Types Of Urinary Incontinence
Urgency incontinence, also known as overactive bladder, is involuntary urination or a very strong desire or urgency to urinate.
Stress incontinence is a weakness of the bladder or sphincter muscles.
Overflow incontinence, also known as after-dribble, is a consequence of not emptying the bladder properly.
Functional incontinence happens when you know you need to urinate, but due to mental or physical reasons, such as dementia or impaired mobility, cannot make it to the bathroom in time.
Dealing With Overflow Incontinence
After-dribble/overflow incontinence is where a small amount of urine leaks out after youve finished.
The good news is that this type of incontinence responds well to self-treatment. Here are some tips:
- Sit down on the toilet to empty your bladder.
- Make sure elatics, belts or briefs are not tight around your penis and scrotum to ensure the urethra is straightened when urinating.
- Alternatively, place your fingertips behind the scrotum and apply gentle upward and forward pressure to encourage urine flow.
Medications For Unspecified Oab
If your doctor cant find a cause for your OAB, dont worry. Drugs can still help ease your symptoms. Some of these drugs work by relaxing your bladder. They stop involuntary contractions that bring on the urge to urinate. Other drugs help strengthen the tissues around your bladder that may have become weak. The stronger tissue can help improve your bladder control.
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Natural Treatment For Overactive Bladder
Bladder training and pelvic floor exercises are just two natural treatments for overactive bladder. Research suggests that these nondrug remedies can be very effective for many women, and they have almost no side effects.
But before starting any OAB treatment, itâs important to understand bladder function and what things may cause overactive bladder.
Another way to strengthen pelvic floor muscles is electrical stimulation, which sends a small electrical pulse to the area via electrodes placed in the vagina or rectum.
Until you get your overactive bladder under control, wearing absorbent pads can help hide any leakage.
Other lifestyle tips for preventing incontinence include:
What Causes Overactive Bladder
An overactive bladder can be caused by several things, or even a combination of causes. Some possible causes can include:
- Weak pelvic muscles: Pregnancy and childbirth can cause your pelvic muscles to stretch and weaken. This can cause the bladder to sag out of its normal position. All of these factors can cause leakage.
- Nerve damage: Sometimes signals are sent to the brain and bladder to empty at the wrong time. Trauma and diseases can cause this to happen. These can include:
- Pelvic or back surgery.
- Stroke.
Often, there may be no specific explanation for why this is occurring.
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Anticholinergic Drugs For Oab
The largest class of drugs used to treat OAB is anticholinergic drugs. They work by blocking a chemical in your body called acetylcholine. This chemical sends a message to your bladder to contract. By blocking this chemical, these drugs reduce the contractions that cause you to release urine. In studies that compared the drugs, all anticholinergics worked in treating OAB.
Anticholinergics are sold under different brand names. Some are also available as generic drugs. These medications include:
- oxybutynin
- solifenacin
- fesoterodine
All of these drugs except for Oxytrol come as either tablets or capsules that you take by mouth. Oxytrol is available as a skin patch.
The most common side effects of anticholinergic drugs include:
- dry mouth
- blurry vision
- constipation
Seniors have the greatest risk of side effects from these drugs. These medications may also cause drowsiness and an increased risk of falls in seniors. Oxybutynin may cause more side effects than the other drugs in this class. However, taking oxybutynin in its extended-release form may reduce some of the side effects. Anticholinergics may also worsen dementia symptoms and should be used with caution in people with this disease.
Lycopodium Clavatum Homeopathic Medicine For An Overactive Bladder With Frequent Urination At Night
Lycopodium Clavatum is an effective homeopathic medicine for an overactive bladder in cases of frequent urination at night. The quantity of urine in such cases is also very high. There is a feeling of bearing down on the bladder region along with the need to wake up at night because of the urge to urinate. Stitching pain in the bladder is also present in some cases. Lycopodium Clavatum is also helpful in cases of an overactive bladder in males suffering from prostate enlargement.
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A New Nonprescription Product For Overactive Bladder In Women
W. Steven Pray, PhD, DPhBernhardt Professor, Nonprescription Products and DevicesCollege of Pharmacy
Gabriel E. Pray, PharmD CandidateCollege of PharmacyWeatherford, Oklahoma
US Pharm
Occasionally, the nonprescription product market undergoesa significant change. There is no greater change than the debut of anew product labeled to treat a medical condition that has never beforebeen judged amenable to self-care. The September 2013 introduction ofOxytrol For Women to the nonprescriptionproduct market is a perfect example of an Rx-to-OTC switch that couldalter the health care habits of countless women.1,2
Treatment Of Oab In Older Patients
Conventional treatment for OAB with conservative and lifestyle measures in combination with antimuscarinic pharmacotherapy is effective in older people. In direct contradiction to the usual geriatric paradigms of prescribing, older people: are more likely than young to require, and ask for, medication for their bladder problem appear to require higher doses of medication , and, despite higher reported rates of adverse events, are more adherent to their medication than younger users.
