What Are The Types And Symptoms Of Urinary Incontinence
Urinary incontinence can be short-term or long-lasting . Short-term incontinence is often caused by other health problems or treatments. This topic is about the different types of chronic urinary incontinence:
- Stress incontinence means that you leak urine when you sneeze, cough, laugh, lift something, change position, or do something that puts stress or strain on your bladder.
- Urge incontinence is an urge to urinate that’s so strong that you can’t make it to the toilet in time. It also happens when your bladder squeezes when it shouldn’t. This can happen even when you have only a small amount of urine in your bladder. Overactive bladder is a kind of urge incontinence. But not everyone with an overactive bladder leaks urine.
- Overflow incontinence means that you have the urge to urinate, but you can release only a small amount. Since your bladder doesn’t empty as it should, it then leaks urine later.
- Total incontinence means that you are always leaking urine. It happens when the sphincter muscle no longer works.
- Functional incontinence means that you can’t make it to the bathroom in time to urinate. This is usually because something got in your way or you were not able to walk there on your own.
What Are The Treatments
Not all patients need treatment, especially if their symptoms are not too bothersome. As discussed above, about a third of patients with symptoms remain unchanged after 4 years. Therefore, observation is a reasonable option in patients with uncomplicated BPH.
In those who are more bothered, or those with complicated symptoms, medications or surgery can be offered.
Emerging Options For Oab
The 3-adrenergic receptor is the most abundant of the AR subtypes in human detrusor muscle, suggesting that this subtype mediates detrusor relaxation. The mechanism by which -AR agonists induce relaxation of smooth muscles is not fully understood, but it is believed that an intracellular pathway for smooth muscle relaxation is activated by cAMP. Some animal studies of 3-adrenoceptor agonist have revealed increased bladder capacity, no change in micturition pressure and no change in residual volume . Selective 3-AR agonists should have a theoretical advantage over non-selective -AR agonists, as the latter may exhibit serious cardiovascular side effects like tachycardia or decrease of blood pressure by stimulating 1- and 2-adrenoceptors .
Botulinum Toxin Injections For Oab
To treat incontinence, doctors inject botulinum toxininto the bladder muscle. This is done with a needle that is inserted via a long tube called a cystoscope that goes up into the bladder. âThe goal is to reduce the over-activity of the bladder muscle so that the patient has better control, but still allow enough muscle contraction to empty the bladder,â Rames says. The effects generally last for about 9 months. So far there donât seem to be any major side effects from botulinum toxin, although itâs only recommended if your symptoms arenât controlled with behavioral therapies, medications, or a combination of both.
Linda Brubaker, MD, professor, department of obstetrics & gynecology and urology, Loyola University Chicago Stritch School of Medicine, Chicago.
Ross Rames, MD, associate professor of urology, Medical University of South Carolina, Charleston.
UpToDate: âTreatment of Urinary Incontinence.â
National Association for Continence: âOveractive Bladder Treatment.â
Duthie JB. Cochrane Summaries, Dec. 7, 2011.
National Association for Continence: âUrgency Urinary Incontinence/Overactive Bladder.â
News release, FDA.
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What Are The Causes Of Male Overactive Bladder
Overactive bladder is caused by abnormal messages in the nerves that supply the bladder that causes the bladder muscle to contract out of a mans control.
In men the commonest cause of OAB is blockage i.e. due to prostate enlargement that makes it harder for the urine to be passed and as a result the bladder has to work harder and becomes overactive.
Some cases of male overactive bladder are idiopathic i.e. the man does not have a defined or identifiable neurological abnormality but the bladder nerve pathways are nevertheless misbehaving.
Other cases of OAB are due to neurogenic detrusor overactivity i.e. the person has a definite neurological problem identified e.g. a spinal cord injury, past stroke or neurological condition such as Multiple Sclerosis or Parkinsons disease.
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Tips For Coping With An Enlarged Prostate
When a man reaches about age 25, his prostate begins to grow. This natural growth is called benign prostatic hyperplasia and it is the most common cause of prostate enlargement. BPH is a benign condition that does not lead to prostate cancer, though the two problems can coexist.
Although 50% to 60% of men with BPH may never develop any symptoms, others find that BPH can make life miserable. The symptoms of BPH include:
- a hesitant, interrupted, weak urine stream
- urgency, leaking, or dribbling
- a sense of incomplete emptying
- more frequent urination, especially at night.
As a result, many men seek treatment. The good news is that treatments are constantly being improved. Patients and their physicians now have more medications to choose from, so if one doesnt do the trick, another can be prescribed. And thanks to some refinements, surgical treatments are more effective and have fewer side effects than ever before.
