Does Caffeine Affect Incontinence
Caffeine irritates the bladder and can make incontinence worse. Coffee has the biggest effect, so stop drinking it or switch to decaffeinated coffee. Fizzy drinks, tea, green tea, energy drinks and hot chocolate also contain caffeine, so cut down on these too and replace them with water and herbal or fruit teas.
Sacral Nerve Stimulation Therapy
Sacral nerve stimulation is a treatment in which mild electrical impulses are sent to the sacral nerves near the lower back. A device — implanted in the upper buttocks under the skin — is used to provide electrical pulses that influence bladder function. The procedure to implant the device does involve surgery, but it is minimally invasive, and reversible.
How Common Is Urinary Incontinence
Losing bladder control doesnt commonly occur in younger men, but if youre an older man especially over the age of 60 your chances of developing urinary incontinence increases due to associated prostate issues. The National Institutes of Health reports that between 11% and 34% of older men experience incontinence at least occasionally and 2-11% report it is a problem daily.
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It can affect your everyday life because if you strain physically, or even sneeze or cough, you could find yourself with leakage in your pants. As a result, you might stop doing things you enjoy, such as socializing or sporting activities. Even sexual encounters can be affected, as position and pressure during intercourse can cause bladder spasm or leakage.
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Other Treatments To Try
In rare cases when all OAB treatment fails and overactive bladder is severe, doctors may recommend one of several types of surgery.
A procedure called bladder augmentation uses part of the bowel to increase bladder capacity. Or, urinary diversion, an alternate route for bladder drainage for severe, complicated OAB patients.
Sacral nerve stimulation. Another procedure implants a small device, similar to a pacemaker, under the skin. The device is connected to a wire, which sends small electrical pulses to nerves around the pelvic floor that control the bladder and muscles surrounding it. This helps build bladder control. Itâs often called a bladder pacemaker. The main limitation with this treatment is that it keeps you from having a spinal MRI.
Percutaneous tibial nerve stimulation. The doctor places a needle on nerves near your ankle that affect bladder control. Youâll have one session a week for 12 weeks and then maintenance treatments as needed. This procedure is done in the office.
An overactive bladder doesnât have to get in the way of your daily life. With a little time, patience, and the right treatment, you can regain control — and peace of mind. Whatever treatment for overactive bladder you and your doctor decide upon, it’s important that you stick with it. If you do, chances are your condition will improve in time.
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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
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Botulinum Toxin Injections For Oab
You might be wondering, “Botox? Like movie stars use on their forehead?” Yes, the same substance that dermatologists use to smooth out wrinkles can also be used to relax an overactive bladder.
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. “The 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,” Rames says. The effects generally last for about 9 months. So far there don’t seem to be any major side effects from botulinum toxin, although it’s only recommended if your symptoms aren’t controlled with behavioral therapies, medications, or a combination of both.
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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: “Treatment of Urinary Incontinence.”
National Association for Continence: “Overactive Bladder Treatment.”
Duthie JB. Cochrane Summaries, Dec. 7, 2011.
National Association for Continence: “Urgency Urinary Incontinence/Overactive Bladder.”
News release, FDA.
Behavioral Therapies For Oab
Some people with urinary incontinence may get relief by making simple changes to their lives and that’s what experts recommend trying first.
If you have stress incontinence, for instance, in which you leak urine when you cough, sneeze, or laugh, your doctor may tell you to limit how much you drink.
If you have urge incontinence, in which you get the sudden urge to urinate and can’t always make it to the bathroom in time, your doctor may tell you to avoid spicy foods, caffeine, and carbonated drinks, because they can irritate the bladder and make the problem worse.
Exercises to strengthen the pelvic floor muscles, known as Kegels, can help people with stress incontinence. Kegels can also help people with urge incontinence. Sometimes, Kegels are combined with biofeedback techniques to help you know if you are doing the exercises properly.
For urge incontinence, bladder training, sometimes called bladder retraining, can also help. This involves gradually increasing the interval time between trips to the bathroom, working up to longer and longer intervals between bathroom stops.
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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.
