctor, and have not yet selected them, you might seek out a doctor of the same sex, if you think that would help you feel more comfortable. Or, you might bring up the topic first with your doctor’s nurse.
Preparing for the conversation about urinary incontinence may help you feel more in control. That means being able to answer the questions your doctor is likely to ask, including:
- When did your urinary incontinence symptoms begin?
- Have you had urinary incontinence symptoms before?
- What drugs are you on, and when did you start each of them?
- Do you leak urine with physical activity, coughing or sneezing?
You may find it easier to talk about incontinence if you acknowledge it as a medical condition that needs treatment, just as high blood pressure, arthritis, or high cholesterol does. Treatment options for urinary incontinence are plentiful.
When Should I See A Doctor About Incontinence
Its important to know that incontinence can be treated. Many people believe that its something that just goes along with aging and is an unavoidable issue. If you find that incontinence is disturbing your daily activities and causing you to miss out on things you typically enjoy, talk to your healthcare provider. There are a wide range of options to treat incontinence.
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What Is The Evidence For Effective Treatments For Urinary Incontinence
Women have several options to manage their urinary incontinence and these primarily include either drug or non-drug treatments. Many studies have shown that the majority of women improve their symptoms using non-drug conservative interventions and these include:
Intra-vaginal electrical or magnetic stimulation may help some women with incontinence . However, some women do not benefit from these non-drug treatments, or they are unable to access these treatments, or make the necessary lifestyle changes. In this case, doctors may suggest the use of drugs to help with incontinence problems. We review the current scientific evidence about the effectiveness of these drugs to help manage incontinence.
Urinary Incontinence In Men
Bladder leakage in men can be caused by a birth defect of the urinary tract.
Men also have the risk of contracting urinary incontinence with a history of prostate cancer. The treatment from radiation and medication may result in temporary or permanent bladder leakage.
An enlarged prostate without cancer cells may lead to a condition known as benign prostatic hyperplasia, or BPH. This condition causes the prostate to expand and apply pressure to the urethra, resulting in the walls of the bladder also expanding and thickening. Over time, the bladder weakens and retains some volume after urination.
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Why Does Pregnancy Cause Incontinence
During pregnancy, your body goes through a lot of physical changes. As your uterus stretches to hold the growing baby, a few things happen. Your bladder can be squished by the expanding baby, making your bladder hold less than before. You might experience an increased urgency to pee during pregnancy because your bladder cannot hold as much as before. This might become even more challenging towards the end of pregnancy when the baby is at its largest.
Another reason for incontinence during pregnancy is the weakening of your pelvic floor muscles. These muscles are the support structures for all of the organs in your pelvis. During pregnancy, they can be stretched and weakened as your uterus expands.
Treatment Of Nocturnal Enuresis
While nocturnal enuresisdefined as involuntary loss of urine during sleep that occurs at least twice a week in children older than 5 years of age for at least 3 monthsis the most common urologic complaint in pediatric patients, it also affects a significant number of adults. Nocturnal enuresis in adults may have multiple underlying pathologies, and treatment should first target identifiable etiologies, although a generalized approach can then be followed, utilizing behavioral and lifestyle modifications followed by medical therapy.
Such basic measures as evening fluid restriction and daytime bladder training can be beneficial. Desmopressin decreases nighttime urine production it is administered orally for primary nocturnal enuresis and intranasally or sublingually for nocturnal polyuria. Imipramine has been one of the most common pharmacologic therapies. Oxybutynin and other anticholinergics have been used.
Although pharmacologic treatment can help, the underlying disorder often returns after discontinuation. Conditioning therapy with moisture-sensitive alarms are effective. Positive results usually persist even after the device is removed.
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Pelvic Floor Muscle Exercises
Also known as Kegel exercises, these exercises are especially effective for stress incontinence but may also help urge incontinence. To do pelvic floor muscle exercises, imagine that youre trying to stop your urine flow. Then:
- Tighten the muscles you would use to stop urinating and hold for five seconds, and then relax for five seconds.
- Work up to holding the contractions for 10 seconds at a time.
- Aim for at least three sets of 10 repetitions each day.
What Are Important Things To Know About Urinary Incontinence And Medications
We need to remember that drugs are not free of consequences and that they always increase our risk for unwanted side effects. First, women who want help with their incontinence problems should seek to make lifestyle changes such as exercising more and losing excessive weight. The earlier in our lives we adopt such healthy behaviors, the better we will be when we get older . Keeping with these healthy behaviors is a key for success when dealing with incontinence. However, for some women, lifestyle changes may not be enough and they may wish to discuss the use of drugs to manage their incontinence. If you are considering asking your doctor about the use of drugs, go prepared. Women should inform themselves about the specific benefits, harms, and costs of the medications. Together women and their doctors can make the best choice and select the optimal balance between the benefits and potential harms of medications for treating incontinence.
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Living With An Artificial Urinary Sphincter
The only time youll need to interact with the device is when you squeeze the pump to urinate.
Its important to go to all your scheduled follow-ups to make sure the device is functioning properly. AUS devices eventually need to be replaced, but they can last for many years.
