Overactive bladder and incontinence part 8

Medications

Unlike may other bladder disorders, there are some decent medications that can treat overflow incontinence. These medications all work in the same manner. They relax the bladder muscles and reduce urge incontinence. The available drugs include

- tolterodine (Detrol)
- oxybutynin (Ditropan)
- oxybutynin skin patch (Oxytrol)
- trospium (Sanctura)
- solifenacin (Vesicare)
- darifenacin (Enablex).

For the best effects, it is highly recommended that these medications be combined with above mentioned lifestyle changes. There is a lot of clinical evidence showing that these drugs do work for hyperactive bladder but the problem is never cured. The treatment has to be continued for many months. Relapse is very common when drug treatment is stopped.

The major problem with the above drugs is side effects. Most individuals develop some type of side effect over time. The longer the treatment continues, the more prominent side effects become. The typical side effects of anti cholinergic drugs include

- Dry eye sensation
- Dry mouth
- Excessive thirst
- Headaches
- Nausea
- Constipation

To limit or eliminate these side effects, there are now some extended release preparations that can be applied as a skin patch. If dry mouth or dry eye sensation persists, one should use sugar free candy, apply eye drops or use products like Biotene that can help moisten the mouth for long periods

Botox

There is some anecdotal evidence that Botox can help relieve overflow incontinence. Botox can paralyze bladder muscles and reduce the urge to pee. Research is still ongoing and Botox has not yet been approved for use in this disorder. Some reports indicate that Botox when injected into bladder muscles can provide relief for as long as 4-6 months. However, it has also been observed that Botox injections in older men can create another problem- retention of urine. One develops a feeling of a full bladder but is unable to void. Often the only way to resolve this problem is to use a catheter to empty the bladder.

Overactive bladder and incontinence part 3

What causes overflow incontinence?

Most of us have no problems with urination. The bladder is about the size of I-1.5 liter muscular pocket. The muscles have a complex set of nerves, which sense filling of the bladder. There are also other nerves that relax the bladder when the bladder is filling with urine. When the bladder capacity has reached a certain limit, the nerves stimulate muscles and the bladder empties. The outflow of bladder known as the urethra also has complex network of nerves that prevent the urine from running out of the bladder continuously. When the bladder contracts the urethra relaxes and the urine flows out.

Why the bladder muscles start to contract prematurely is not known. In the majority of cases, no cause of an overactive bladder is ever identified. Some neurological disorders which cause an overactive bladder include multiple sclerosis. Parkinson’s, stroke or chronic diabetes

Factors that can aggravate an overactive bladder include:

- excess fluid intake
- poor kidney function
- diabetes
- urinary tract infection
- anatomical abnormalities of bladder/ureter
- bladder cancer
- bladder stones
- excess consumption of coffee beverages
- excess consumption of alcoholic beverages
- certain medications that increase urine production
like diuretics

Who is prone to developing an over active bladder?

The two most common disorders, which are associated with overactive bladder are diabetes and enlarged prostate in men

Bed Wetting and Treatment with Oxybutynin (Ditropan) Part 1

Besides vasopressin and the tricyclic antidepressant (imipramine), other medications are also used to treat nocturnal enuresis. This includes the anticholinergic drugs. Over the past 40 years, many different anti cholinergic medications have been developed and some have found use in treatment of bed wetting.

In some individuals who wet the bed it has been observed that the bladder muscle is hyperactive. Any minor stimuli causes it to contract which then results in bed-wetting. The anti cholinergic medications act by relaxing the bladder muscles.

There are also some individuals who have a very small bladder and are not able to retain urine. Some features of a hyperactive and small bladder include:

- Sudden need to urinate
- Urinate more often than normal
- Persistent dribbling of urine or having wet pants or underclothes
- Leakage of urine when the urge to urinate comes on (unable to control urine flow)
- Pain on urination

By decreasing the incidence of muscle spasms in the bladder, the bed wetting episodes decrease- at least that is how it is in theory.