Manage your Fluid Intake: There is no scientific evidence that states we need eight 8 oz. glasses (64 oz.) of fluid every day. Remember, what goes in must come out. Many women, unless you exercise heavily or work in hot conditions, can drink less than 64 oz. per day. In 2004, the Institutes of Medicine reported that most people meet their daily hydration needs by letting their thirst be their guide. You must also remember that we get additional fluids from our diets in the form of soups, stews, fruits, etc. It has been shown that we get as much as 20% of our daily fluids from our diet. If you are used to drinking large amounts of fluids every day and you are bothered by how frequently you need to go to the bathroom, these suggestions may help you:
Avoid Fluids that can be Bladder Irritants: Some chemicals in our beverages can behave as diuretics and bladder irritants. If you are sensitive to these chemicals, they may cause you to make large amounts of urine or may aggravate bladder spasms resulting in a more frequent need to urinate. Although there are no scientific studies to prove this, the best thing to do is to stop the suspected irritant for a week or two and see if it makes a difference.
Some common bladder irritants include:
Caffeine – Try to stop or at least reduce your caffeinated beverages like coffee, tea, and cola to see if your bladder control improves. If you drink a lot of caffeine, you should taper down slowly to avoid a caffeine withdrawal headache. Many teas have tannins which also affect the bladder
Artificial Sweeteners – Beverages that contain artificial sweeteners like aspartame or saccharin can also be a bladder irritant. Diet Pepsi, Mountain Dew or Coke then would be especially problematic because of the artificial sweetener and the caffeine.
Citrus juices – Some people find that juices like orange or grapefruit juice can also irritate their bladder.
Weight Loss: Being overweight puts extra pressure on your bladder. Weight loss will relieve some of that pressure and will help you regain your bladder control.
Void on a Schedule: Sometimes, the message that the bladder is full comes without warning and often too late. In these cases, women find that they lose urine on the way to the bathroom. There isn’t enough time between the message and their ability to get to the bathroom before they start to leak. Voiding on a schedule, also referred to as “Timed Voids” may help prevent these leaking episodes. It is exactly what it sounds like. You urinate on a schedule, sometimes even when you don’t feel like you have to so that you are not caught off guard.
Completing a bladder diary helps to determine when you usually leak and what is a reasonable period of time between trips to the bathroom. Slowly, you can stretch the time between trip to the bathroom until you are voiding every 3 or 4 hours. Often times women find that keeping a bladder diary helps them be more consistent with their schedule.
Strengthen your Pelvic Floor Muscles with Kegel Exercise: Most bladder control problems are caused by weak pelvic muscles. These pelvic floor muscles attach to the bones of the pelvis in a way that creates a support for the pelvic organs. These muscles help prevent urine leakage. Pregnancy, childbirth, and increasing age all weaken the muscles of the pelvic floor. Exercising the pelvic floor muscles can strengthen the pelvic muscles and improve bladder control. Identifying the correct muscles to exercise is important. These are the same muscles you would use to hold back gas or to stop the flow of urine midstream. Your doctor or a physical therapist can help make sure that you are contracting the right muscles. Once you have correctly identified the muscles, you contract and hold the squeeze for a few seconds and then completely relax the muscles before the next squeeze. Expect that it will take about 6 to 8 weeks of exercising before you notice that you have fewer leaks and more bladder control.
Urge Suppression Strategies – “Freeze and Squeeze”: If you have trouble reaching the bathroom before you start losing urine, we recommend trying this technique.
When you get the urge to urinate:
Bladder Training: Once you have mastered the Urge Suppression technique, you can now train your bladder to increase the time between the initial urge and the time you actually void. Simply follow the Urge Suppression technique, but instead of walking calmly to the bathroom at your normal pace, you will wait a few minutes before voiding. At first you may only be able to postpone voiding by 1 minute, but keep trying to increase the interval between the initial urge and the time you actually void until you are only voiding every 3 to 4 hours. Like any new technique, this takes practice and time to master, so we recommend trying this at home initially until you become more successful.
Urinary Incontinence Medicines: Medicines for bladder control generally work by blocking signals that may cause muscle spasms in the bladder muscles.
Talk with your doctor about how your OAB medicine is working. If your symptoms are not improving, ask about the possibility of shifting to a different drug.
Anticholinergics suppress overactive muscle activity, which may be causing the bladder to contract during the filling stage and also suppress involuntary bladder contractions and help decrease urinary frequency as well as the “gotta go” sensation.
Side Effects: Rarely, women break out in hives. They may also experience swelling of the skin, eyes, lips, and mucous membranes. Typically, this side effect does not last long. If you experience side effects, contact your doctor and seek care.
Bladder medications can cause eye dryness and sensitivity and dry mouth.
** Myrbetriq works through a different pathway and may cause an elevation in your blood pressure. If you take any of these medicines, you may need to take a few steps to deal with side effects.
|Brand Name||Generic Name|
Tolterodine extended release form
Oxybutynin extended-release form
Oxybutynin patch delivery system
|Gelnique®||Oxybutynin chloride 10% gel|
|Anturol®||Oxybutynin chloride 3% gel|
Trospium chloride extended-release form
If conservative strategies are not enough to manage your bladder symptoms, talk to Dr. Tarnay or Dr. Grisales about other options.