July 27, 2011

Women in their 30s and 40s may begin to notice the onset of symptoms associated
with overactive bladder — for example, leaking urine when you laugh, sneeze or
cough, or having to urinate with sudden urgency. Because the bladder is not
outwardly visible, it is important to know your body and be on the lookout for
changes in your patterns of urine elimination. Loss of bladder control is not
necessarily a normal part of the aging process, and effective treatments are
readily available.

Overactive bladder (OAB) is one of the
conditions I see most often in my female patients. Millions of Americans — both
women and men — are living with OAB, whether diagnosed or not, so know that you
are not alone and you should not be ashamed to discuss your concerns with your
family doctor. In fact, a study published recently in the Journal of
Urology reported that the prevalence of urinary incontinence
increased in men and women from 2001 through 2008.

Symptoms of OAB include frequent trips to
the bathroom to urinate, even at nighttime; a sudden need to empty your
bladder; and urge incontinence (leakage or loss or urine).

The condition may result from a variety
of causes, including urinary tract infections; side effects of diseases such as
multiple sclerosis or Parkinson’s disease, fibromyalgia, and irritable bowel
syndrome; and side effects of certain types of prescription medicines such as
diuretics, narcotic pain relievers, some antidepressants, and antihistamines.
In men, urinary incontinence may develop after surgery for prostate cancer,
which can weaken the muscles or nerves that control bladder function. People
with diabetes or those who are overweight or obese are more prone to urinary
incontinence.

Treatments for OAB range from
prescription medications that reduce the urge to urinate too frequently, to
behavioral therapies, such as pelvic-muscle exercises (Kegel exercises)
designed to strengthen the muscles that control urine flow. In some cases, I
may recommend that a patient limit fluid intake or avoid dietary triggers of
bladder irritation, such as caffeine, artificial and natural sweeteners,
alcohol, and citrus fruits and juices.

If any of these conservative treatments
are not effective in controlling symptoms of OAB, a referral to a specialist in
urologic gynecology (urogynecology) or a urologist may be recommended as a next
step.

You can read more about bladder health in
this online guide
published by the American Urological Association. The National Association for
Continence also has published helpful information on
incontinence for both women and men.

*Joshua Feinberg, D.O., is a family
medicine physician in practice at the Crozer Health Pavilion,
145 Brinton Lake Road, Suite 201, Glen Mills, PA 19342, 610-459-1619