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.