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Overactive Bladder

Restroom Sign Do you have Overactive Bladder (OAB) symptoms?

If you answer “yes” to one of more of these questions, you may have OAB.

  1. I use the bathroom more than 8 times during the day
  2. I get up more than twice during the night to use the bathroom
  3. I am bothered by the number of times I have to go
  4. I often have an overwhelming urge to urinate, an urge that is difficult to ignore
  5. I’ve had wetting accidents because I am unable to control the urge to go and can’t get to the restroom in time

To learn more about OAB, read through the following information or talk to your clinician.

What is OAB?

Symptoms: OAB is used to describe a collection of symptoms.  A patient may have one or more of these symptoms:

  1. A sudden, intense urge to urinate (urinary urgency), sometimes followed by the loss of urine (urge incontinence)
  2. Urinating more than 8 times daily or twice at night (urinary frequency).

Cause: OAB is generally caused by bladder muscles that are overly sensitive or overactive.  This overactivity is caused by damage to nervous system or to the nerves and muscles associated with bladder. The cause of the nerve damage is often unidentified and you should discuss your symptoms with your doctor. Overactive Bladder symptoms of urinary urgency, urinary frequency or urge incontinence may be present in people with interstitial cystitis or post-radical prostatectomy.

Prevalence: It is estimated that over 16% of the adult population have one or more of these symptoms.  Both men and women can have OAB.

How is OAB treated?

A variety of treatments are available, including behavior modification, pelvic muscle strengthening, medications and neuromodulation.

Behavioral Modifications:

  • Scheduled Toileting: the patient is prompted to use the bathroom every 2-4 hours.
  • Bladder Training: involves scheduled toileting in which the length of time between bathroom visits is gradually increased.
  • Pelvic Muscle Rehabilitation: pelvic floor exercises, commonly referred to as Kegel exercises, are often recommended. Depending on the severity of a patient's symptoms, Kegel exercises may be combined with:
    • Pelvic muscle stimulation: mild electrical stimulation to help automate the process of performing Kegel exercises.  Stimulation is generally applied using a home-use device.
    • Biofeedback: a process using visual or auditory signals to assist targeting the right muscle during exercise.

Drug Therapy : Anticholinergics or antimuscarinics may be prescribed. Hormone therapy, such as estrogen creams, may also be effective in helping to improve pelvic floor muscle function.

Neuromodulation : Bladder function is regulated by a group of nerves at the base of the spine called the sacral nerve plexus. By stimulating these nerves through gentle electrical impulses (neuromodulation), your bladder activity can be changed.  This can be done throug

URINARY INCONTINENCE DIAGNOSIS AND TREATMENT

Urinary incontinence, in men or women, can be a very disheartening and life-changing problem.  But, it is nothing to be embarrassed about. Some urinary incontinence problems are complex and some can be treated very simply with medications.   There are different types of urinary incontinence and we believe that it is only after you have been diagnosed properly, that the propery treatment can be recommended and discussed with you.   If you make an appointment with us, we will ask you a number of questions to fully under the nature and extent of your problem.   Questions like do you leak with exercise?  Do you leak when you cough or sneeze?  Do you have trouble getting to the bathroom before you leak?  Do you have to wear pads for leakage?  After fully assessing the extent of your problem, we will recommend a battery of tests which will include a urine culture to check for infection, possibly a cystoscopy, video urodynamics, and a complete examination.  Based on our findings, we will recommend treatment options for you.  They could be as simple as prescribing a medication to you for an overactive bladder.   You could be a candidate for a surgical "Sling" procedure if your bladder anatomically has "fallen".  There are new minimally invasive procedures like Medtronic's Interstim Treatment, Uroplasty's Macroplastique, Renessa injections, among others.  We have included some explanations of the tests below.  You don't have have to live "life interrupted" by so many bathroom breaks, or accidents.  Call us to day for an appointment.  The sooner, the better!

Urodynamics is a study and form of testing that is used by various physicians to determine patient bladder health. It can be used for both male and female patients to detect many different bladder conditions. Doctors use Urodynamics testing to test the urethra and the bladder for functionality, and to insure that they both are capable of storing urine. When your doctor performs Urodynamics testing, she is also testing the strength and capacity of your sphincter muscles. Urodynamics testing can be used to determine the source of conditions such as: strong, sudden urges to urinate, incontinence, excessive urination, problems initiating urination, achy or painful urinating, repetitive urinary tract infections and problems with bladder emptying.

Cystoscopy  cystoscopy (si-ˈstäs-kÉ™-pÄ“) is endoscopy of the urinary bladder via the urethra. It is carried out with a cystoscope. Diagnostic cystoscopy is usually carried out with local anaesthesia. General anaesthesia is sometimes used for operative cystoscopic procedures. The urethra is the tube that carries urine from the bladder to the outside of the body. The cystoscope has lenses like a telescope or microscope. These lenses let the doctor focus on the inner surfaces of the urinary tract. Some cystoscopes use optical fibres (flexible glass fibres) that carry an image from the tip of the instrument to a viewing piece at the other end. Cystoscopes range from between the thickness of a pencil, up to approximately 9mm and have a light at the tip. Many cystoscopes have extra tubes to guide other instruments for surgical procedures to treat urinary problems. There are two main types of cystoscopy - flexible and rigid - differing in the flexibility of the cystoscope. Flexible cystoscopy is carried out with local anaesthesia on both sexes. Typically, xylocaine gel (such as the brand name Instillagel) ...

Read more: http://www.righthealth.com/topic/cystoscopy#ixzz1RReWEIR4

Macroplastique is an injectable soft-tissue bulking agent used to treat stress urinary incontinence (SUI) primarily due to intrinsic sphincter deficiency (ISD). Macroplastique has been used in Europe since 1991 and has proven to be an effective and safe treatment alternative for those suffering from SUI.

Read more: http://www.macroplastique.com

Renessa The Renessa Procedure is a minimally-invasive approach to the treatment of bladder leaks resulting from Stress Urinary Incontinence (SUI).  SUI is the most common type of urinary incontinence, affecting 15 million women in the United States alone. It is the involuntary leakage of urine which occurs during periods of increased intra-abdominal pressure (“stress”).  SUI can occur during laughing, sneezing, coughing, exercise, lifting, and other activities.  SUI diminishes a woman’s quality of life, often limiting her professional, social, sexual, and recreational activities.

Read more: http://www.renessa.com

Medtronic Interstim Implant is an implantable device that stimulates the sacral nerves with mild electrical pulses. To help discover if neurostimulation will work for you, your doctor may offer a trial assessment, so you can try neurostimulation without making a long-term commitment.

Read more: http://www.medtronic.com/health-consumers/overactive-bladder/about-therapy/index.htm

To better assess your urinary incontinence problem, take a moment to fill out this questionnaire:

h an office-based procedure or by surgically implanting a device in your buttock.

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