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Frequent Urination

Q: My husband always teases me for having "tiny bladder syndrome," and I'll admit I go to the bathroom more than most people. But it hasn't been a real problem until recently. Now I can't even sit through an entire movie without making at least one trip to the ladies' room! Whenever I go out, I'm constantly keeping an eye out for the nearest toilet just in case. What's wrong with me?

Dr. Donnica:
It sounds like you have a classic case of overactive bladder or OAB, but you should consult your physician to make a proper diagnosis. OAB is an embarrassing, disruptive, chronic medical condition that affects 17 million people in the US, including nearly one out of every five adults over the age of 45. It is marked by symptoms of urinary frequency or urinating more than eight times in a 24-hour period, including two or more times a night. Other symptoms include urinary urgency (a strong and sudden need to urinate) and urge incontinence (the accidental loss of urine caused by a sudden and unstoppable urge to urinate).

Many people with overactive bladder mistakenly believe that the condition is an unavoidable part of aging that they must learn to live with. As a result, many patients suffer in silence without seeking help. Eliminating alcohol, cigarettes and foods that are bladder irritants (like coffee, tea, spicy foods, chocolate, tomato-based products, artificial sweeteners, and caffeine) may help a bit, but most OAB sufferers find that this condition is best treated with prescription medicine. Bladder retraining techniques may also help. A trained healthcare professional can help teach you to resist or inhibit the feeling of urgency, postpone voiding, and urinate according to a timetable (rather than in response to a feeling of urgency).

A new therapy, known as Interstim, is also available for patients who have not responded to conventional treatments. Interstim involves implanting an electrical stimulator into the body, which sends impulses to the sacral nerve that controls the bladder. A recent study found that sacral nerve stimulation stopped leaks completely in 52% of the patients, and significantly reduced symptoms in 76%. This modality is typically reserved for patients in whom the standard treatments of behavioral therapy and medications have not helped.

Created: 6/29/2005  -  Donnica Moore, M.D.

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