Clinical Management of Urinary Incontinence in Women

Incontinence is a devastating condition affecting millions of American women. It is a source of embarrassment that results in women becoming reclusive and deciding not to engage in socialization. Urinary incontinence, defined as the involuntary leakage of urine, affects 20 million persons nationwide Help is available. You don’t have to depend on Depends! This blog will discuss the problem and the treatment options for urinary incontinence.
Most cases of urinary incontinence in women fall under one of three major subtypes: urge, stress, or mixed. I believe in going from tshe least invasive (behavioral modification) to more invasive (surgery) interventions is the best approach. Bladder retraining and pelvic floor muscle exercises are first-line treatments who present with urge incontinence or “I gotta go right now”! Medication with anticholinergic medications is another option for treating urge incontinence if behavioral therapy is unsuccessful; however, because of adverse effects such as constipation and blurred vision and confusion, these agents are not recommended in older adults.

Pelvic floor muscle exercises or Kegel exercises are considered first-line treatment for stress incontinence or loss of urine with coughing, laughing or sneezing. Alternatives for treating stress incontinence include vaginal pessaries. At this time no medications are approved by the U.S. Food and Drug Administration for treating stress incontinence. Minimally invasive procedures injection of periurethral bulking agents, can be used if stress incontinence does not respond to less invasive treatments.

Third line treatment consists of surgical interventions, such as sling and urethropexy procedures, should be reserved for stress incontinence that has not responded to other treatments.

Bottom Line: Women suffering from urinary incontinence do not have to suffer and should speak to their doctor about treatment options. Usually some of the options are helpful and can make women comfortable and able to engage in most activities without the embarrassment of the loss of urine.

Non-Medical Treatments of Urinary Incontinence

Incontinence is a devastating condition affecting millions of American women. It is a source of embarrassment that results in women becoming reclusive and deciding not to engage in socialization. Urinary incontinence, defined as the involuntary leakage of urine, affects 20 million persons nationwide Help is available. You don’t have to depend on Depends! This blog will discuss the problem and the non-medical treatment options for urinary incontinence.

WEIGHT LOSS
Women who are overweight or obese and who experience stress incontinence should be encouraged to lose weight, which has been shown to reduce the frequency of incontinence symptoms.32

BEHAVIORAL TREATMENTS
Pelvic floor muscle exercises are the mainstay of behavioral therapy for stress incontinence. Up to 38 percent of patients with stress incontinence alone who follow a pelvic floor muscle exercise regimen for at least three months experience a cure. Increased effectiveness is demonstrated in women undergoing longer training and in those following comprehensive clinic-based training rather than self-help booklets.
Manual feedback (palpating the pelvic muscles during the exercises) and biofeedback (using a vaginal or anal device that provides visual or audio feedback about pelvic muscle contraction) have been used to teach patients the correct technique. Weighted intravaginal cones have also been used for improving technique when women have difficulty identifying their pelvic floor muscles. Although these strategies may improve technique and, consequently, symptoms in the short term, there is no evidence that they result in higher rates of long-term improvement or cure than the exercises alone.

ELECTRICAL AND MAGNETIC STIMULATION
Electrical stimulation of the pelvic floor muscles with a vaginal or anal electrode can be used in women who cannot voluntarily contract pelvic floor muscles.13 This can be done at home and typically consists of two 15-minute sessions daily for 12 weeks. Medicare has approved its use in patients who have incontinence that does not respond to structured pelvic floor muscle exercise programs.

Extracorporeal magnetic innervation involves a series of treatments in which the patient sits, fully clothed, on a chair that generates a low-power magnetic field. Patients typically undergo two or three treatments per week for six to eight weeks. One early study showed this method to be most effective for women who have mild stress incontinence (i.e., using three sanitary pads per day or fewer). A more recent study found it to be more effective than sham treatment for women who are unable to generate adequate pelvic floor muscle contractions.

