Having bladder control problems? Here are 7 things you should know before seeing a doctor

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FEATURE — If you have bladder control issues, there is no need to be embarrassed in seeing a doctor. However, there are seven things you should know before making a trip to the doctor’s office.

1. The two most common bladder problems are overactive bladder and stress incontinence. They are very different and treated very differently.

Before you go in to be seen, keeping a bladder diary for a week is very helpful for the person who sees you to get an idea of what is happening: when, where you are, circumstances, leakage, et cetera.

2. Overactive bladders and bladder infections can feel very similar. When you are seen, you should always be checked for a bladder infection.

3. Symptoms of an overactive bladder are having to make a run for the bathroom, frequent urination and getting up several times at night to go.

Another symptom is getting the urge when you bounce on you heels or hear water running. It is a neurological problem, not one that is treated surgically. In most cases it can be controlled or even cured with retraining and medication. The longer you let it go without treatment, the harder it is to eliminate.

4. Symptoms of stress incontinence include leaking with coughing, sneezing, laughing, jumping, et cetera.

You typically don’t have a warning or experience great urgency; it just suddenly happens. This is an anatomic problem with the pelvic support mechanism that keeps the bladder from leaking when there is increased pressure, and this defect is usually caused by pregnancy and childbirth. It rarely happens in women who haven’t given birth.

5. Treatment for overactive bladder is done by using a medication — Detrol, for example — that helps relax the bladder and lessen that sense of urgency.

Concurrently, I have patients do retraining exercises in which they void every hour on the hour for a week. The next week they go every hour and a half. The next week every two hours. This is done until she can easily go three hours between voids without urgency for a few months. Then the medicine is discontinued.

6. Medications do not work well for stress leakage.

There are devices that fit in the vagina to help support the bladder neck that can help mild symptoms. They are all devices meant to support the bladder neck during times of increased pressure, and they work to varying degrees.

More definitive cure comes from a minimally invasive surgical procedure that in experienced hands is highly successful at improving and curing stress incontinence. No treatment is guaranteed to be 100 percent successful in all women, but suburethral sling placement is the most successful.

7. All treatments are covered by your insurance, so don’t let that be a barrier to being seen.

Sometime when history alone does not explain what is going on, I will do what is called office cystometrics — where we see how well you empty, how well your bladder fills and at what point your bladder involuntarily contracts. This can greatly help direct treatment in less-than-clear circumstances.

The extent you want to go addressing bladder control problems depends on how much they affect your quality of life. Though they are very common, you do not have to just live with them. Almost all are very treatable, and if not curable, they can be vastly improved. Talk to your doctor; don’t be embarrassed. I talk about this all day, every day of my life. Your quality of life matters.


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Copyright St. George News, SaintGeorgeUtah.com LLC, 2018, all rights reserved.

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  • Redbud September 24, 2018 at 6:42 am

    Thanks for this article, I’ve already soaked through my Depends.

  • Striker4 September 24, 2018 at 9:17 am

    Wow ! that was almost funny

    • Redbud September 24, 2018 at 9:43 pm

      It will be even more funny when you have to wear them!

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