Some General Lifestyle Measures Which May Help
- Your GP may refer you to the local continence adviser. Continence advisors can give advice on treatments, especially pelvic floor exercises. If incontinence remains a problem, they can also give lots of advice on how to cope. Examples include the supply of various appliances and aids such as incontinence pads, etc.
- Getting to the toilet. Make this as easy as possible. If you have difficulty getting about, consider special adaptations like a handrail or a raised seat in your toilet. Sometimes a commode in the bedroom makes life much easier.
- Obesity. Stress incontinence is more common in women who are obese. Weight loss is advised in those who are overweight or obese. It has been shown that losing a modest amount of weight can improve urinary incontinence in overweight and obese women. Even just 5-10% weight loss can help symptoms.
- Smoking can cause cough which can aggravate symptoms of incontinence. It would help not to smoke.
Recommended Treatments For Stress Urinary Incontinence
The progression of science and medicine has resulted in the development of innovative treatment techniques for Stress Urinary Incontinence. These non-invasive treatments are relatively quick, easy, painless and comparatively inexpensive. These new solutions for SUI are fast-acting, long-lasting, and with minimal downtime are the most recommended by many medical professionals. Check with your provider or find a Certified Member of The National Menopause Association for a consultation.
Treatment Options For Urgency Incontinence:
- Pelvic floor physical therapy This therapy helps to retrain the bladder.
- Medications A range of medications can help you hold your bladder for longer and decrease your urinary frequency symptoms.
- Botox injections in the bladder Botox relaxes the wall of your bladder in order to prevent it from contracting when it’s not supposed to.
- Peripheral nerve stimulation This treatment uses a needle to stimulate a nerve in your foot that travels up the leg to the spine, where it connects with the bladder and calms it down.
- Sacral neural modulation In this outpatient surgical procedure, a bladder pacemaker is implanted to help control how the bladder is stimulated by the sacral nerve.
“Regardless of which type of incontinence you’re experiencing, it’s important to get evaluated simply because there are so many options for treating urinary incontinence,” says Dr. Lindo. “We always start with conservative treatment approaches, but if those don’t work, you don’t have to continue to suffer. We can help to improve your quality of life.”
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How To Do Them
Stand, sit or lie down with your knees slightly apart. Relax.
Find your pelvic muscle. Imagine that you are trying to hold back urine or a bowel movement. Squeeze the muscles you would use to do that. DO NOT tighten your stomach or buttocks.
Women: to make sure youve got the right muscle, insert your finger into your vagina while you do the exercise. You should feel a tightening around your finger.
Men: when you tighten the pelvic floor muscle, your penis will twitch and contract in towards your body.
- Tighten the muscles for 5 to 10 seconds. Make sure you keep breathing normally
- Now relax the muscles for about 10 seconds
- Repeat 1220 times, three to five times a day
Stick to it! You should begin to see results after a few weeks. Like any other muscle in your body, your pelvic muscles will only stay strong as long as you exercise them regularly.
If youre having a hard time doing Kegel exercises, your healthcare professional can teach you how to do them correctly. He/she may even suggest a tool or device to help make sure youre using the right muscles .
Your doctor may also suggest biofeedback, a training technique thats used to monitor the contraction of the pelvic floor muscles as you do your Kegel exercises. Biofeedback uses a machine that records the contractions of your muscles and translates the movement into a visual signal that you can watch on a monitor. Some people find this helpful in learning how to do Kegel exercises correctly.
Is Incontinence More Common In Women
Incontinence is much more commonly seen in women than in men. A large part of this is because of pregnancy, childbirth and menopause. Each of these events in a womans life can lead to bladder control issues. Pregnancy can be a short-term cause of incontinence and the bladder control issues typically get better after the baby is born. Some women experience incontinence after delivery because of the strain childbirth takes on the pelvic floor muscles. When these muscles are weakened, youre more likely to experience leakage issues. Menopause causes your body to go through a lot of change. Your hormones change during menopause and this can alter your bladder control.
Men can also experience incontinence, but it isnt as common as it is in women.
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Who Can And Cannot Take Tolterodine
Tolterodine can be taken by most adults. It can also be taken by children aged 2 years and over, on the advice of their specialist.
Tolterodine is not suitable for some people. To make sure it’s safe for you, tell your doctor or pharmacist before starting tolterodine if you:
- have ever had an allergic reaction to tolterodine or any other medicine
- have kidney or liver problems
- have myasthenia gravis, a condition that causes muscle weakness
- have digestive problems such as heartburn and acid reflux
- are pregnant, trying to get pregnant or breastfeeding
Drugs Stopping Sudden Bladder Muscle Contractions
Six approved antimuscarinic drugs work because they block nerve signals regulating bladder muscle contractions the drugs help to relax the bladder muscle and to decrease urges to void. Several studies have shown that these drugs resolve urinary incontinence in one woman among every eight or nine treated . These drugs include:
- Darifenacin ,
However, these drugs, especially oxybutynin, may cause adverse effects which may include:
For oxybutynin, one out of every 16 women stopped using it because of intolerable side effects.