DEVICES
Vaginal inserts, including incontinence pessaries and incontinence tampons, can be used for treating stress incontinence in pregnant women, in those who are not surgical candidates, and in those whose symptoms have not responded to previous surgeries. Vaginal inserts compress the bladder neck and urethra, thus decreasing urine loss caused by stress incontinence. Although pessaries are not widely used, their associated risks and costs are low, and they achieve results quickly. There are few contraindications to pessary use (e.g., active pelvic infection, severe ulceration, allergy to product materials, noncompliance). Incontinence tampons, which also place pressure on the bladder neck, are available in Europe.
[corrected] Urethral plugs are devices that are inserted into the urethra to prevent urine loss during activities that cause stress incontinence (e.g., running). They are available in two lengths: 3.5 cm and 4.5 cm. There is limited evidence promoting or discouraging their use, and they are associated with a number of adverse effects, including urinary tract infection (occurring in up to 31 percent of women over a two-year period), hematuria or blood in the urine (3 percent), and migration into the bladder (1 percent). Despite this, multi-year studies indicate a high degree of patient satisfaction, and the likelihood of significant adverse effects diminishes with continued use.

Bottom Line: Urinary incontinence is a devastating problem affecting millions of American women. You don’t have to suffer in silence. Help is available; speak to your physician

Leaking Urine? You Don’t Have To Depend on Depends!

Urinary incontinence is one of the most discouraging and depression conditions that affects both men and women. Incontinence can lead to a reclusive life style because of embarrassment and even be a cause of nursing home admission.

Urinary incontinence affects millions of men and women. There are numerous medical treatment options and perhaps one of the easiest solutions is dietary modification. This blog will discuss some of the dietary changes that you can implement to help control your urinary incontinence.

The solution isn’t always to limit your water intake
Remember that if you don’t drink enough water, you might get dehydrated. The problem is, when you have incontinence, drinking a lot of water could also give you problems. Even, the recommended six to eight glasses of water a day can give you problem since you have incontinence. Now, if you don’t drink as much and you will only have little water in your body, this can irritate your bladder and this could make you go often. So, the best way is to ask your doctor what would work best for you.

Cut down on alcohol
Alcohol directly affects your bladder. This is diuretic – so, that makes you go more often to the comfort room. The problem with alcohol is that, this interferes with the signaling mechanism of the brain down to your bladder. So, if you have alcohol with you, you will not be able to control your bladder fully.
However, there are some people who can still control their bladder even if they are drinking alcohol. So, if you don’t want to stop alcohol, the best bet here is to stop it first – and then, add back little by little, so you will know how much of alcohol your body can tolerate.

Go low on the “joe” (caffeine)

You can find caffeine in your soft drinks, teas, chocolate and even in decaffeinated coffees – though in small quantity. The problem with caffeine is since it tells your body to get rid of liquid; you’ll keep on coming back to the comfort room. So, avoid them if you can.

However, if you really love that coffee zest, be sure to do it in the morning. Avoid it at night, though – especially after past 7 p.m. – if you don’t want that sleep disturbed. Be sure also to limit yourself to one or two caffeinated drinks a day.

Avoid Spicy Foods
Avoid eating spicy foods like Mexican, Chinese, chili peppers, chili, and horseradish. Remember that spicy foods can irritate the lining of your bladder -just like caffeine does.

Stay away from acidic foods
Acidic foods like citrus foods and juices – as, oranges and pineapple have acids that can irritate your bladder – just like what spicy foods and caffeine can do – which can make you feel on the go – always!
Tomatoes and cranberry juice are also acidic. Yes, cranberry juice may help bladder infections – but, this doesn’t help if your bladder is overactive. So, please stay away from them if you can.

The Whiz says go easy on the fizz
The carbonated drinks may not have caffeine, but they can irritate a sensitive bladder – and when your bladders are irritated, then you have that urge to go to the rest room as always.
You have to remember that diet is not the only way to go to control your urinary incontinence. You also have to check on your weight gain, diabetes, constipation, aging – and certain cancers (well, I hope this is not the case) since these conditions may cause you your problem.

