Drug Increasing Bladder Capacity To Hold Urine
Two medications, in the beta-three adrenergic agonist class of drugs, have been studied in women with urgency incontinence. These medications work by improving the bladderâs capacity to hold urine and therefore increase the time between âurgentâ trips to the toilet.
Mirabegron and solabegron are newer drugs and have been designed to resolve urgency urinary incontinence without causing bothersome harms. However, fewer clinical studies have examined these drugs. Future research will help us to know more about the long-term safety of mirabegron and solabegron.
Am I At A Higher Risk Of Incontinence At An Older Age
Your body constantly changes throughout your life. As you age, the muscles that support your pelvic organs can weaken. This means that your bladder and urethra have less support often leading to urine leakage. Your risk for developing incontinence as you age might be higher if you have a chronic health condition, have given birth to children, went through menopause, have an enlarged prostate or have had prostate cancer surgery. Its important to talk to your healthcare provider over time about the risks of incontinence and ways you can manage it without interference to your daily life.
Do Pelvic Floor Muscle Exercises
Strong pelvic floor muscles hold in urine better than weak muscles. You can strengthen your pelvic floor muscles by doing Kegel exercises. These exercises involve tightening and relaxing the muscles that control urine flow. Researchers found that women who received pelvic floor muscle training had fewer leaks per day than women who didnt receive training.6 You should not do pelvic floor exercises while youre urinating.
Men can also benefit from pelvic floor muscle exercises. Strengthening these muscles may help a man leak urine less often, especially dribbling after urination.
A health care professional, such as a physical therapist trained in pelvic floor therapy, can help you get the most out of your Kegel exercises by helping you improve your core muscle strength. Your core includes your torso muscles, especially the lower back, pelvic floor muscles, and abdomen. These muscles keep your pelvis lined up with your spine, which helps with good posture and balance. Your physical therapist can show you how to do some exercises during daily activities, such as riding in a car or sitting at a desk.
You dont need special equipment for Kegel exercises. However, if you are unsure whether you are doing the exercises correctly, you can learn how to perform Kegel exercises properly by using biofeedback, electrical stimulation, or both. Biofeedback uses special sensors to measure muscle contractions that control urination.
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Causes Of Urge Incontinence
The urgent and frequent need to pass urine can be caused by a problem with the detrusor muscle in the wall of the bladder. The detrusor muscles relax to allow the bladder to fill with urine, then contract when you go to the toilet to let the urine out.
Sometimes the detrusor muscle contract too often, creating an urgent need to go to the toilet. This is known as having an ‘overactive bladder’. The reason your detrusor muscle contracts too often may not be clear, but possible causes include:
- drinking too much alcohol or caffeine
- poor fluid intake this can cause strong, concentrated urine to collect in your bladder, which can irritate your bladder and cause symptoms of overactivity
Stopping these medications, if advised to do so by a doctor, may help resolve your incontinence.
Treatment Options For Men With Urinary Leakage
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Urinary incontinence is a common and often embarrassing condition that results in the unintentional loss of urine. While women are more likely than men to experience symptoms of urinary incontinence, it can be particularly troublesome for men.
About 3% to 10% of men will experience symptoms in their lifetimes and report a high level of associated stress due to the condition. Some men say they would rather be impotent than incontinent.
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When Should People Seek Medical Care For Urinary Incontinence
Urinary incontinence is an underdiagnosed and underreported medical problem that is estimated to affect up to 13 million people in the United States, predominantly women. This includes 10%-35% of adults and 50%-84% of residents in nursing homes. It has also been estimated that most women with urinary incontinence fail to seek appropriate treatment for the condition because of the social stigma. People with incontinence often live with this condition for six to nine years before seeking medical therapy. Living with urinary incontinence puts people at risk for rashes, sores, and skin and urinary tract infections. Effective treatments for this common problem are available in many cases.
Dietary Measures
Some foods can worsen symptoms of urinary frequency and urge incontinence. Changes in diet can help improve some people’s symptoms. Monitoring the diet often requires reading food labels and avoiding foods and drinks that contain stimulants. Stimulants worsen the symptoms of urinary urgency and frequency.
