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- $Unique_ID{BRK01997}
- $Pretitle{}
- $Title{Treatments for Uncontrollable Bladders}
- $Subject{treat treating treatment Treatments Uncontrollable control
- controllable bladder Bladders old older incontinence age aging urine urinate
- urinating urination Urge stress physical laugh laughing cough coughing lift
- lifting pregnancy pregnant examine examination examinations behavior
- behavioral therapy therapies drug drugs medicine medicines medication
- medications electric electrical stimulate stimulation stimulations surgery
- surgeries operation operate operations muscle muscles Kegel exercise exercises
- retrain retraining spasm spasms nerve nerves test tests testing}
- $Volume{}
- $Log{}
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- Copyright (c) 1993 Tribune Media Services, Inc.
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- Treatments for Uncontrollable Bladders
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- QUESTION; I find that I have a very distressing and embarrassing problem which
- I can not bring myself to discuss with my doctor. There are times when I just
- lose my water, and I can't do anything about it. I head for the bathroom, but
- never quite make it. Does this mean back to diapers for me, or have they come
- up with any treatments to help older folks like me? Please consider writing
- something about this problem in your column.
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- ANSWER: While incontinence is more frequent in older people, it is found in
- all age groups. At least one estimate puts the number of Americans who suffer
- from incontinence above 10 million adults, so you do have a bit of company.
- Incontinence refers to the situation where there is a loss of ability to
- control urination and it may be divided into two classifications. "Urge
- incontinence" mean that the person cannot hold urine long enough to make it to
- the bathroom, and sounds like it might be your problem. About 25 percent of
- people with the problem have this type. In another 25 percent, it is
- associated with "stress" incontinence, where urine leaks out during physical
- events, such as laughing, coughing or lifting heavy things. Stress
- incontinence often occurs during the last months of pregnancy as well, when
- the enlarged uterus pushes down upon the bladder. In many cases the exact
- cause of the incontinence can not be found even after diligent examination.
- However, if you are to get the treatment you need, and there are several
- that can help, you will have to confide your problem to your doctor, for only
- after proper examination can a successful treatment strategy be developed.
- There are essentially four ways to treat incontinence; behavioral therapy,
- drug therapy, electric stimulation and surgery. Behavioral therapy takes time
- and patience to learn, and helps you become more aware of the muscles used in
- controlling urination. Exercises (called Kegel exercises) are used to
- strengthen the voluntary muscles that affect urination. You might also be
- placed on a strict schedule for urination, in the beginning as often as every
- hour, to retrain the muscles of your bladder. Gradually this time can be
- increased as you are able to go for these increasing periods of time without
- losing your water. After 6 weeks of such training, almost 85 percent of the
- patients achieve good results with 10 to 15 percent gaining complete control.
- Drugs can be used to help increase the bladder's capacity and to reduce
- involuntary muscle spasms that can cause you embarrassment. Spasms cause your
- muscles to contract at the worst moment, pushing urine out of the bladder when
- you are not prepared. In some cases, using electrical stimulation of the
- bladder muscles can help you regain control. When all these methods do not
- produce the results you may desire, surgery can be used to either increase
- bladder capacity or to disrupt the nerve impulses that lead to spasms by
- blocking certain nerves.
- It is hard to know which one or which combination of several of these
- methods would work best in your case. That can only be worked out after you
- have had the benefit of some testing, by your own physician. And you must be
- willing to try out new therapies if the first attempts are less than
- satisfactory. It is the rare family physician indeed that hasn't seen and
- dealt with this problem, so you need not feel embarrassed. I know that
- revealing this problem may not be the easiest thing you have ever done, but it
- is certainly the best path towards solving your dilemma.
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- The material contained here is "FOR INFORMATION ONLY" and should not replace
- the counsel and advice of your personal physician. Promptly consulting your
- doctor is the best path to a quick and successful resolution of any medical
- problem.
-