Bottom Line: Now, if even after following those diet regimen and your condition is still not improving, it is time that you should check with your doctor.

A Balloon In The Bladder-A New Treatment For Incontinence

Laughter is the best medicine; but not for overactive bladder! This is a common condition affecting 15 million American men and women. Now a new novel treatment that does not require surgery is currently undergoing clinical studies in the United States in order to achieve FDA approval.

Stress urinary incontinence or loss of urine with coughing, sneezing, laughing, or even bending over to tie your shoes is the most prevalent form of incontinence among women, affects an estimated 140 million women worldwide. SUI is defined as the inability of the bladder to store urine during normal everyday physical activities without sudden increases in bladder pressure.

The Solace Bladder Control System is a non-surgical alternative to involuntary urinary leakage. The Solace Bladder Control Balloon is a small, lightweight device that floats within the urinary bladder. The balloon is designed to eliminate or reduce involuntary urinary leakage. It acts as a “shock absorber” to reduce the temporary pressure changes in the bladder that cause urinary leakage.

The Solace Bladder Control Balloon procedure is performed in the physician’s office. No medication or preparation is required before the procedure. The physician places the Solace Bladder Control Balloon into the bladder through a small tube inserted into the bladder under a local anesthetic. Pressure reduction is immediate. The balloon can be removed at any time.

For more information on the Bladder Control Balloon go to http://www.stopsui.com.

Bottom Line: Incontinence is a common condition that affects millions of American men and women. At the present time there is no medication to treat this problem. The Bladder Control Balloon may be a treatment option.

10 Reasons That Sex Contributes to Good Health

On so many occasions many of my male and female patients have indicated that as they reach middle age, that sexual intimacy has taken a back seat and is less important than it was years ago. For this blog, I would like to illuminate 10 reasons to take the sex drive off the back shelf and put it on the front burner. Both you and your partner will be glad you did.
Sex not only feels good. It can also be good for you. Here’s what a healthy sex life can do for you.
1. Revs Up Your Immune System Humming
Sexually active people miss fewer days of work and make fewer visits to the doctor.
People who have sex have higher levels of what defends your body against germs, viruses, and other foreign substances. Researchers found that those men and women who had sex once or twice a week had higher levels of the a certain antibody compared to those who had sex less often.
You should still do all the other things that make your immune system happy, such as:
Eat right.
Stay active.
Get enough sleep.
Keep up with your vaccinations.
Use a condom if you don’t know you and your partner’s STD status.
2. Boosts Your Libido
Having sex will make sex better and will improve your libido.
For women, having sex increases vaginal lubrication, blood flow to the pelvis, and elasticity of the vagina, all of which make sex feel better and help you crave more of it.
3. Improves Women’s Bladder Control
A strong pelvic floor is important for avoiding incontinence, involuntary loss of urine, something that will affect about 30% of women at some point in their lives.
Good sex is like a workout for your pelvic floor muscles. When you have an orgasm, it causes contractions in those muscles, which strengthens them.
4. Lowers Your Blood Pressure
Research suggests a link between sex and lower blood pressure. Numerous studies have reported that sexual intercourse lowered systolic blood pressure, the first or top number on your blood pressure test.
5. Counts as Exercise
Sex is a really great form of aerobic exercise. It won’t replace the treadmill, but it counts for a short cardio workout.
Sex uses about five calories per minute, four more calories than watching TV! It bumps up your heart rate.
So get busy! You may even want to clear your schedule to make time for it on a regular basis. Consistency or regular sex helps maximize the benefits.
6. Lowers Heart Attack Risk
A good sex life is good for your heart. Besides being a great way to raise your heart rate and provide you with a cardio workout more fun than spinning, sex helps keep your estrogen levels in women and testosterone levels in men in balance.
When either one of those is low you begin to get lots of problems, like osteoporosis and even heart disease.
Having sex more often may help. During one study, men who had sex at least twice a week were half as likely to die of heart disease than the less sexually active men who had sex rarely.
7. Lessens Pain
Before you reach for an aspirin, ibuprofen or a pain pill, try an orgasm.
An orgasm can block pain by releasing endorphins which are much more powerful than morphine. Orgasm releases endorphins that helps raise your pain threshold.
Stimulation without orgasm can also be effective. Vaginal stimulation can block chronic back and leg pain, and many women report that genital self-stimulation can reduce menstrual cramps, arthritic pain, and in some cases even headache.
8. Send Big “C” Out To Sea
Going for the sexual homerun or orgasm may help ward off prostate cancer.
The prestigious the Journal of the American Medical Association reported that men who ejaculated frequently (at least 21 times a month) were less likely to get prostate cancer.
You don’t need a partner to reap this benefit: Sexual intercourse, nocturnal emission, and masturbation were all part of the equation.
9. Improves Sleep
You may nod off more quickly after sex, and for good reason.
After orgasm, the hormone prolactin is released, which is responsible for the feelings of relaxation and sleepiness after sex.
10. Eases Stress
Being close to your partner can soothe stress and anxiety.
Even touching and hugging can release your body’s natural feel-good hormones. Sexual arousal releases a brain chemical that revs up your brain’s pleasure and reward system.
Sex and intimacy can boost your self-esteem and happiness, too,
Bottom Line: Who would have “thunk” that sex is good for you and can help keep you healthy and well. As my wise Jewish mother, St. Sara, would say, “It may not help but it voidn’t hoit!” Rest in peace St. Sara.