When researchers compared the benefits and harms across these six different antimuscarinic drugs, they found that although these drugs demonstrate similar benefits, the potential for adverse effects was not the same . Women should discuss with their doctor what adverse effects are the most troubling for them. They can then choose the medication with the least risk for those specific side effects.
Unfortunately, none of the clinical studies evaluated the long-term safety of these antimuscarinic drugs. All drugs were tested in older women . However, we do not know long-term safety of these drugs in real-life geriatric settings. Future research should look at long-term safety in older women who are also taking several medications because of other chronic diseases.
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Dosage And Strength Of Standard Tablets
Standard tablets come as either 2.5mg, 3mg or 5mg.
The usual starting dose of 2.5mg is 1 tablet, taken twice a day, in the morning or evening, or 1 tablet, taken 3 times a day.
If you take 3 doses a day, space each dose evenly throughout the day. You could take it first thing in the morning, in the middle of the afternoon and at bedtime.
Causes Of Overflow Incontinence
Overflow incontinence, also called chronic urinary retention, is often caused by a blockage or obstruction to your bladder. Your bladder may fill up as usual, but as it is obstructed you will not be able to empty it completely, even when you try.
At the same time, pressure from the urine that is still in your bladder builds up behind the obstruction, causing frequent leaks.
Your bladder can become obstructed as a result of:
Overflow incontinence may also be caused by your detrusor muscle not fully contracting, which means that your bladder does not completely empty when you go to the toilet. As a result, the bladder becomes stretched. Your detrusor muscles may not fully contract if:
- there is damage to your nerves, for example as a result of surgery to part of your bowel or a spinal cord injury
- you are taking certain medications
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Extracorporeal Magnetic Resonance Therapy
Extracorporeal magnetic resonance therapy has been introduced as a therapy for stress incontinence. The NeoControl unit was approved by the Food and Drug Administration for this purpose in 2000. Resonating magnetic flux within a magnetic field induces electrical depolarization of targeted nerves and muscles. No probes are required. The patient simply sits on a chair containing the magnetic device.
A small study achieved an improvement rate of 77% after 8 weeks of therapy, with 56% of patients being completely dry. However, a 3-year follow-up study found that the benefits tend to be temporary: at 6 months, the recurrence rate was 53%.
Will I Have Incontinence For My Entire Life
Sometimes incontinence is a short-term issue that will go away once the cause ends. This is often the case when you have a condition like a urinary tract infection . Once treated, frequent urination and leakage problems caused by a UTI typically end. This is also true for some women who experience bladder control issues during pregnancy. For many, the issues end in the weeks after delivery. However, other causes of incontinence are long-term and related to conditions that are managed throughout your life. If you have a chronic condition like diabetes or multiple sclerosis, you may have incontinence for a long period of time. In those cases, its important to talk to your provider about the best ways to manage your incontinence so that it doesnt interfere with your life.
A note from Cleveland Clinic
It can be embarrassing to talk about bathroom habits with your healthcare provider. This embarrassment shouldnt stop you from treating incontinence, though. Often, your healthcare provider can help figure out the cause of your bladder control issue and help make it better. You dont need to deal with it alone. Talk to your healthcare provider about the best ways to treat incontinence so that you can lead a full and active life without worrying about leakage.
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Say Goodbye To Leaks Say Hello To Relief
Leaks can get in the way of your daily routine and keep you from having fun. But, incontinence medication can help you manage your symptoms. Talk to your doctor about any new medication plan before you start popping pills. Bladder leaks doesnt have to keep you locked in the bathroom all day. Youve got places to go and things to do!
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Are You At Risk For Stress Urinary Incontinence
SATURDAY, Nov. 20, 2021 — If you pee a little when you laugh, dance, exercise or sneeze, you may have stress urinary incontinence.
While this can be annoying, it can be treated — and even some small lifestyle changes can make a big difference, according to the Urology Care Foundation, the official foundation of the American Urological Association.
It might help to lose weight or to stop smoking, which will lessen your coughing. You can do exercises, known as Kegels, which strengthen the pelvic floor and help support your bladder, the foundation says.
Absorbent products may help to contain the leaks, at least over the short term or long term, depending on what you choose.
Your health care provider can also help fit you with a medical device that can be obtained by prescription or purchased over the counter.
There are two main types of urinary incontinence, according to the foundation. The first is SUI , in which you release a small to moderate amount of urine when you cough, sneeze or laugh.