AUS devices are compatible with MRIs, but its still a good idea to let healthcare professionals know ahead of time that you have one.
Other treatments for male urinary incontinence include:
Behavioral And Lifestyle Changes
Changing your lifestyle may help with bladder problems. Losing weight, quitting smoking, saying no to alcohol, choosing water instead of other drinks, and limiting drinks before bedtime can help with some bladder problems. Preventing constipation and avoiding lifting heavy objects may also help with incontinence. Even after treatment, some people still leak urine from time to time. There are bladder control products and other solutions, including disposable briefs or underwear, furniture pads, and urine deodorizing pills that may help.
Visit the National Institute of Diabetes and Digestive and Kidney Diseases for more information on urinary incontinence in men and urinary incontinence in women.
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What Are The Symptoms Of Urinary Incontinence
The following are common symptoms of urinary incontinence. However, each individual may experience symptoms differently. Symptoms may include:
Needing to rush to the restroom and/or losing urine if you do not get to the restroom in time
Urine leakage with movements or exercise
Leakage of urine that prevents activities
Urine leakage with coughing, sneezing or laughing
Leakage of urine that began or continued after surgery
Leakage of urine that causes embarrassment
Constant feeling of wetness without sensation of urine leakage
Feeling of incomplete bladder emptying
The symptoms of urinary incontinence may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.
Types Of Urinary Incontinence
There are different types of incontinence:
- Stress incontinence occurs when urine leaks as pressure is put on the bladder, such as during exercise, coughing, sneezing, laughing, or lifting heavy objects. Its the most common type of bladder control problem in younger and middle-aged women. It also may begin later, around the time of menopause.
- Urge incontinence happens when people have a sudden need to urinate and cannot hold their urine long enough to get to the toilet. It may be a problem for people who have diabetes, Alzheimers disease, Parkinsons disease, multiple sclerosis, or stroke.
- Overflow incontinence happens when small amounts of urine leak from a bladder that is always full. A man can have trouble emptying his bladder if an enlarged prostate is blocking the urethra. Diabetes and spinal cord injuries can also cause this type of incontinence.
- Functional incontinence occurs in many older people who have normal bladder control. They just have a problem getting to the toilet because of arthritis or other disorders that make it hard to move quickly.
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Other Useful Counseling Information
The pharmacist should be familiar with other usefulinformation regarding Oxytrol For Women that is not required on thenonprescrip-tion product label.4 For instance, patients usinganticholinergics such as oxybutynin should be warned not to enter hotenvironments, since that group of medications reduces the ability tosweat, and the wearer may suffer heat prostration, with fever and heatstroke. Oral dosage forms of oxybutynin have caused angioedema,4and patients should be informed that the appearance of any symptomsthat might be angioedema is sufficient cause for a 911 call, withimmediate transport to an emergency room.
The label warning against use in gastric retention is required because anticholinergics decrease gastric motility.4However, the label omits other examples of patients who are at highrisk of complications due to decreased gastric motility, such as thosewith ulcerative colitis, intestinal atony, and myasthenia gravis. It isalso vital to know that patients with gastroesophageal reflux should useOxytrol For Women with caution, a warning that also includes patientswho are taking bisphosphonates , since these drugs can induce or worsen reflux.4
To facilitate compliance, patients can be instructed tochange patches on the same 2 days each week. Product packages have acalendar on the back to help patients remember when changing is due.4
Control Your Urge To Urinate
You may be able to control, or suppress, the strong urge to urinate, which is called urge or urgency suppression. With this type of bladder training, you can worry less about finding a bathroom in a hurry. Some people distract themselves to take their minds off needing to urinate. Other people find that long, relaxing breaths or holding still can help. Doing pelvic floor exercises to strengthen your pelvic floor also can help control the urge to urinate. Quick, strong squeezes of the pelvic floor muscles can help suppress urgency when it occurs, which may help you get to the toilet before you leak.
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% Money Back Guarantee
200% Money Back – Simply check with your doctor and make sure they “okay” you to take U-Control. If after using U-Control for at least 30 days, you don’t see improvements in your urgency and urinary control, then simply send back the unused bottles along with a simple 1-page note giving me your honest feedback of the product and we will give you 200% of your money back. That’s correct, you will get DOUBLE your money back.
What Makes Yale Medicine’s Approach To Treating Female Incontinence Unique
Incontinence is a difficult subject for patients to talk about. Here at Yale Medicine, we know the best conversations start with listening. We guide you towards treatments that best match your goals and lifestyle.
We are experts in the latest non-surgical and surgical techniques, and we have an established Urogynecology fellowship program. “We are training the future urogynecologists and that makes us stay sharp,” Dr. Harmanli says. “Plus, at Yale, we are surrounded by other specialists such as urologists, gynecologists, and colorectal surgeons with whom we can coordinate your care.”
At Yale Medicine Urogynecology & Reconstructive Pelvic Surgery, you will work with not only doctors but physical therapists and our nurse practitioner Cherrilyn Richmond, who will coach you through pelvic floor exercises.
Furthermore, Yale researchers are at the forefront of developing new innovative treatment modalities that in 20 years, Dr. Harmanli trusts, ” going to fix most these problems.”
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