Foods
Drinks
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 someones quality of life. In general, there are three approaches to treatment: medication, behavioral interventions, and surgery.
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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.
Treatments For Urinary Incontinence
Healthcare providers can help find the best treatment for urinary incontinence. There are many different options available such as:
Indwelling catheters
If you have urinary incontinence, your provider might prescribe a catheter A balloon holds the tube inside your bladder. The catheter drains urine out of the bladder into a bag outside the body.
Urine drainage bags
If you have urinary incontinence, your provider might prescribe a urine drainage bag to help collect urine coming out of the bladder. You can hide it under clothing and strap it to your leg. Your doctor can help you find a urine drainage bag thats the right size for you and feels comfortable to wear.
Catheters for intermittent catheterization
Your doctor may recommend a catheter that you dont have to wear all the time. Instead, you or your healthcare provider can insert and remove clean catheters 3 to 5 times a day. This helps decrease the chance of infection.
Absorbent products
Some providers may recommend that you use adult pads or adult diapers. These products help absorb urine leaking from the bladder, which helps protect your skin and clothes. You have the option of purchasing absorbent products that you throw away after each use, or you can purchase reusable products.
Toilet substitutes
Some people who experience urinary incontinence may have concerns about getting to a toilet in time. Toilet substitutes like commodes can provide convenience and peace of mind.
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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.
Botulinum Toxin A Injections
Botulinum toxin A can be injected into the sides of your bladder to treat urge incontinence and overactive bladder syndrome.
This medicine can sometimes help relieve these problems by relaxing your bladder.
This effect can last for several months and the injections can be repeated if they help.
Although the symptoms of incontinence may improve after the injections, you may find it difficult to completely empty your bladder.
If this happens, you’ll need to be taught how to insert a thin, flexible tube called a catheter into your urethra to drain the urine from your bladder.
Botulinum toxin A is not currently licensed to treat urge incontinence or overactive bladder syndrome, so you should be made aware of any risks before deciding to have this treatment.
The long-term effects of this treatment are not yet known.
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Different Forms Of Urinary Incontinence
Urinary incontinence can affect people in various ways, depending on the cause of the problem:
Total incontinence
This is when your bladder cant store any urine, and so constantly leaks.
Urge incontinence
This is the sudden and intense need to pass urine. It can affect those with neurological conditions, such as Parkinsons disease.
Overflow incontinence
Also known as chronic urinary retention, this is when you cant fully empty your bladder, which results in frequent leaking.
Stress incontinence
When the muscles that control urine flow become weak, urine can leak out at times of physical stress, such as when you cough, laugh or lift something heavy.
Mixed incontinence
Dosage For Tolterodine Tablets
Adults will usually take 2mg in the morning and 2mg in the evening. Leave a gap of 12 hours between doses.
Children will usually take between 1mg and 4mg a day.
If you are giving tolterodine to a child to stop bedwetting, the usual dose is 1mg taken at bedtime. The dose can be increased up to a maximum of 2mg twice a day, depending on response.
If you have kidney or liver disease, or you’re affected by side effects, your doctor may reduce your dose to 1mg twice a day.
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Common Questions About Tolterodine
Tolterodine is a type of medicine called an antimuscarinic muscle relaxant.
It works by relaxing the muscle that is found in the wall of the bladder. This helps to increase the volume of pee your bladder can hold and control the release of pee.
Tolterodine begins to work within 3 to 8 hours but it may take up to 4 weeks before it takes full effect. If the symptoms do not improve after 1 to 2 weeks, talk to your doctor.
Talk to your doctor if your symptoms get worse at any time.
Usually, you’ll need to take tolterodine for a long time.
After 4 weeks your doctor will check that tolterodine is helping your symptoms. They’ll also do a review every 6 to 12 months after that to check it’s still working for you.
Take tolterodine until your doctor tells you to stop. Do not stop taking it just because you feel better.
Do not take tolterodine for longer than you need to. Your doctor will check every 6 to 12 months that your treatment is still needed.
There may be an increased risk of confusion and possibly dementia in people taking tolterodine, but more study needs to be done. If you’re worried about this, talk to your doctor.