Best Treatment For Bladder Leaks
Recent research strengthens the link between incontinence drugs and dementia risk. Here’s how to find relief.
Drugs for an overactive bladder are promised to curb frequent bathroom breaks and bladder leaks.
But is taking medicationsmost of them members of a class of drugs called anticholingericsreally the best solution for regaining control of your bladder?
Anticholinergics commonly cause mental confusion, especially in older adults, and have, in the past, been linked to an increased risk of dementia.
Now, a large analysis from the U.K., published last week in the journal BMJ, has found that anticholinergic drugs, especially those used for bladder problems, Parkinsons disease, and depression, are associated with a higher likelihood of dementia in older adults even 20 years after use.
While this class of medications has long been known to be linked to memory troubles, it was not known whether the effects were permanent, says Michael Hochman, M.D., an associate professor of clinical medicine at the Keck School of Medicine at the University of Southern California. But this study suggests that the effects may not entirely reverse after stopping the medication.
The research doesnt prove that the drugs cause dementiaonly that there is an association between the two. However, this study does raise concerns, and anticholinergic medications for incontinence have several other well-established side effects, Hochman says.
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Solutions For A Leaky Bladder
Research has found that at least half of people with urinary incontinence dont discuss the condition with a health care provider. But theres no need to feel embarrassed. If you have a leaky bladder, youre definitely not alone. Bladder leakage, or urinary incontinence, affects women and men of all ages, though it becomes more common later in life.
And its definitely worth discussing, because of the many ways it can interfere with enjoying daily lifefrom exercise and travel to social outings and romance, says E. James Wright, M.D., director of urology at Johns Hopkins Bayview Medical Center.
How Is It Treated
Treatments depend on the type of incontinence you have and how much it affects your life. Your treatment may include medicines, simple exercises, or both. A few men need surgery, but most don’t.
There are also some things you can do at home. In many cases, these lifestyle changes can be enough to control incontinence.
- Cut back on caffeine drinks, such as coffee and tea. Also cut back on fizzy drinks like soda pop. And limit alcohol to no more than 1 drink a day.
- Eat foods high in fiber to help avoid constipation.
- Don’t smoke. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
- Stay at a healthy weight.
- Try simple pelvic-floor exercises like Kegels.
- Go to the bathroom at several set times each day. Wear clothes that you can remove easily. Make your path to the bathroom as clear and quick as you can.
- When you urinate, practice double voiding. This means going as much as you can, relaxing for a moment, and then going again.
- Use a diary to keep track of your symptoms and any leaking of urine. This can help you and your doctor find the best treatment for you.
If you have symptoms of urinary incontinence, don’t be embarrassed to tell your doctor. Most people with incontinence can be helped or cured.
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Other Useful Counseling Information
The pharmacist should be familiar with other usefulinformation regarding Oxytrol For Women that is not required on thenonprescrip-tion product label.4 For instance, patients usinganticholinergics such as oxybutynin should be warned not to enter hotenvironments, since that group of medications reduces the ability tosweat, and the wearer may suffer heat prostration, with fever and heatstroke. Oral dosage forms of oxybutynin have caused angioedema,4and patients should be informed that the appearance of any symptomsthat might be angioedema is sufficient cause for a 911 call, withimmediate transport to an emergency room.
The label warning against use in gastric retention is required because anticholinergics decrease gastric motility.4However, the label omits other examples of patients who are at highrisk of complications due to decreased gastric motility, such as thosewith ulcerative colitis, intestinal atony, and myasthenia gravis. It isalso vital to know that patients with gastroesophageal reflux should useOxytrol For Women with caution, a warning that also includes patientswho are taking bisphosphonates , since these drugs can induce or worsen reflux.4
To facilitate compliance, patients can be instructed tochange patches on the same 2 days each week. Product packages have acalendar on the back to help patients remember when changing is due.4
Cleavers And Corn Silk
Cleavers, or sticky willy, is a plant that clings to everything, as its name implies. Cleavers tea is marketed as detoxifying and as providing lymphatic support, but no evidence documents its use to reduce OAB symptoms.
