Wednesday, April 17, 2024

Nasal Spray For Urinary Incontinence

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Things You Must Not Do

Incontinence Treatment by Katelaris Urology Ep 54

Do not use MINIRIN Nasal Spray to treat any other complaints unless your doctor tells you to do so.

Do not give your medicine to anyone else, even if they have the same condition as you.

Do not stop using your medicine or change the dosage without checking with your doctor. If you stop taking it suddenly, your condition may worsen.

New Products: Nasal Spray Launched To Treat Nocturia Due To Nocturnal Polyuria

Nasal spray launched to treat nocturia due to nocturnal polyuria

Avadel Pharmaceuticals plc has announced the launch of desmopressin acetate , an emulsified microdose nasal spray. Desmopressin is the first and only FDA-approved treatment proven to help adults with nocturia due to nocturnal polyuria, according to Avadel. The treatments formulation works in the kidneys to lessen nighttime urine production. The nasal spray is a proprietary emulsified microdose of desmopressin combined with a permeation enhancer that increases the transport of desmopressin across the nasal mucosa. Delivered via a unique spray pattern, NOCTIVAs formulation substantially increases the bioavailability of the active drug, allowing for microdosing, rapid absorption, and consistency from dose to dose.

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Which Diseases Can Cause Incontinence

Diabetes, strokes and nerve diseases, such as multiple sclerosis. These diseases can damage the nerves that control the bladder which is where urine is stored before it leaves the body. These diseases can also weaken the “sphincter,” a ring of muscle around the opening of the bladder. This ring usually keeps urine from leaking out. Men can have incontinence from problems such as overgrowth of the prostate gland or cancer of the prostate gland, both of which can block the flow of urine. In these cases, urine leaks out when the bladder becomes too full.

Also Check: Urinary Incontinence After Prostate Surgery

How To Do Them

Stand, sit or lie down with your knees slightly apart. Relax.

Find your pelvic muscle. Imagine that you are trying to hold back urine or a bowel movement. Squeeze the muscles you would use to do that. DO NOT tighten your stomach or buttocks.

Women: to make sure youve got the right muscle, insert your finger into your vagina while you do the exercise. You should feel a tightening around your finger.

Men: when you tighten the pelvic floor muscle, your penis will twitch and contract in towards your body.

  • Tighten the muscles for 5 to 10 seconds. Make sure you keep breathing normally
  • Now relax the muscles for about 10 seconds
  • Repeat 1220 times, three to five times a day

Stick to it! You should begin to see results after a few weeks. Like any other muscle in your body, your pelvic muscles will only stay strong as long as you exercise them regularly.

If youre having a hard time doing Kegel exercises, your healthcare professional can teach you how to do them correctly. He/she may even suggest a tool or device to help make sure youre using the right muscles .

Your doctor may also suggest biofeedback, a training technique thats used to monitor the contraction of the pelvic floor muscles as you do your Kegel exercises. Biofeedback uses a machine that records the contractions of your muscles and translates the movement into a visual signal that you can watch on a monitor. Some people find this helpful in learning how to do Kegel exercises correctly.

What Additional Methods Can Be Used To Treat Bedwetting

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In the vast majority of children, bedwetting improves on its own over time, so treatment is not needed. If bedwetting is a significant problem for a child, there are seevralk ways to apprioach bedwetting

Cut back on their liquid intake well before bedtime, particularly anything that includes caffeine. Encourage your child to not only use the bathroom 15 minutes before bed, but again just before you tuck them in. Often times, they pee only enough so they no longer feel the urge and may not be emptying their bladder. Remove any sleep disrupters from their room, like pets or electronics.

Another treatment for bedwetting is a moisture alarm. This device includes a water-sensitive pad with a wire connected to a control unit. When moisture is detected, an alarm sounds, waking the child. In some cases, another person may need to be in the room to waken the child if they do not do so on their own.

Setting an alarm so the child wakes up to urinate – timed voiding – may also work to reduce bedwetting at night.

