Posts Tagged ‘Bladder spasms’

Some Practical Advice On the Management of Urinary Incontinence

March 30, 2010

If you suffer from incontinence, whatever else you do, these practical tips can make your symptoms less severe:

  • KEEP THE BLADDER AS CLOSE TO EMPTY AS POSSIBLE. Go to the restroom even when the urge is not overwhelming, and stay as long as it takes to empty the bladder.
  • TIME YOURSELF. If you lose control at regular intervals (say every four hours), empty your bladder before it happens. Wear a wrist alarm to remind you.
  • WEAR CLOTHES AND TROUSERS THAT ARE EASY TO OPEN, or remove quickly, so that you won’t lose time fumbling when you need to void.
  • CONSUME LESS alcohol, fruit juices, carbonated beverages, spicy foods, dairy products, sugar, and artificial sweeteners. These all can irritate the bladder and worsen your symptoms.
  • DON’T WEAR girdles, corsets, pants or high heels all can weaken the pelvic muscles that control urination.
  • TRY CROSSING YOUR LEGS before you sneeze or cough. Chances are you will leak less.
  • AVOID CAFFEINE in any form.  It is a diuretic for most people
  • DON’T SMOKE. Women who do are twice as lucky to become incontinent.

You Don’t Have to Depend on Depends-Menopause and Bladder Control-

March 10, 2010

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.

Dr. Neil Baum is a physician at Touro Infirmary and can be reached at (504) 891-8454 or through his website, http://www.neilbaum.com

Bladder Spasms – When You Really Gotta Go!

March 7, 2010

Have you ever had that strong desire to urinate or a cramping sensation in your lower abdomen that comes without warning and if you didn’t get to the restroom in a nanosecond, you would urinate on yourself?  Most of us have one of these bladder spasms at one time or another but some people have them all the time and their quality of life is certainly diminished.  This article will discuss the causes and the treatment of bladders spasms.

Causes of bladder spasms

Bladder spasms can occur because of something in your diet, such as alcohol, acidic or citrusy foods, that irritate the bladder.  There are also medications such as diuretics that can make you go to the bathroom frequently.  A urinary tract infection, or an irritation of the nerves that supply the bladder are frequently associated with bladder spasms.  The latter situation is referred to as neurogenic bladder.  Another condition that causes bladder spasms is interstitial cystitis, which is associated with urinary frequency, burning on urination, pelvic pain and bladders spasms.  Bladder spasms are commonly associated with the use of a urinary catheter, which is inserted into the bladder to drain the urine from the bladder to a bag on the outside of the body.  When the catheter is removed, the bladder spasms will quickly subside.  However, there are many times when the cause of bladder spasms cannot be identified.

Who is at risk for bladder spasms?

Anyone at any age can have bladder spasms. You are more likely to have bladder spasms with urine leakage if you:

  • Are elderly
  • Are going through menopause
  • Recently delivered a baby or are pregnant
  • Have a urinary tract infection
  • Have recently had lower abdominal or pelvic surgery
  • Have nerve or bladder muscle damage caused by disease or injury

Treatment of bladder spasms

Your doctor will attempt to identify the cause of your bladder spasms and select an appropriate treatment.  Often a combination of treatments will work best.

Change in diet. This may help prevent bladder pain if certain foods and beverages are the culprit behind your spasms. Avoid spicy, acidic, or citrusy foods, as well as excessive caffeine and alcohol.  Your doctor can provide you with a food list of the most common culprits.

Timed voiding. This involves timed trips to the bathroom to urinate, usually every 1.5 to 2 hours. As the bladder spasms get better and fewer wetting accidents occur, you can extend the time between trips to the bathroom.

Pelvic floor exercises (“Kegels”). Kegels and other forms of physical therapy help strengthen and relax the bladder and other muscles that help the body hold in urine. To tighten your pelvic muscles, squeeze your muscles in the same way as if you were trying to stop the flow of urine or prevent yourself from passing gas. Your doctor can provide you with instructions for performing Kegel exercises.

Medicines to relax the bladder. The most commonly prescribed drugs to prevent spasms are called anticholinergics. They include Detrol, Ditropan, Vesicare, Enablex, Gelnique, and Toviaz.  A common side effect of all of these medications is dry mouth.

Electrical stimulation implant (Inter-Stim). This is placed under the skin to deliver gentle electrical pulses to the bladder at regularly timed intervals. This treatment is only recommended for the most severe bladder spasms that do not get better with other treatments.

Biofeedback. Biofeedback is a method that teaches the mind how to control normally automated body functions. Bladder training is a type of biofeedback. Some doctors believe biofeedback and behavioral changes work better than medicines for treating urge incontinence. A combination of biofeedback and medications may work best.

Bottom Line:  Bladder spasms occasionally occur in nearly everyone.  However, if they are so frequency that they impact your quality of life, then it is time to see your doctor.  Help is available for nearly everyone who suffers from bladders spasms.

Dr. Neil Baum is a physician at Touro Infirmary and can be reached at (504) 891-8454 or via his website, http://www.neilbaum.com