Dripping and Depends-Loss of Urine After Prostate Gland Surgery

You Don’t Have to Depend On Depends!

Prostate cancer is the second most common malignancy in men. Many men will choose to have surgery on their prostate gland and have the entire gland removed if the disease is confined to the prostate gland. Unfortunately, the sphincter, or muscle that controls urination, is often injured at the time of surgery or is included in the surgical specimen. As a result men will have problems with urination after the surgery.

There are three types of urinary incontinence may develop after prostate cancer treatment. These are stress incontinence, overflow incontinence, and urge incontinence.

If you have stress incontinence, you leak small amounts of urine when you cough, sneeze, exercise or put pressure on your bladder. Kegel exercises may help strengthen the muscles in your pelvic floor. This allows you to delay urinating until you reach a toilet.
You may have thought that Kegel exercises were something only women do. In fact, the muscles that are strengthened with Kegel exercises are the same in both sexes. (For more information on Kegel exercises, please refer to my website, http://www.neilbaum.com)

Urge incontinence occurs when your bladder suddenly contracts and expels urine. You get an urge to urinate even though you know you emptied your bladder not long before. You urinate, and then get the urge again a half-hour later. Urge incontinence often comes in waves. It may not bother you all morning, for example, but it becomes insistent mid-afternoon. In the course of a few hours you may feel the urge four or five times.

Bladder retraining helps by increasing the amount of urine your bladder can hold. In this technique you suppress your urge and gradually prolong the time between trips to the toilet. This really works, but now and then there’s a crisis. You’ve ignored the urge, and ignored it again, and suddenly you’re pretty sure you aren’t going to hold it and need to dash to the bathroom. The trick is to know when your bladder is at its limit and go to the bathroom just before you have to make that mad dash.

Prescription medications, particularly oxybutynin (Ditropan), tolterodine (Detrol) and some antidepressants, can be effective. The antidepressants aren’t treating depression: They calm the sensations that come from your bladder.

Overflow incontinence results when your bladder cannot empty completely. As a result, urine dribbles out. Alpha blocker drugs help to more fully empty the bladder.

Even if your incontinence can’t be cured, it can be managed. Absorbent underwear and highly absorbent disposable pads can be worn with everyday clothing. A condom-like device can be fitted over your penis and connected to a drainage bag. There is also a rubber clamp that can be used to compress the urethra or the tube that transports urine from the bladder through the penis to the outside of the body. Also there is a ring that can be applied to the penis that will gently compress the urethra and prevent urine loss.

