Controlling Overactive Bladder
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Overactive Bladder: How To Take Back Control
http://healthology.com/webcast_transcript.asp?f=urologic_health&c=urology_oa
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ANNOUNCER: It's no secret that our bodies change as we age, and many of the
abilities we have in our youth fade away with the years. But there's an
embarrassing problem which contrary to popular belief, older people don't
have to live with, urinary incontinence.
THERESA ROCHE: If I was going to be out in the park walking, I knew I had to
wear a depends. And if I was going some place to the supermarket, I knew
every bathroom in every supermarket. I thought it was the normal part of
aging.
ANNOUNCER: In fact, most urinary incontinence is caused by an abnormal
condition called overactive bladder, in which a major bladder muscle
contracts too frequently causing various urinary difficulties.
PHIL HANNO, MD: Overactive bladder is a combination of symptoms that are
very common in women and in men. They're urinary frequency -- patients have
to go to the bathroom to empty their bladder quite often. Urgency, where
they don't really have an option as to when they're going to go. They get a
sudden urge to go and they'd better be there, or they may wet themselves.
ANNOUNCER: Effective treatments are available, but the first step is paying
close attention to your problem.
PHIL HANNO, MD: I think patients who experience symptoms of an overactive
bladder should keep a voiding diary. They should record how often they void,
the time they're voiding, and what kind of volumes they're voiding, you
know, how many ounces they void on an average time, that would be very
helpful, and how many times they wake up at night. And then they should see
their doctor and bring that information with them when they see their
doctor, and that gives the doctor tremendous -- tremendously helpful clues
in terms of determining what's going on and what the best treatment would
be.
ANNOUNCER: Once overactive bladder is diagnosed, there are a number of
treatment options available.
ERIC ROVNER, MD: Probably the best treatment for most patients to start with
is a program called behavioral modification, and it's a combination of
treatments, including some behavioral measures, such as voiding or urinating
by the clock as opposed to by the sense of urinary urgency, changing certain
aspects of their diet, losing weight, stop smoking, among other things,
decreasing caffeine intake, decreasing alcohol intake.
And an integral component of the behavioral modification program is pelvic
floor exercises. Pelvic floor exercises are Kegel exercises. They are
intermittent contractions or voluntary contractions of the pelvic floor
muscles -- the muscles around the rectum and bladder. They are very
effective when done as part of a behavioral modification program.
ANNOUNCER: In addition to exercises and lifestyle changes, there are several
medications that doctors can prescribe.
ERIC ROVNER, MD: These are drugs that block the activity of the nervous
system on the bladder. These agents, in effect, reduce bladder overactivity.
They allow the bladder to fill up to a bigger volume, allow patients to
postpone urination a little bit longer, reduce nocturia -- that is, waking
up at night -- reduce urinary frequency considerably.
The agents that work include Detrol, which is tolterodine; Ditropan, also
known as oxybutynin, and then there's a number of lesser-known agents that
are also used to some degree.
ANNOUNCER: Used in combination with behavior therapies, medical treatments
can greatly improve bladder control in most patients.
ERIC ROVNER, MD: We don't cure overactive bladder, but we do rebalance the
function of the lower urinary tract so that patients' quality of life can be
vastly improved.
JULIA ROJAS: My life has changed tremendously in one month. I feel more
confident to go out and not to have an accident. It's just been wonderful
how these pills have worked on me in such a short time.
ANNOUNCER: As with any medication, drugs like Detrol and Ditropan have
potential side effects that patients should be aware of.
PHIL HANNO, MD: The primary side effect is dry mouth. Some patients become
constipated with these medicines. Generally, when a medication has benefits
that outweigh the side effects, the patient likes to take it, and the doctor
recommends it, and most of the time for overactive bladder the benefits of
these medicines far outweigh the side effects.
ANNOUNCER: If patients don't benefit from medical and behavioral approaches
there are surgical options doctors can turn to as well. But all too often,
doctors don't even get the chance to treat overactive bladder.
ERIC ROVNER, MD: Less than half of the patients that suffer from overactive
bladder actually discuss it with their health care provider. It's truly a
closet condition.
ANNOUNCER: So if you're one of the many people who are suffering needlessly
from overactive bladder, talk to your doctor today because regaining control
means winning back your freedom.
Video Broadcast
Overactive Bladder: How To Take Back Control
Š 2002 Healthology, Inc
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Brought to you by Cowboy and Paul Jones. See Paul Jones website at
www.mult-sclerosis.org for this article and many more.