If these methods aren’t working, medication Increasing levels of ADH might help treat nighttime incontinence. Desmopressin, or DDAVP, is a synthetic version of ADH. This drug, which is approved for use in children, comes in pills, nose drops, or nasal spray.

In addition, the drug imipramine can be used. This medication affects the brain as well as the bladder. According to researchers, an estimated 70% of kids who wet the bed may be helped by the use of these drugs.

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Gaining Control Of Ms

You should talk to your provider right away if you experience urinary symptoms so that the appropriate therapy can be prescribed, says Epstein. Early intervention leads to fewer complications and improved quality of life, she says.

Your doctor may refer you to a urologist a specialist in diseases of the urinary tract for a complete checkup, diagnosis, and treatment plan. A urologist may perform urodynamic testing, or urodynamics, which examines the lower urinary tract function, including pressure, volume, and how the bladder is storing and releasing urine, according to Stanford Health Care.

This can range from simple observation to precise measurements using sophisticated instruments to better measure how the bladder and urethra are working, says Kaplan.

Bladder problems can often be managed effectively with certain lifestyle adjustments, medication, physical therapy, or devices. The following are some treatment options.

What Is In This Leaflet

This leaflet answers some common questions about MINIRIN Nasal Spray.

It does not contain all the available information. It does not replace of talking to your doctor or pharmacist.

All medicines have risks and benefits. Your doctor has weighed the risks of you taking MINIRIN Nasal Spray against the benefits they expect it will have for you.

If you have any concerns about taking this medicine, ask your doctor or pharmacist.

Keep this leaflet with the medicine. You may need to read it again.

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Hemophilia A & Von Willebrand Disease

Indicated for patients with hemophilia A or von Willebrand disease with Factor VIII coagulant activity levels > 5% will also stop bleeding in patients with episodes of spontaneous or trauma-induced injuries

IV

  • Infants 3 months, children, and adolescents
  • 0.3 mcg/kg IV
  • If used preoperatively, administer 30 min before procedure
  • May repeat dose if needed

Intranasal

  • Infants 11 months, children, and adolescents
  • < 50 kg: 150 mcg intranasally
  • 50 kg: 300 mcg intranasally If used preoperatively, administer 2 hr before procedure

Fluid intake should be limited 1 hr prior to dose until the next morning or at least 8 hr after administration

Repeat use determined by clinical symptoms and laboratory values

Planned Times For Drinking And Urinating

OTRIVIN DR. FOHEID ALSOBEI

Drink water at designated times during the day, and plan bathroom breaks afterward.

Bladder training can be helpful, too. This technique involves keeping a journal and scheduling times to urinate, whether or not you feel the urge, says Epstein.

Double voiding is another technique that can help, the Urology Care Foundation says. To double void, urinate, wait a few minutes, then try to urinate again.

Also Check: Urinary Tract Infection In Children

Beta Agonists For Bladder Problems

This class of medication, mirabegron , works by relaxing the bladder muscle during the storage phase, thus increasing the capacity of bladder to hold more urine. They can be used for the treatment of overactive bladder . Mirabegron is the first drug in this category.

  • How beta-agonist drugs work: They work by relaxing the bladder muscles and reducing bladder overactivity.
  • Who should not use this medication: Individuals with the following conditions should not use mirabegron or a similar class of drugs:
  • Allergy to this drug
  • Advanced kidney disease
  • Side effects of mirabegron include: elevation of blood pressure, urinary retention , dry mouth, inflammation of nasal passages, and constipation
  • Use: Mirabegron can be taken orally with or without food. It should be taken whole without crushing or chewing.
  • Drug or food interactions: Patients should inform their doctor if they are taking any other medications for leaky bladder. Certain medications actions and side effects can be enhanced if combined with mirabegron. For example, chlorpromazine, desipramine, digoxin, encainide, flecainide, metoprolol, nortriptyline, pimozide, propafenone, tetrabenazine, or thioridazine may have an increased risk of their side effects when combined with mirabegron.
  • Genetic And Familial Factors