It’s safe to take tolterodine with everyday painkillers like paracetamol and ibuprofen.
If you want to stop taking tolterodine, talk to your doctor first.
If you’ve been taking it for at least 6 months, your doctor may suggest at your review that you can stop taking it for up to 4 weeks to see how your symptoms change without it.
Diagnosis For Urinary Incontinence
Only a licensed healthcare professional can diagnose urinary incontinence. The best treatment for urinary incontinence depends on the underlying cause and the type of urinary incontinence you have. To determine a diagnosis, your doctor may have you undergo a physical exam and complete other tests.
Your doctor will check your urine for an infection or other potential abnormalities, like hematuria, proteinuria, and glycosuria.
Bladder diary
You will record how much you drink and urinate each day and whether you experienced bladder leakage or a strong desire to urinate.
Post-void residual measurement
Your doctor will ask you to urinate into a container. The doctor checks the amount of urine left in your bladder using ultrasound . The doctor can help determine if you have an obstruction in your bladder or a problem with your bladder or nerves.
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Care For Pregnant Women
The hormonal and anatomical changes of pregnancy mean that being pregnant increases the risk for both urinary tract infections and yeast infections. Not only this but pregnant people and their unborn babies may experience more health complications with even simple infections. UTIs and yeast infections during pregnancy can lead to a higher risk of preeclampsia, premature labor, and low birth weight.
Pregnant women who think they have a UTI or a yeast infection should see their healthcare provider without delay, as these infections should be treated right away to prevent serious complications to both the mother and the child. Your healthcare provider can also help you pick the safest treatments, since some antibiotics and antifungals are not suitable for pregnant women.
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Pharmacologic Agents That Cause Urinary Incontinence
A variety of drugs have been implicated in urinary incontinence, and attempts have been made to determine the mechanism responsible based upon current understanding of the processes involved in continence and the transmitters that play a role. Each of the processes described previously can be manipulated by pharmacologic agents to cause one or more types of incontinence.
The drugs commonly pinpointed in urinary incontinence include anticholinergics, alpha-adrenergic agonists, alpha-antagonists, diuretics, calcium channel blockers, sedative-hypnotics, ACE inhibitors, and antiparkinsonian medications. Depending upon the mode of action, the effect may be direct or indirect and can lead to any of the types of incontinence. Taking these factors into account, it is important to consider a patients drug therapy as a cause of incontinence, particularly in new-onset incontinence patients and in elderly patients, in whom polypharmacy is common.11,12
On the other hand, a pharmacologic agent or any other factor that results in chronic urinary retention can lead to a rise in intravesical pressure and a resultant trickling loss of urine. In this way, drugs that cause urinary retention can indirectly lead to overflow incontinence.2
It is useful to note that many antidepressants and antipsychotics exhibit considerable alpha1-adrenoceptor antagonist activity.1
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Dosage And Strength Of Standard Tablets
Standard tablets come as either 2.5mg, 3mg or 5mg.
The usual starting dose of 2.5mg is 1 tablet, taken twice a day, in the morning or evening, or 1 tablet, taken 3 times a day.
If you take 3 doses a day, space each dose evenly throughout the day. You could take it first thing in the morning, in the middle of the afternoon and at bedtime.
Symptoms Of Urinary Incontinence
Having urinary incontinence means you pass urine unintentionally.
When and how this happens varies depending on the type of urinary incontinence you have.
Although you may feel embarrassed about seeking help, it’s a good idea to see your GP if you have any type of urinary incontinence.
Urinary incontinence is a common problem and seeing your GP can be the first step towards finding a way to effectively manage the problem.
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What Are The Types Of Urinary Incontinence
More than half of people with stress incontinence also have urge incontinence. Having both stress and urge incontinence is known as mixed incontinence. An overactive bladder causes urge incontinence. This type of urinary incontinence causes you to leak urine when you feel an urgent need to pee.
Overflow incontinence is a different type of urinary incontinence. It causes you to leak urine because your bladder is too full or you cant completely empty it.
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 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:
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How To Use Patches
Oxybutynin patches are applied twice a week.
They work like a plaster., you stick them to your skin.