But there are some things men dealing with BPH can do on their own. When symptoms are not particularly bothersome, watchful waiting may be the best way to proceed. This involves regular monitoring to make sure complications arent developing, but no treatment. For more troubling symptoms, most doctors begin by recommending a combination of lifestyle changes and medication. Often this will be enough to relieve the worst symptoms and prevent the need for surgery
Fda Approves New Drug For Uti Two Devices For Oab/incontinence
The FDA approved cefiderocol in patients 18 years of age or older who have limited or no alternative treatment options, for the treatment of complicated urinary tract infections , including pyelonephritis, caused by the following: susceptible Gram-negative microorganisms: Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, and Enterobacter cloacae complex.
The approval of cefiderocol is based on data from the pivotal APEKS-cUTI study, a multinational, multicenter, double-blind clinical trial that evaluated the drugs efficacy and safety versus imipenem/cilastatin in patients with cUTI, according to a statement from Shionogi & Co., Ltd., the drugs manufacturer. Study results showed the response rates for the composite endpoint of microbiological eradication and clinical response at the test of cure were significantly higher in the cefiderocol arm compared to the IPM/CS arm.
In the study, 72.6% of patients in the cefiderocol arm met the primary endpoint versus 54.6% in the IPM/CS arm at TOC. The adjusted difference between the groups was 18.58% . Clinical response rates at the TOC visit were similar between cefiderocol and IPM/CS.
Serious adverse events were reported for 4.7% of patients who received cefiderocol and 8.1% of patients who received IPM/CS.
Shionogi said it anticipates making the drug commercially available in early 2020.
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Overactive Bladder Causes And Symptoms
Overactive bladder is a clinical condition that happens when the muscles of the bladder contract involuntarily. When the bladder muscle contracts too frequently or at the wrong time, the person might have signs of an OAB.
The condition is marked by a sudden need to urinate that is difficult to manage with or without accidental urinary discharge and typically with elevated urinary frequency. Unintentional urinary leakage due to urgency is referred to as UUI. Excessive urination and nocturnal symptoms are some of the other symptoms of OAB.
More than 30 million people in the US suffer from troubling symptoms of OAB, which can significantly hamper the day-to-day activities of the patients.
Diet And Lifestyle Strategies
- Limit alcohol to no more than 1 drink a day.
- Eat less of any food that might irritate your bladder. Then look for changes in your bladder habits. Such foods include citrus fruit, chocolate, tomatoes, vinegars, spicy foods, dairy products, and aspartame.
- If you smoke, quit.
- Avoid constipation:
- Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fiber.
- Drink enough fluids. Don’t avoid drinking fluid because you are worried about leaking urine.
- Get some exercise every day. Try to do moderate activity at least 2Â½ hours a week. Or try to do vigorous activity at least 1Â¼ hours a week. It’s fine to be active in blocks of 10 minutes or more throughout your day and week.
- Take a fiber supplement with psyllium or methylcellulose each day. Read and follow all instructions on the label.
- Schedule time each day for a bowel movement. Having a daily routine may help. Take your time and don’t strain.
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Diagnosis Of Enlarged Prostate Gland And Urinary Problems
If you are troubled by urination problems, see a doctor no matter what your age. If your doctor agrees that your symptoms need further evaluation and treatment, you may need to undergo a few tests.These may include:
- general examination medical history and review of any health conditions including obesity, diabetes, obstructive sleep apnoea, depression and erectile dysfunction. A rectal examination may be done to check the size and shape of your prostate gland
- a urine check to ensure the prostate is not infected
- a flow-rate check to estimate the speed with which you pass urine
- an ultrasound examination to assess if the bladder is emptying completely and to examine your kidneys
- urodynamics a series of tests on the bladder to see how your urinary system is functioning may be recommended in some circumstances.
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Can An Enlarged Prostate Cause Overactive Bladder In Men
Although overactive bladder affects up to 30% of men in the United States, many men have difficulty asking for help. Thats why its important to know that overactive bladder in men, like most urinary incontinence issues, is not a disease in its own rightits the symptom of some other underlying issue. In men, the cause is often related to an enlarged prostate this CAN be caused by a cancerous tumor, so its important to seek diagnostic treatment at the first sign of trouble. Here are five symptoms to help you decide when its time to talk with your doctor.rnrn rn
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Research Question : Are Men Diagnosed With Pca More Likely To Have Luts/oab
The search related to this question resulted in 245 publications that were screened for eligibility. Of those, 53 were read in full, from which 11 were ultimately included in our review. The remainder had not explicitly measured or indicated the prevalence of OAB/LUTS at PCa diagnosis/positive biopsy. A complete flow diagram of the study selection is provided in Fig. 1. Among the included publications, 10 were prospective studies and one was retrospective.