Bottom Line: Fortunately, most men who have prostate gland surgery will be able to control their urination. The few who have problems with urination can be helped with exercises, medications, devices, and only rarely will need additional surgery to correct the problem.

When You Gotta Go-Putting a Handle On Overactive Bladder

As many as one in four adult women experience episodes of urine leaking involuntarily, according to the National Association for Continence. And about 17% of women and 16% of men have continuing problems with overactive bladder (OAB).
If you have OAB, you know how difficult and embarrassing it can be to manage your overactive bladder at work. How can you keep things dry and professional? Many experts will advise you to try behavioral therapy, and if that fails, seek medical or surgical treatment. All that can take time. Here are some tips to help you manage OAB at the office, at the shop, and on the road.
1. Don’t dehydrate yourself at work.
You may think you should restrict beverages so you’ll urinate less, but fluid restriction can be counterproductive.
Cutting back on your fluid consumption results in a dark colored urine which is highly concentrated; this actually acts as a bladder irritant.
2. Keep on schedule.
Scheduled fluid intake and urination are the keys to managing OAB. If you know you’ll have a big presentation at noon, stop drinking fluids at about 11 a.m., and then take a bathroom break right before your big appearance.
3. Know where the restrooms are located.
Familiarize yourself with all the restrooms on your floor, especially when you’re on a visit to a different office or at a conference. This is often called “toilet mapping” and can increase your security when you know exactly where the restrooms are.
4. Give yourself an exit.
The power spot at most work meeting is at the front of the room. But if you have an overactive bladder, sit in the back of the room and at the end of the aisle for presentations.
5. Know your triggers.
Stay away from obvious OAB triggers in work situations — coffee and anything else with caffeine, acidic drinks like orange juice, chocolate, and spicy foods.
6. Plan your travels.
Choose airline seats ahead of time if at all possible so that you can have an aisle seat near the restroom.
7. Make friends when traveling.
Solicit help from flight attendants when traveling. For example, explain your situation, and ask if they can let you know ahead of time when the seat belt light is about to come on so you can go to the bathroom first.
8. Involve your boss.
Most supervisors will be reasonable about scheduling regular bathroom breaks.
I can assure that doctors who treat patients with OAB will write letters confirming the condition so that the boss doesn’t think it’s just an excuse to get another break.
9. Kegel-keep squeezing
The pelvic floor contractions called Kegels are a great way to keep your bladder muscles strong in general, and you can do them without people noticing.
Even if you haven’t been doing Kegels regularly, if the urge to urinate hits, a quick series of pelvic floor contractions can sometimes abate that sensation until you can get to the bathroom.
See my article on Kegels at http://www.neilbaum.com/kegel-exercises-for-men.html
10. Don’t fear the pad.
If you know you’re going to be having a horribly hectic day, wear a pad or other protective undergarment that day. For men, there are “condom catheter” devices, that can collect urine until you can change. Condom catheters allows a little more control so that in the worst-case situation, you’re not going to have a visible accident.
11. Get help!
You don’t have to live with overactive bladder, at work or at home. People wait an average of seven years before seeking professional help for continence issues, but there’s no need to suffer in silence.
Bottom Line: The overactive bladder can be tamed. Start with your family physician. Your doctor may refer you to a urologist or urogynecologist, who can discuss your options for medication, behavioral therapies, or surgery.

This article was excerpted from 11 Ways to Manage OAB at Work

By Gina Shaw
http://www.webmd.com/urinary-incontinence-oab/america-asks-11/oab-work

Want To Tame That Overactive Bladder? Here’s 10 Food Groups to Avoid

1. Avoid citrus juices like oranges, grapefruit, and pineapple

These fruits are highly acidic and irritate the bladder.