    Genetic predisposition is the most frequently supported etiologic variable. One review4 found that when both parents were enuretic as children, their offspring had a 77 percent risk of having nocturnal enuresis. The risk declined to 43 percent when one parent was enuretic as a child, and to 15 percent when neither parent was enuretic. Another investigation5 found a positive family history in 65 to 85 percent of children with nocturnal enuresis. If the father was enuretic as a child, the relative risk for the child was 7.1 if the mother was enuretic, the relative risk was 5.2. In addition, certain chromosomal loci have been implicated in nocturnal enuresis.6,7

    Familial factors that have been found to have no relationship to the achievement of continence include social background, stressful life events, and the number of changes in family constellation or residences.7

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    Renal Disease And Enuresis

    Renal disease among patients with sickle cell disease is a major comorbid condition that can lead to premature death. Seven sickle cell disease nephropathies have been identified: gross hematuria, papillary necrosis, nephrotic syndrome, renal infarction, hyposthenuria, pyelonephritis, and renal medullary carcinoma. The presentation of these entities is varied but may include hematuria, proteinuria, renal insufficiency, concentrating defects, or hypertension.

    The common presence ofnocturnal enuresis occurring in children with sickle cell disease is not well defined but is troublesome for affected children and their parents. The overall prevalence of enuresis was 33% in the Cooperative Study of Sickle Cell Disease, with the highest prevalence among children 6-8yr old. Furthermore, enuresis may still occur in approximately 9% of older adolescents. Patients with sickle cell disease and nocturnal enuresis should have a systematic evaluation for recurrent urinary tract infections, kidney function, and possibly obstructive sleep apnea syndrome. Unfortunately, most children with nocturnal enuresis do not have an etiology, and targeted therapeutic interventions have been of limited success. However, referrals to pediatric urologists should be considered.

    May Loo MD, in, 2009

    What Causes Overactive Bladder In Children

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    Children with overactive bladders have a need to urinate more often than usual because their bladder muscles have uncontrollable spasms. The muscles surrounding the urethra — the tube from the bladder that urine passes through — can be affected. These muscles are meant to prevent urine from leaving the body, but they may be “overridden” if the bladder undergoes a strong contraction.

    Urinary tract infections can cause a need to urinate as the urinary tract becomes inflamed and uncomfortable. Certain neurological conditions may cause these symptoms.

    Another cause of overactive bladder is a condition called pollakiuria, or frequent daytime urination syndrome. Children who have pollakiuria urinate frequently. In some cases, they may urinate every five to 10 minutes or urinate between 10 and 30 times a day. This condition is most common among children aged 3 to 8 and is present only during waking hours. There are no other symptoms present. Doctors believe that pollakiuria is related to stress. Usually, the condition goes away after two to three weeks without requiring treatment.

    Other causes of overactive bladder in children include:

    • consumption of caffeine, which increases urine output and can cause spasms in the bladder muscle
    • consumption of ingredients that a child may be allergic to
    • events that cause anxiety
    • refraining from completely emptying the bladder when on the toilet
    • obstructive slep apnea

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    Developing A Treatment Plan

    One study1 found that 23 to 36 percent of parents had used punishment as their primary means of dealing with bed-wetting. Hence, family education is crucial. Parents and the affected child need to know that bed-wetting is a common problem, and parents should be instructed not to blame or shame the child. The physician can foster a sense of optimism about the potential for improvement while at the same time giving the child responsibility for achieving urinary control at night.

    Sometimes the very process of seeking help leads to improvement of nocturnal enuresis. One study26 comparing the use of desmopressin plus behavior therapy, placebo plus behavior therapy, and desmopressin therapy alone found improvement in all three groups in the first weeks after enrollment, before the actual study had even begun.

    The timing of treatment should be individualized. It is important that the child be motivated to take an active role. The younger the child, the more fragile his or her motivation may be. The depth of this motivation can be assessed by assigning the child the task of keeping the voiding log. If the child seems inadequately motivated, it may be best to ask the family to postpone treatment until the child is ready.