Corn silk, the strands you pluck from corn before eating it, is also used to make a tea. This tea is said to ease urinary tract infection symptoms, but no data backs up that claim. Nor is there scientific proof that corn silk would help OAB.
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Follow Directions To Manage Safety Concerns
Like any item worn in the vagina, bladder supports come with a small but important risk of toxic shock syndrome .
They can typically be worn safely for up to eight hours within a 24-hour period.
As with any other tampon or device youd insert into the vagina, youd want to make sure that its removed as directed, says Dr. Vasavada.
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.
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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.
What Causes Bladder Leaks
There are two main types of urinary incontinence:
Stress incontinence
If you have this type, activities that raise the pressure inside your abdomen cause urine to leak through the ring of muscle in your bladder that normally holds it in. Coughing, sneezing, jumping and lifting heavy objects could lead to a leak.
Going through childbirth, smoking or being overweight can raise the risk of stress incontinence for women, Wright says. Stress incontinence in men is rare, and when it arises, its often due to prostate cancer treatment, such as radiation or surgery.
Urge incontinence
With this type, your brain, spinal cord and bladder dont work together properly to allow you to hold and release urine at the right time. Your bladder may suddenly empty itself without warning. Or you may feel like you need to urinate frequently, a problem called overactive bladder.
Some diseases that affect the nervous system, such as multiple sclerosis or stroke, can cause this kind of incontinence, says Wright. In men, an enlarged prostate may be the culprit. But in many cases, doctors dont know what causes urge incontinence.
It is possible to have both types of incontinence at the same time.
TRY IT: Keep Records
Your doctor will want to know as much as possible about your bladder leakswhen they occur, how much urine comes out, and what youre doing when leaks happen. Consider keeping a diary of when you urinate and when you have leaks, recommends Wright.
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Revive Reusable Bladder Support
Revive is a reusable bladder support that is clinically shown to manage stress urinary incontinence reducing leaks for up to 12 hours. Each box contains a 31-day supply with an easy to use applicator, which means you can just place it and go about your day, discreetly managing your leaks. In clinical trials, over 90% of women felt the product was a good fit upon first use, and over 70% experienced a reduction in SUI symptoms.
- Reusable bladder support device worn internally to reduce leaks caused by stress urinary incontinence .
- SUI is bladder leakage with physical activity or movement
- 1 month-supply with a reusable applicator.
- Provides protection for up to 12 hours per day.
- Clinically tested and FDA cleared for over-the-counter use.
- No sizing required. One size fits most.
What’s in your Revive® kit:
- One Reusable Bladder Support Device
- One Reusable Applicator
- One Month Strings Supply
- Travel Case
- Instructions for Use
What is Stress Urinary Incontinence ?
A New Nonprescription Product
Women may try the behavioral changes mentioned above, aswell as one of several prescription medications that relax the muscles of the bladder to preventcontractions. Physicians may also attempt such therapies as applicationof electrical impulses or Botox.
A new nonprescription product may be helpful for overactive bladder. It is known as Oxytrol For Women, which is available as a patch that is worn continuously on the skin for 4 days and contains the medication oxybutynin.
This product may be appropriate for you if you have hadtwo or more of the following symptoms for at least 3months: 1) urinary frequency, more than 8 times in 24 hours 2) urinaryurgency and 3) urge incontinence. However, urinary frequency can alsobe caused by urinary tract infections, diabetes, pregnancy , and other more serious conditions. If you think you have anyof these, you should see a physician instead.
The products label will have many additional useprecautions, warnings, and instructions. You should read and heed eachof these. Further, it is wise to Consult Your Pharmacist for additional assistance regarding use of this innovative new approach to overactive bladder.
Remember, if you have questions, Consult Your Pharmacist.
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Cystex Urinary Pain Relief Tablets
Cystex Urinary Pain Relief Tablets is yet another product that contains Methenamine, and therefore works in the same way as AZO Urinary Tract Defense.
The dose of Methenamine in both products is identical and both contain the same amount of Sodium salicylate .
Cystex Urinary Pain Relief Tablets will not change the color of the urine as some other OTC medications do.
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
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