2. Avoid Chocolate

Chocolate contains caffeine, a substance that irritates the bladder.

3. Avoid: Caffeine containing beverages such as Coffee and black tea

Caffeine is a diuretic, which causes you to urinate more often, and the caffeine stimulates the bladder. Even decaf versions have this effect. That’s because decaffeinated coffee and tea are seldom caffeine-free.  Herbal teas are without caffeine and are not bladder irritating.

4. Avoid: Hot sauce, chili peppers, wasabi

Spicy nachos, hot peppers, jambalaya, kabobs, and curries are significant bladder irritants.

5. Avoid: Sugar and honey

Sugars tend to stimulate the bladder. Know that for some people, even artificial sweeteners (such as aspartame) are bladder irritants.  Good news: Stevia is a natural sweetener that does not irritate the bladder.

6. Avoid Tomatoes

Tomatoes, like citrus fruits, are acidic; hence their bladder-irritating quality.

7. Avoid Alcohol

Alcohol interferes with brain signals that tell you when to “go.” It’s also a dehydrator and a diuretic that makes you need to go to the bathroom more.

8. Avoid milk and cheese

Different dairy products tend to affect people differently. For some, all dairy is a bladder-baddie. Others are bothered only by very rich and creamy milk products, such as cream cheese, sour cream, or aged cheeses.

9. Avoid Energy drinks

These drinks are very high in caffeine, which bothers the bladder.

10. Avoid Carbonated Drinks

Quenching your thirst with a carbonated beverage (colas, other flavors, fizzy water, seltzer) is counterproductive if you have an overactive bladder. The carbonation is a bladder trigger, an effect that’s intensified if the drink also contains caffeine. You may consider drinking straight water or one of the flavored vitamin waters.

Now I’ve told you what to avoid.  How about what to add to your diet?  Numero Uno is good, ol’ water.   If you drink too little (fewer than about eight cups a day), urine becomes concentrated, which can cause even more bladder irritation.

Bottom Line: There are so many foods and fluids that cause bladder irritability.  I suggest you look at your diet and see if you are consuming too many of these foods and fluids that exacerbate your condition.  Your bladder will thank you!

11 Suggestions For Decreasing Prostate Symptoms

The prostate gland is walnut sized organ at the base of the bladder.  In order men the gland increases in size and causes symptoms such as going to the bathroom frequently, dribbling after urination, and getting up at night to urinate.  Here are a 11 suggestions that you might consider to relieve those symptoms.

1.  Don’t drink anything several hours before you go to sleep.

2.  Avoid caffeinated beverages such as coffee and tea as the caffeine acts as a diuretic

3.  Limit your alcohol consumption especially at the dinner meal.

4.  Avoid spicy foods.

5.  Take medications such as your diuretics or water pills early in the day when going to the bathroom to urinate is not such an inconvenience.

6.  Avoid antihistamines and decongestants

7.  Don’t hold off going to the restroom

8.  Use the clock to help with urination. Make an effort to urinate every 3-4 hours.  Putting your bladder on a schedule is very helpful and a good habit to have.

9. Go and then go again. Stand at the toilet and empty your bladder, walk away from the toilet for a minute or two and then return and try emptying the bladder again.

10. Avoid cold seats such as at football games in the winter.

11. If you bike ride, especially for long distances, stand on the pedals every 10 or 15 minutes to take the pressure off of your prostate gland.

Bottom Line: These steps won’t cure the enlarged prostate but they will lessen the symptoms.  If your symptoms persist, consider a visit to your urologist

Menopause and Bladder Control

Some women begin to have problems with their bladder and experience overactive bladder (gotta go, gotta go right now) and urinary incontinence or loss of urine at inopportune times at the time or shortly after menopause.

Does Menopause Affect Bladder Control?

Yes. Some women have bladder control problems after they stop having periods (menopause or change of life). If you are going through menopause, talk to your health care team.

After your periods end, your body stops making the female hormone estrogen. Estrogen may help keep the lining of the bladder and urethra healthy. A lack of estrogen could contribute to weakness of the bladder control muscles.