    All treatments should be explained carefully. One study18 found that when choices were well explained, slightly more parents selected no treatment at all than treatment with desmopressin, indicating that many parents simply want reassurance.

    Options For Treatment Remedies Or Management Of Incontinence

    Once you understand the reason for your incontinence, the choice of what to do about it, and if and how to treat it, is up to you. Most professionals suggest that their patients first try a form of treatment other than the use of medication or surgery.

    Depending upon the type and cause of your incontinence, lifestyle changes, or exercises, with or without equipment to help identify and strengthen the pelvic floor muscles, may help. For some, medications that affect the bladder or the sphincter can be effective. Surgery, an artificial sphincter, or an injection of a substance into the sphincter muscle may be recommended. Absorbent products or collection devices may help. Whichever you choose, be sure to discuss the latest information available with your health care professional. You may find that something new has been developed which may be appropriate for you.

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    Alcohol Consumption Before Bed

    Many people experience bedwetting only after they have consumed alcoholin the hours before bedtime. Alcohol suppresses ADH production and irritates the detrusor muscle, which signals to your brain that its time to urinate.

    Treating alcohol-related incontinence: Reducing your alcohol intake can make a big difference in your life, especially if it is causing uncomfortable side effects like bedwetting.

    Pelvic Floor Physical Therapy

    Medication Therapy Management (MTM)- Patient’s positive encounter with pharmacist

    Exercises that engage the pelvic floor muscles are often recommended for incontinence, according to the National MS Society. A pelvic floor physical therapist can teach a person to contract, relax, and coordinate the muscles involved in bladder and bowel control, helping to normalize these functions.

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    Speak With A Urologist Today To Get Help With Your Nighttime Incontinence

    If your symptoms are creating discomfort in your life, you will absolutely benefit from speaking with a physician! Your urologist can help determine the causes of your problems and find the best lifestyle changes and medical treatments to alleviate them.

    The urologists at Norman Urology have helped countless women and men manage their symptoms. We can help you determine which treatments will be the most effective.

    If youre experiencing urinary incontinence, reach out to schedule an appointment with us today. We look forward to helping you feel more in control!

    Is Bedwetting Related To Overactive Bladder In Children

    Yes. Some of the same conditions or circumstances that increase the likelihood of nighttime incontinence may — in combination with infrequent urination — result in incontinence during the day. These conditions and circumstances include pressure from a hard bowel movement or other causes listed above.

    Another cause of nighttime incontinence is related to the antidiuretic hormone , which the body produces to slow urine production. Children tend to produce more ADH at night, so there is less need to urinate. If the body does not produce enough ADH, the production of urine may not slow and the bladder may overfill, leading to bedwetting.

    Some other potential causes of bedwetting include:

    • Family history
    • Stress and life changes like a new sibling, changes in living circumstances
    • Sleep disruptions
    • Type 1 Diabetes- also causes increase thirst and urination

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    What Minirin Nasal Spray Is Used For

    The active ingredient, desmopressin acetate, in MINIRIN Nasal Spray is a synthetic version of a naturally occurring substance produced in the brain called vasopressin.

    It has a number of different actions on the body including an action on the kidney to reduce the amount of urine produced. This means that MINIRIN Nasal Spray can be used for several different conditions including:

    • primary nocturnal enuresis in patients over 6 years of age, who have a normal ability to concentrate urine and who have not responded to treatment with an enuresis alarm or in patients in whom an enuresis alarm is contraindicated or inappropriate and where the oral administration of desmopressin is not feasible..
    • cranial diabetes insipidus
    • as a diagnostic test to establish if the kidneys have the ability to concentrate urine.

    Ask your doctor if you have any questions about why this medicine has been prescribed for you. Your doctor may have prescribed it for another reason.

    This medicine is not addictive.

    It is available only with a doctor’s prescription.

    This medicine is not expected to affect your ability to drive a car or operate machinery.

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