Flowchart of study selection .
Details for the 11 publications included in the review are provided in Table 2. All studies examined LUTS as an outcome measurement, however, they did not differentiate between voiding and storage symptoms. These studies used four different questionnaires to measure LUTS. Each of these studies reported PCa-related factors, including prostate-specific antigen levels and tumor stage. Of the studies examining the relationship between PCa and LUTS, results varied but tended to indicate an inverse association between PCa and LUTS.
The Initial Causes Differences In Symptoms Of Enlarged Prostate And Overactive Bladder
One of the first symptoms of prostate issues is pain or tenderness in the groin or lower back. This can be the result of a noncancerous condition called enlarged prostatic tissue, or it could be an infection of the bladder. In either case, its important to see a doctor as soon as possible. If youre suffering from prostate pain, you may want to consider reducing your caffeine intake.
Another symptom of a potentially enlarged prostate is difficulty starting a stream of urine, leaking, or dribbling. These symptoms are not serious, but theyre still alarming. Most men put up with an enlarged prostate for years before seeking medical attention, but they typically seek treatment as soon as they notice symptoms. Even if you dont have symptoms, its worth getting checked to determine if you have any prostate issues.
If you experience nightly bathroom runs, you may be experiencing an enlarged prostate. You may be having difficulty starting a stream of urine, or you may even be dribbling or leaking during the day. These problems arent life-threatening, but can become a nuisance. You should not ignore these signs and seek treatment as soon as you notice them. If you feel any of these symptoms, you should consult a doctor.
How Is Painful Urination Diagnosed
Be sure to tell your doctor all of your symptoms. This will help them make the right decision about the course of treatment.
Your doctor will also want to know how long you have had your symptoms and whether they occurred suddenly or gradually. They will also want to know if you have any trouble urinating or a weak stream. They will also ask if you feel pain when you begin urinating or after.
Once they have taken your history and symptoms, your doctor will perform a physical exam. They will also take a urine sample to test for a UTI.
Your urine sample will be analyzed for both red and white blood cells and any foreign chemicals.
Your doctor will look for white blood cells in your urine to see if you have a bacterial infection. They can also take a culture of your urine to determine what bacteria is causing the infection. After they get these results, you may need further testing, or they will have a diagnosis and can prescribe medication.
Overactive Bladder In The Vulnerable Elderly
Accepted for publication 26 June 2014
3 October 2014Volume 2014:6 Pages 131138
Urinary symptoms such as urgency/frequency and incontinence become increasingly prevalent with aging.1,2 A large multinational population-based survey estimated the prevalence of overactive bladder in Europe and Canada to be 12.8% in women and 10.8% in men.2 The NOBLE study showed similar trends in the USA, with OAB being twice as prevalent in individuals over 65 years of age than in those aged 45 years or younger.3 Urinary symptoms have a considerable negative impact on quality of life and health in the elderly,4,5 and have been shown to be associated with increased risk of falls and fractures.6,7 Costs associated with urinary symptoms in the aged are significant.8,9 With the aging of the population, it is estimated that by 2025 there will be 52 million adults in the USA with lower urinary tract symptoms.10 Thus, the burden of these symptoms on society is increasing.
Vulnerable or frail elderly
Evaluating OAB in the vulnerable elderly
Figure 1 Conceptual relationship of clinical factors.Notes: Symptoms, measurable function, and morbidity related pathophysiology, their evaluation and any treatments are related concerns which must be identified, clarified, and prioritized. While this sometimes-subtle distinction is always important, it assumes greater importance in the vulnerable elderly.
Who is the patient?
What are feasible treatment options?
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Treatment For Urge Incontinence
Treatments for urge incontinence vary between patients and are based on the underlying cause of the problem. These treatments may include:
- Improved diet and exercise as well as lifestyle change to reduce the strain on the bladder. This may include changing water consumption habits as well as avoiding diuretics such as alcohol and caffeinated drinks. Spicy and acidic foods can irritate the bladder, making spasms more likely
- Bladder retraining, involving bladder muscle exercises to improve urinary retention. This can improve urge incontinence if there are no other significant challenges
- Pelvic floor exercises such as kegels can assists with urge incontinence
- Medications can be used to treat urge incontinence or its underlying cause, however patients should be aware of side-effects
- Surgery can be used to treat urge incontinence or its root cause . Surgery does come with risks that should be discussed with a qualified medical professional
- In-office BPH therapy can effectively improve or eliminate urge incontinence in men suffering from excess prostatic tissue with excellent long-term results and few sexual side effects. Urologix offers both Cooled ThermoTherapy and Prostiva RF . As with any medical procedure, you should talk to a medical professional to learn about the benefits and risks
- Nerve stimulation