Who Should Not Use These Medications
These medications should not be used by anyone who has trouble passing urine or who has any condition that slows down the movement of material through the stomach, intestines, or bowel . People with a type of glaucoma known as narrow-angle glaucoma should not use these medications .
Speak to your doctor if you have other stomach or intestinal problems, heart problems , neurologic disease, liver disease, or kidney disease, or if you are pregnant or breast-feeding.
Your Medication Has Become Less Effective Over Time
Its important for patients to know that, even if a medication works very well, it may become less effective after a year or two. We dont know why this isit may be either due to the progression of the OAB disease process, or maybe blocking the receptors in the bladder isnt as effective after a while. Long-term studies have shown that patients tend to stop taking their medications after a few years because they feel that theyre not working as well, but before stopping your medication, ask your doctor about other options. Another medication can give you the results youre looking for if your current drug isnt cutting it anymore.
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Side Effects And How To Manage Them
Since these medications work in a similar way, they also share certain side effects. The most common side effects are dry mouth and constipation.
To manage dry mouth, try chewing sugarless gum, sucking on ice chips or sugarless hard candies, or using a saliva substitute . If you’re still troubled by dry mouth, speak to your doctor.
To prevent and manage constipation, try increasing the amount of fibre in your diet and getting more exercise. You can also speak to your doctor or pharmacist about using medications to prevent or relieve constipation.
Drinking plenty of fluids may also help in combatting dry mouth and constipation, but the increase in fluids may affect your condition. Talk to your doctor to see if this is a viable option for you.
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Questions To Ask Your Health Care Provider
- What causes neurogenic bladder?
- Can neurogenic bladder be prevented?
- Can you help me or do I need to see a specialist in neurourology? If so, how can I find the right one for me?
- Will I need to have tests to find out what is causing my neurogenic bladder?
- Would you explain each test and why you are recommending them?
- What types of treatment are available for neurogenic bladder?
- Are there side effects of treatment?
- What are the pros and cons of each type of treatment?
- What treatment do you recommend for me and why?
- What happens if the first treatment doesnt help?
- Are there any lifestyle changes I can make that could help my symptoms?
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Who Can And Cannot Take Mirabegron
Mirabegron can be taken by adults .
It is not suitable for everyone. To make sure it’s safe for you, tell your doctor or pharmacist before starting mirabegron if you:
- have had an allergic reaction to mirabegron or any other medicines in the past
- have liver or kidney problems
- have high blood pressure
- are not able to pee or empty your bladder completely
- have a blockage in your bladder
- have a heart problem called QT prolongation
- are pregnant, trying to get pregnant or breastfeeding
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Prognosis Of Overactive Bladder
Overactive bladder is a set of symptoms, not a disease in its own right. How long your OAB lasts, and whether it gets better or worse, will depend on the underlying causes.
You may be able to reduce the burden of OAB through lifestyle changes, drug treatments, or certain nonsurgical or surgical procedures.
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Are There Any Long
In general, you may have side effects within the first week of receiving Botox injections. Most of the time, these side effects are temporary, but sometimes, side effects can last for several months or longer.
But possible long-term side effects of Botox can include:
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Nerve Disease Or Spinal Cord Injury
Many events or conditions can damage nerves and nerve pathways. Some of the most common causes are
- vaginal childbirth
- infections of the brain or spinal cord
- accidents that injure the brain or spinal cord
- multiple sclerosis
- heavy metal poisoning
- pelvic injury or trauma
In addition, some children are born with nerve problems that can keep the bladder from releasing urine.
You Cant Stand The Side Effects
Of course, as with any medication, there are several side effects to be aware of. OAB medications may cause dry eyes, dry mouth, constipation, and drowsiness. Some drugs also prevent patients from fully emptying their bladders. One drug in particular, oxybutynin , has been associated with some memory loss, so Ill try to give older patients a different one. For example, trospium anddarifenacin are thought to cause fewer cognitive side effects , so Ill choose one of those for patients who are concerned about those issues.
If youre experiencing any side effects to the point where you dont want to use your medication anymore, talk to your doctor. He or she may lower your dosage or switch you to an extended-release version of your medication, which may reduce side effects. You could also try a patch or gel form for fewer side effects. However, if those tweaks dont work, ask to try something new: each OAB drug affects your body differently, so its important to try other options instead of giving up on medication altogether.
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How Effective Is Botox
Botox has been shown to be an effective treatment option for bladder problems. In studies, people who received Botox injections for overactive bladder symptoms saw improvements in certain symptoms, such as frequent urination, in the 12 weeks after treatment. People also noticed an increase in the amount released during urination.
Another improvement that people using Botox for OAB symptoms noticed after receiving the injections was fewer episodes of urinary incontinence. In studies, these improvements lasted from 19 to 24 weeks.
In other studies of Botox used for OAB symptoms in adults, people reported improvements in their symptoms and in their quality of life.