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Seven Effective Treatments For Overactive Bladder
Overactive bladder occurs when sudden or frequent urges to urinate become hard to control, and can often lead to leakage .
In order to best treat overactive bladder, a urologist must pinpoint the underlying cause. Treatment will depend on symptom severity and the degree to which they impact someone’s quality of life. In general, there are three approaches to treatment: medication, behavioral interventions, and surgery.
Percutaneous Tibial Nerve Simulation
A less invasive option called percutaneous tibial nerve stimulation is also available. It only takes about half an hour per session to perform and is usually done in a doctors office.
In PNTS, a needle electrode is inserted near the ankle that delivers electrical pulses to the tibial nerve. This nerve is linked directly to the sacral nerve.
As in SNS, these electrical pulses help block inappropriate bladder signaling.
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Can Overactive Bladder Be Prevented Or Avoided
Overactive bladder cannot be prevented. However, you can reduce the risk of overactive bladder by treating those diseases and conditions that cause it. For example, following your doctors treatment advice for diabetes will reduce nerve damage. If you are pregnant, talk to your doctor about the potential for bladder damage if you have a vaginal delivery.
What Foods And Drinks To Avoid
While you may want to drink less liquid so you dont have to urinate as often, you should still make sure you stay hydrated. More concentrated urine, usually darker in color, can irritate your bladder and cause more frequent urination.
Other foods and drinks can contribute to OAB symptoms, including:
- alcohol
- tea
- tomato-based foods
You can test which drinks or foods irritate your bladder by eliminating them from your diet. Then reincorporate them one by one every two to three days at a time. Permanently eliminate the particular food or drink that worsens your symptoms.
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What Works Best To Help Men With Overactive Bladder
HealthDay Reporter
TUESDAY, Jan. 14, 2020 — Learning how to control the urge to urinate may be all the therapy men need to treat an overactive bladder, a new study suggests.
A combination of drugs and behavioral therapy seems to work better than drugs alone, but behavioral therapy alone also worked better than drugs, the researchers found.
The trial of 204 men with overactive bladder suggests behavioral therapy may be a good way to start treatment, the study authors said.
“The study provides good evidence that for the group of men with overactive bladder, symptoms without obstruction from an enlarged prostate can be successfully managed with behavioral therapy alone,” said Dr. Manish Vira, who was not involved with the study, but reviewed the findings. He’s vice chairman of urologic research at Northwell Health’s Arthur Smith Institute for Urology in Lake Success, N.Y.
Many medications typically prescribed for overactive bladder have significant side effects, especially in older men using multiple medications, Vira added.
For the trial, Kathryn Burgio, associate director of research at the Birmingham VA Medical Center in Alabama, and colleagues randomly assigned men to six weeks of behavioral therapy alone, drug therapy alone, or combined drug and behavioral therapy. After the initial six weeks, all of the men received combination therapy for another six weeks.
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JAMA Internal Medicine
Why Is This Medication Prescribed
Oxybutynin is used to treat overactive bladder in certain adults and children. Oxybutynin is also used as an extended-release tablet to control bladder muscles in adults and children 6 years of age and older with spina bifida , or other nervous system conditions that affect the bladder muscles. Oxybutynin is in a class of medications called anticholinergics/antimuscarinics. It works by relaxing the bladder muscles.
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Oxybutynin May Cause Side Effects Tell Your Doctor If Any Of These Symptoms Are Severe Or Do Not Go Away:
- dry mouth
- dry eyes, nose, or skin
- stomach pain
- change in ability to taste food
- headache
- difficulty falling asleep or staying asleep
- nervousness
- frequent, urgent, or painful urination
- fast, irregular, or pounding heartbeat
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s MedWatch Adverse Event Reporting program online or by phone .
Oxybutynin may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.
What Should I Know About Storage And Disposal Of This Medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture .
It is important to keep all medication out of sight and reach of children as many containers are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location one that is up and away and out of their sight and reach.
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website for more information if you do not have access to a take-back program.
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Cholinergic Drugs For Bladder Problems
This class of drugs includes bethanechol . Cholinergic refers to nerve cells or fibers that use a certain type of chemical to send signals within the body. Cholinergic drugs are used when the bladder is not emptied completely following urination. This problem is known as residual urine in the bladder.