In Urge Urinary Incontinence or Overactive Bladder, you may have a sudden, uncontrollable need to pass urine. Leaks with this can be moderate to large.
Common risk factors for SUI are gender, with women more likely to have the condition pregnancy and giving birth smoking and chronic coughing being overweight pelvic or prostate surgery, and nerve injuries to the spine or neurologic disease.
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Symptoms Of Urinary Incontinence
Having urinary incontinence means you pass urine unintentionally.
When and how this happens varies depending on the type of urinary incontinence you have.
Although you may feel embarrassed about seeking help, it’s a good idea to see your GP if you have any type of urinary incontinence.
Urinary incontinence is a common problem and seeing your GP can be the first step towards finding a way to effectively manage the problem.
Dosage And Strength Of Liquid
Oxybutynin is available as a liquid for children and people who find it difficult to swallow tablets. It comes in 2 strengths:
- 2.5mg of oxybutynin in a 5ml spoonful
- 5mg in oxybutynin in a 5ml spoonful
The usual starting dose for an adult is 5mg, taken twice a day , or 5mg, taken 3 times a day.
The dose will usually be lower for adults over 65 and children.
If you take 3 doses a day, space each dose evenly throughout the day. You could take it first thing in the morning, in the middle of the afternoon and at bedtime.
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Common Questions About Tolterodine
Tolterodine is a type of medicine called an antimuscarinic muscle relaxant.
It works by relaxing the muscle that is found in the wall of the bladder. This helps to increase the volume of pee your bladder can hold and control the release of pee.
Tolterodine begins to work within 3 to 8 hours but it may take up to 4 weeks before it takes full effect. If the symptoms do not improve after 1 to 2 weeks, talk to your doctor.
Talk to your doctor if your symptoms get worse at any time.
Usually, you’ll need to take tolterodine for a long time.
After 4 weeks your doctor will check that tolterodine is helping your symptoms. They’ll also do a review every 6 to 12 months after that to check it’s still working for you.
Take tolterodine until your doctor tells you to stop. Do not stop taking it just because you feel better.
Do not take tolterodine for longer than you need to. Your doctor will check every 6 to 12 months that your treatment is still needed.
There may be an increased risk of confusion and possibly dementia in people taking tolterodine, but more study needs to be done. If you’re worried about this, talk to your doctor.
If you want to stop taking tolterodine, talk to your doctor first.
If you’ve been taking it for at least 6 months, your doctor may suggest at your review that you can stop taking it for up to 4 weeks to see how your symptoms change without it.
What Causes Incontinence
There are many different reasons that you could experience incontinence. These causes can vary depending on if youre a woman or man. Some causes are temporary health conditions that usually go away once treated. In those cases, your incontinence also usually stops once the condition is treated. Incontinence can be caused by long-term medical conditions. When you experience leakage issues because of a chronic condition, its usually something you will have to manage over a longer period of time. Even with treatment, chronic conditions usually dont go away. Incontinence may have to be managed over time as a symptom of your chronic condition.
Temporary or short-term causes of incontinence can include:
- Urinary tract infections : An infection inside your urinary tract can cause pain and increase your need to pee more often. Once treated, the urge to urinate frequently usually goes away.
- Pregnancy: During pregnancy, your uterus places extra pressure on the bladder as it expands. Most women who experience incontinence during pregnancy notice that it goes away in the weeks after delivery.
- Medications: Incontinence can be a side effect of certain medications, including diuretics and antidepressants.
- Beverages: There are certain drinks like coffee and alcohol that can make you need to urinate much more often. If you stop drinking these beverages, your need to urinate frequently typically goes down.
- Constipation: Chronic constipation can cause you to have bladder control issues.
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What If I Take Too Much
Taking 1 extra dose of oxybutynin is unlikely to harm you.
However, you may get more side effects, such as a dry mouth or headache.
The amount of oxybutynin that can lead to an overdose varies from person to person, and too much oxybutynin can be dangerous.
Urgent advice: Contact 111 for advice now if:
You take 2 or more extra doses of oxybutynin and you:
- have hallucinations
- feel very restless or excited
- have dilated pupils in your eyes
- are not able to pee
What Is The Evidence For Effective Treatments For Urinary Incontinence
Women have several options to manage their urinary incontinence and these primarily include either drug or non-drug treatments. Many studies have shown that the majority of women improve their symptoms using non-drug conservative interventions and these include:
Intra-vaginal electrical or magnetic stimulation may help some women with incontinence . However, some women do not benefit from these non-drug treatments, or they are unable to access these treatments, or make the necessary lifestyle changes. In this case, doctors may suggest the use of drugs to help with incontinence problems. We review the current scientific evidence about the effectiveness of these drugs to help manage incontinence.
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