Two studies looked at adults who had urinary incontinence with detrusor overactivity* linked with a neurological condition. These studies found that people who received Botox injections had fewer episodes of urinary incontinence. These improvements lasted 42 to 48 weeks for at least half the people in the study.
If you have questions about the results you can expect with this drug, talk with your doctor.
* This refers to overactivity of the detrusor muscle, which is the muscle that lines the bladder.
- overactive bladder symptoms in adults
- urinary incontinence with detrusor overactivity* linked with a neurological condition such as multiple sclerosis or a spinal cord injury, in adults and children ages 5 years and older
* This refers to overactivity of the detrusor muscle, which is the muscle that lines the bladder.
Overactive Bladder Treatment Options
Research indicates that most people believe the symptoms of an overactive bladder are an inevitable and normal part of growing older, rather than a treatable medical problem. This couldnt be further from the truth.
In fact, fewer than half of individuals with incontinence actually consult a healthcare provider about their problem. This is unfortunate, since there are many treatments available to combat symptoms of OAB.
Even though it may feel embarrassing to talk about your condition, its important to talk to your doctor about your incontinence symptoms. Watch our short film below about the importance of speaking up about bladder leakage.
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How Is Botox Given
To treat bladder conditions, Botox is given as an injection into the detrusor muscle .
At each injection appointment, adults with OAB symptoms or children with detrusor overactivity will receive a Botox injection in 20 sites, located 1 centimeter apart in the detrusor muscle.
Adults with detrusor overactivity will receive a higher dose of Botox, which is injected in 30 sites, located 1 cm apart in the detrusor muscle.
In some cases, your doctor may inject a medication before your Botox injection to help with pain.
Your doctor will monitor you for at least 30 minutes after each Botox injection. If youre using Botox to treat OAB symptoms, youll need to show that you can urinate before leaving your doctors office.
If you have questions about what to expect at your injection appointments, talk with your doctor.
What Other Lifestyle Changes Can A Person Make To Control Their Symptoms
A lot of OAB management comes down to lifestyle.
Certain foods and drinks can worsen symptoms, such as coffee, alcohol, spicy foods, and chocolate. Cutting back on these items or avoiding them altogether can make a big difference for some people.
Smoking, having obesity, and drinking carbonated beverages can also worsen symptoms. Weight loss and smoking cessation may help OAB symptoms and benefit overall health.
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About Oab And Detrusor Overactivity
OAB and detrusor overactivity can both cause trouble with urination. With these conditions, you may have involuntary spasms in your bladder muscles, even when you dont actually need to urinate.
The exact cause of OAB isnt known. But some possible factors or causes may include:
- consuming caffeine, alcohol, or other bladder irritants
- taking medications that increase urine output
- other bladder problems, such as bladder stones
- not completely emptying the bladder
Detrusor overactivity can be linked with neurological conditions such as MS or a spinal cord injury. These neurological conditions affect how your brain communicates with the rest of your body. In some cases, they can cause bladder problems such as detrusor overactivity.
What Is Overactive Bladder
Overactive Bladder, or OAB, is the frequent and urgent need to empty your bladder. Also sometimes called spastic bladder or irritable bladder, OAB affects an estimated 33 million people in the USA alone. And half of the people with Overactive Bladder are struggling with Urgency Urinary Incontinence , when leakage actually occurs.
Overactive bladder can be a nuisance at best, and debilitating at worst. Its frustrating to constantly be running to the bathroom, and can cause anxiety, shame and even depression when its is also accompanied by urinary incontinence.
Contrary to what many people think, overactive bladder is NOT a normal part of getting older, and isnt something you should think you have to live with. Its a real medical condition that deserves treatment.
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Cautions With Other Medicines
Mirabegron may affect the way other medicines work, and other medicines may affect how mirabegron works.
Tell your pharmacist or doctor if you’re taking:
- digoxin, a medicine for heart failure or abnormal heart rhythm
- imipramine or desipramine, medicines for urinary incontinence or nerve pain
- dabigatran, a blood thinner
- ketoconazole or itraconazole, medicines used to treat fungal infections
- ritonavir, a medicine used to treat HIV
What If I Forget To Take It
If you forget to take your medicine, take it as soon as you remember unless the next dose is due in less than 6 hours. In this case skip the missed dose and take your next one at the usual time.
Do not take a double dose to make up for a missed dose.
If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.
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Drugs For Overactive Bladder
In people with overactive bladder, muscles in the bladder wall contract at the wrong time. A group of drugs called anticholinergics combat this problem by blocking the nerve signals related to bladder muscle contractions. Research suggests that these drugs also might increase bladder capacity and decrease the urge to go.
Anticholinergic drugs include:
Oxytrol for women is the only drug available over the counter. Overall, these drugs work about the same in treating overactive bladder, and generally people tolerate all of them well. The main side effect is dry mouth, but anticholinergics also can cause constipation, blurred vision, and increased heartbeat.