- How cholinergic drugs work: These drugs contract the bladder, thus allowing complete emptying.
- Who should not use these medications: Individuals with the following conditions should not use cholinergic drugs:
- Parkinson’s disease
- Bladder or bowel obstruction
Specific Antidepressants May Suppress Symptoms
Specific antidepressants such as Tofranil, Tyramine and Norfranil may help to suppress overactive bladder symptoms. Which one your doctor chooses to prescribe will depend on your particular symptoms.
For example, the SSRI class of antidepressants works better for stress incontinence than for urge incontinence, although its not clear how it helps. Alternatively, tricyclic antidepressants are known to have anticholinergic side effects, which relax the bladder muscle and cause the muscles of the bladder neck to contract.
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Percutaneous Tibial Nerve Stimulation
Percutaneous tibial nerve stimulation is a minimally invasive procedure used to alleviate urinary urgency, urinary frequency, and urge incontinence. In 2010, the FDA formally included OAB as an indication for treatment.
PTNS is a form of nerve stimulation. An electrical needle is inserted into the ankle to deliver low-level impulses to the tibial nerve that runs to the knee joint and connects to the larger sciatic nerve.
Although the exact mechanism of action remains unclear, PTNS has proven to be safe and as effective as OAB medications in people with severe OAB. PTNS is performed once weekly on an outpatient basis and involves a total of twelve 30-minute sessions. People tend to experience an improvement of urinary function within six weeks.
In 2019, an implantable PTNS device was released, which early studies have shown may reduce severe urinary urgency by 94% and severe incontinence by 71%.
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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Complementary And Alternative Medicine
There are many complementary and alternative therapies used to treat OAB. These include mind-body therapies that help minimize urinary urgency and symptoms of stress incontinence .
Naturopathic doctors and others also use herbal remedies to treat OAB, but few of these are strongly supported by research. Among those that have some evidence of a positive effect are:
- Gosha-jinki-gan : This traditional Chinese medicine remedy is composed of 10 herbs. Animal studies suggest GJC can mute bladder sensations that contribute to urinary urgency. Small studies in women and men have shown positive results, albeit with side effects in 1 in 10 users .
- Saw palmetto: Saw palmetto is a popular herbal remedy said to increase testosterone levels and alleviate prostate enlargement that can contribute to OAB symptoms in men. A 12-week study involving 44 men with OAB reported improved bladder control and decreased prostate size compared to men who didnt take it.
Always speak with your healthcare provider before using a herbal remedy to treat OAB. The overuse of herbal remedies, especially imported ones, can expose you to substances that may be toxic to your liver and kidneys or interact with drugs you are taking.
Living With Overactive Bladder
Living with overactive bladder will depend on how serious your problem is and how well your treatment works. In either case, living with the condition may require better planning. You may have to plan when you consume liquids and how close you are to a bathroom. You also may consider wearing disposable undergarments that protect your clothing from leaking urine.
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Causticum Homeopathic Medicine For An Overactive Bladder With Involuntary Passage Of Urine Or Urinary Incontinence
Causticum is a beneficial homeopathic medicine for an overactive bladder in cases where there is an involuntary flow of urine. This symptom can cause a lot of problems when it occurs at night or if the patient is walking. Causticum also helps in strengthening the bladder sphincter and in controlling urinary incontinence.
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
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Coping Methods And Quality Of Life Issues
Most women visit their physicians without hesita-tion forsuch conditions as urinary tract infections , vaginal fungalinfections, and birth control. However, for some inexplicable reason, alarge number of those suffering from OAB postpone a medical appointment,many for as long as 6 or 7 years.4 During this time, theyemploy a variety of coping mechanisms of dubious efficacy andquestionable safety. For instance, the use of absorbent pads ispartially effective, but increases the risk of a UTI.4 Somewomen also take great pains to ascertain the location of all bathroomsin advance of an attack of OAB, a behavior known as toilet mapping.4
Women with symptoms of OAB may reduce the extent ofactivities they once found pleasurable, such as movies, walks, tennis,golf, or visiting with friends. They may voluntarily reduce fluidintake, which can lead to dehydration. They may feel forced to wearclothing that would conceal a urine leak, and only sit on furniture thatwould not be permanently stained if a leak were to occur. It becomesapparent that OAB can cause constant concern due to fear of an accidentand also the perception that odor from underclothing or absorbent padsmight be detected by others. If a patient feels forced to lead a moresedentary lifestyle, she may experience greater medical andpsychological problems.