Pressure from coughing, sneezing or lifting can push urine through the weakened muscle. This kind of leakage is called stress incontinence.

Although there is no evidence that taking estrogen improves bladder control in women who have gone through menopause, small does may help thicken the bladder lining and decrease the incontinence.  Your doctor can suggest many other possible treatments to improve bladder control.

What Else Causes Bladder Control Problems in Older Women?

Sometimes bladder control problems are caused by other medical conditions. These problems include:

Infections

Nerve damage from diabetes or stroke

Heart problems

Medicines

Feeling depressed

Difficulty walking or moving

A very common kind of bladder control problem for older women is urge incontinence. This means the bladder muscles squeeze at the wrong time and cause leaks.

If you have this problem, your doctor can prescribe medication that can certainly alleviate that problem.

What Treatments Can Help You Regain Bladder Control?

Your doctor may recommend limiting foods or fluids, such as caffeine, which are bladder irritants and increase the desire to go the rest room.

There are also pelvic exercises that can strengthen the muscles in the urethra and the vagina.   Life’s events like childbirth and being overweight, can weaken the pelvic muscles.

Pelvic floor muscles are just like other muscles. Exercise can make them stronger. Women with bladder control problems can regain control through pelvic muscle exercises, also called Kegel exercises.

Exercising your pelvic floor muscles for just five minutes, three times a day can make a big difference to your bladder control. Exercise strengthens muscles that hold the bladder and many other organs in place.

Two pelvic muscles do most of the work. The biggest one stretches like a hammock. The other is shaped like a triangle. Both muscles prevent leaking of urine and stool.

Pelvic exercises begin with contracting the two major muscles that stretch across your pelvic floor. There are three methods to check for the correct muscles.

1.     Try to stop the flow of urine when you are sitting on the toilet. If you can do it, you are using the right muscles

2.     Imagine that you are trying to stop passing gas. Squeeze those same muscles you would use.

3.     Lie down and put your index finger inside your vagina. Squeeze as if you were trying to stop urine from coming out. If you feel tightness on your finger, you are squeezing the right pelvic muscle.

Do your pelvic exercises at least three times a day. You can exercise while lying on the floor, sitting at a desk or standing in the kitchen.

Be patient. Don’t give up. It’s just five minutes, three times a day. You may not feel your bladder control improve until after three to six weeks. Still, most women do notice an improvement after a few weeks.

Other treatments include inserting a device, a pessary, directly into the vagina to lift the urethra and the base of the bladder to its proper position behind the pubic bone.  And finally, if the conservative methods of medication, exercises, and dietary modification don’t work, then you should talk to your doctor about one of the surgical procedures that can lift the bladder into the proper position to prevent leakage

Bottom Line: No one needs to suffer the embarrassment of urinary incontinence.  Help is available for all those women who have bladder control problems

Urinary Tract Infections in Women-Taking the Burn Out of Urine

Urinary tract infections (UTI) are a serious health problem affecting 8.3 million Americans each year. 53% of all women have had at least one urinary tract infection during their lifetimes. Many women suffer from frequent UTIs. Nearly 20 percent of women who have one UTI will have another infection. This article will cover the causes, symptoms, and treatment of UTIs in women.

What are the causes of UTI?

Most infections arise from bacteria, Escherichia coli (E. coli), which normally lives in the colon. These bacteria gain access to the urinary tract through the urethra or the tube that carries urine from the bladder to the outside of the body.

An infection limited to the urethra is called urethritis. If bacteria move to

the bladder and multiply, a bladder infection, called cystitis, results. If the infection is not treated promptly, bacteria may then travel to the kidneys. A kidney infection is called pyelonephritis.

Microorganisms called Chlamydia and Mycoplasma may also cause UTIs in women, but these infections tend to remain limited to the urethra and reproductive system. Unlike E. coli, Chlamydia and Mycoplasma may be sexually transmitted, and infections require treatment of both partners.