Anticholinergics aren’t right for everyone. Some people with glaucoma, urinary retention, or gastrointestinal disease should avoid using anticholinergic drugs.
The drugs mirabegron and vibegron called beta-3 adrenergic agonists. These medications work by activating a protein receptor in bladder muscles that relaxes them and helps the bladder fill and store urine.
Doctors also treat men with drugs that relax a muscle at the bladder neck and prostate to help with emptying. They include:
How Is Neurogenic Bladder Diagnosed
If your healthcare provider thinks you may have neurogenic bladder, he or she will want to check youre your brain, spinal cord, and bladder. He or she will review your health history and do a physical exam. Other tests may include:
- X-rays of the skull and spine. This imaging test uses invisible energy beams to make images of tissues, bones, and organs.
- Imaging tests of the bladder and ureters
- Ultrasound . This imaging test uses high-frequency sound waves to create images of the organs on a computer screen.
- Cystoscopy. Your healthcare provider puts a thin, flexible tube and viewing device in through the urethra to examine the urinary tract. It checks for structure changes or blockages, such as tumors or stones.
- Tests that involve filling the bladder, such as urodynamics. These tests show how much the bladder can hold and check to see if it fully empties.
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What Other Warnings Should I Know About
In addition to the boxed warning described above, Botox has other warnings. If any of the following medical conditions or other health factors apply to you, talk with your doctor before using Botox:
- if you have a history of side effects from any botulinum toxin product
- if you have a condition that affects your muscles or nerves, such as amyotrophic lateral sclerosis or myasthenia gravis
- if you currently have or have a history of breathing problems, such as asthma or emphysema
- if you currently have or have a history of problems with swallowing
- if you currently have or have a history of bleeding disorders
- if you have a urinary tract infection
- if you have trouble emptying your bladder on your own
- if you have surgery planned
- if youre pregnant or breastfeeding
- if youve had an allergic reaction to the drug or any of its ingredients
Botox injections may interact with other medications youre taking. Tell your doctor about all drugs youre using, including prescription and over-the-counter products.
Also, tell your doctor if you:
- have received other botulinum toxin products or injections in the past
- have recently received antibiotics by injection
- are taking an allergy or cold medication
- use sleep medication
Topical Oestrogen In Postmenopausal Women
Postmenopausal women with dry vaginal and urethral tissues can also be treated with local vaginally inserted oestrogen cream. This is not the same as a hormone tablet or patch that is designed to raise blood levels of oestrogen.
Local or topical oestrogen pessaries aim to treat only the dry vaginal tissues, which can contribute to overactive bladder symptoms in some women . Ovestin® cream or Vagifem Low® pessaries are prescribed twice weekly for this purpose.
Dr. Karen McKertich
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What Can You Do For An Overactive Bladder
OAB occurs in both men and women. Its possible to have overactive bladder at any point in your life. But, its especially common in older adults. The prevalence of OAB in people younger than 50 years of age is less than 10 percent. After the age of 60, the prevalence increases to 20 to 30 percent.
The following are some of the other most common underlying causes and risk factors associated with OAB symptoms:
A healthy, normal functioning bladder holds urine until it gets full and is prompted to empty by nerve signals. However, when nerve damage occurs in the body, the muscles surrounding the urethra can be too loose. This undesirable looseness can cause someone to become incontinent. What can cause nerve damage that can then lead to bladder leakage? Some possibilities include:
- Back or pelvis surgery
Weak pelvic muscles
When a man or womans pelvic floor muscles are weak, bladder control issues can happen. The pelvic floor muscles are like a sling that holds up the uterus and bladder. For women, a pregnancy and childbirth can often lead to a stretching and weakening of the vital pelvic floor muscles. When pelvic floor muscles are compromised for this reason or another, the bladder can then sag out of place. The opening of the urethra also stretches and urine easily leaks out.
Overactive Bladder Treatment Options If Oral Medication Is Not Working
Bladder problems are too common in both men and women. To get rid of these problems, you have to visit the urology center, because the only urologist can help you to treat bladder conditions. You need to understand what to do if you are unable to get rid of bladder problems with oral medications.
Bladder problems are too common in both males and females, which can be treated in several ways. But if you leave them untreated then, these will surely lead you to several other health conditions. Well, Overactive bladder affects too many people across the world, which is explained as a sudden need for urination as well as leads you to loss of urine in between.
To get rid of this condition, you have to visit the urology center, because the only urologisthas specialization to treat these types of conditions in both males and females. He may first prescribe you oral medication to treat overactive bladder which includes-:
- Oxybutynin, you can so with brand Ditropan, Ditropan XL or Control
- Tolterodine-: Brand name Detrol
These are the medicines that are valuable to treat Overactive bladder problems. However, certain people are unable to get rid of this problem with oral medications. In this condition, they may need to undergo several other treatment options which include-:
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