Who is at risk?

In women the rate of UTIs gradually increases with age. Scientists are not sure why women have more urinary infections than men. One factor may be that a woman’s urethra is short, allowing bacteria quick access to the bladder. Also, a woman’s urethral opening is near sources of bacteria in the anus and the vagina. For many women, sexual intercourse seems to trigger an infection, although the reasons for this linkage are unclear.

Some women are more prone to getting a UTI than others. Women with diabetes have a higher risk of a UTI because of changes in the immune system. Any other disorder that suppresses the immune system raises the risk of a urinary infection.

According to several studies, women who use a diaphragm are more likely to develop a UTI than women who use other forms of birth control. Recently, researchers found that women whose partners use a condom with spermicidal foam also tend to have growth of E. coli bacteria in the vagina.

What are the symptoms of UTI?

The most common symptoms include a frequent urge to urinate and a painful, burning feeling in the area of the bladder or urethra during urination. It is not unusual to feel bad all over-tired, shaky, washed out-and to feel pain even when not urinating. Often women feel an uncomfortable pressure above the pubic bone. The urine itself may look milky or cloudy, even reddish if blood is present. Normally, a UTI does not cause fever if it is in the bladder or urethra. A fever may mean that the infection has reached the kidneys. Other symptoms of a kidney infection include pain in the back or side below the ribs, nausea, or vomiting.

How is UTI diagnosed?

To find out whether you have a UTI, your doctor will test a sample of urine for pus and bacteria. In the urinalysis test, the urine is examined for white and red blood cells and bacteria. Then the bacteria are grown in a culture and tested against different antibiotics to see which drug best destroys the bacteria.

How is UTI treated?

UTIs are treated with antibiotic medications. The choice of drug and length of treatment depend on the patient’s history and the urine tests that identify the offending bacteria. The sensitivity test is especially useful in helping the doctor select the most effective drug. The drugs most often used to treat routine, uncomplicated UTIs are trimethoprim (Trimpex), trimethoprimlsulfamethoxazole (Bactrim, Septra, Cotrim), amoxicillin (Amoxil, Trimox, Wymox), nitrofurantoin (Macrodantin, Furadantin), and ampicillin (Omnipen, Polycillin, Principen, Totacillin). A class of drugs called quinolones includes four drugs approved in recent years for treating UTI. These drugs include ofloxacin (Floxin), norfloxacin (Noroxin), ciprofloxacin (Cipro), and trovafloxin (Trovan).

Often, a UTI can be cured with I or 2 days of treatment if the infection is not complicated by an obstruction or other disorder. Many doctors ask their patients to take antibiotics for a week or two to ensure that the infection has been cured. Most doctors suggest that drinking plenty of water helps cleanse the urinary tract of bacteria. During treatment, it is best to avoid coffee, alcohol, and spicy foods.

Recurrent Infections in Women

Women who have had three UTIs are likely to continue having them. Four out of five such women get another within 18 months of the last UTI. Many women have them even more often. A woman who has frequent recurrences (three or more a year) can take low doses of an antibiotic such as TMP/SMZ or nitrofurantoin daily for 6 months or longer. If taken at bedtime, the drug remains in the bladder longer and may be more effective.

Additional steps that a woman can take on her own to avoid an infection:

I. Drink plenty of water every day.

1. Urinate when you feel the need; don’t resist the urge to urinate.
2. Wipe from front to back to prevent bacteria around the anus from entering the vagina or urethra.
3. Take showers instead of tub baths and avoid bubble baths.
4. Cleanse the genital area before sexual intercourse.
5. Avoid using feminine hygiene sprays and scented douches, which may irritate the urethra.
6. Use cotton underwear as synthetics will trap bacteria.

Bottom line: UTIs are one of the most common infections occurring in women. The diagnosis is easily made and most women can be cured with a single course of antibiotics. Others need low-dose daily medication to control their infections.