Pelvic Floor Prolapse ExercisesDo you know the location of the ladies room in every department store? Need to urinate more than 8 times a day? Feel a sudden urge to urinate that is difficult to control sometimes leaking urine? Afraid to walk, run outdoors because you may need a bathroom? Reluctantly used a gross porto potty because you were desperate? Disrupt healthy sleep because you get up at least 2 times a night to urinate?


These are examples of urinary frequency, urgency incontinence and nocturia, symptoms of overactive bladder (OAB). And, you’re not alone. OAB affects 33 million Americans, with over 30% of all men and 40% of all women living with OAB symptoms. Many people don’t seek help because they think nothing can be done.

What Causes OAB?

A common cause of OAB is weakness of the pelvic floor muscle, often occurring after pregnancy and child birth. OAB symptoms can also occur when the muscles of the bladder contract involuntarily, or the nerve signals between your bladder and brain tell your bladder to empty even when it isn’t full. Other causes are: neurological diseases, such as stroke, multiple sclerosis (MS), herniated discs and Parkinson’s. In addition, obesity, age, alcohol, diuretics, caffeine, artificial sweeteners and spicy foods can also play a role in OAB.

Diagram courtesty HealthCommunities.com

Diagram courtesy of HealthCommunities.com

A medical professional can provide you with a full evaluation for OAB. This requires a complete medical history, physical exam, focusing on the abdomen and genitals. A urine sample is taken to test for infection, traces of blood or other abnormalities. A neurological exam may identify sensory problems or abnormal reflexes. An evaluation may include a referral to a urologist who can perform additional to rule out problems whose symptoms can mimic OAB, such as: urinary tract infection, interstitial cystitis, abnormalities in bladder such as stones, polyps and cancer, in men enlarged prostate that blocks the flow of urine, and bladder symptoms of neurological problems, pelvic tumors and others.

What does Dorothy from the Wizard of Oz have to do OAB?

Women with with pelvic floor weakness cannot easily click their heels together like Dorothy of the Wizard of Oz, go ahead, try it. By clicking her heels while dreaming of Kansas she is actually doing a great pelvic floor exercise. Although the red sparkle shoes aren’t necessary for the exercise, physical therapy can be. Physical therapy to strengthen the pelvic floor muscles can be life changing. Carolyn Daniels, Physical Therapist at Middlesex Hospital specializes in physical therapy to strengthen pelvic floor muscles.

There are some things you can try to see if your symptoms improve. Change your diet and reduce caffeine and spicy foods. Stop artificial sweeteners like aspartame, and eliminate alcohol. Work out your bladder-brain pathways by trying to wait longer to use the bathroom, because you can.

What Treatments are Available?

Medications: here are several drugs available to relax the bladder muscle and stop it from contracting at the wrong times. Oxybutynin (Ditropan) Tolterodine (Detrol, Detrol LA), Solifenacin (VesIcare) Fesoterodine Fumarate (Toviaz), Darifenacin (Enablex) and Imipramine. Your medical provider can discuss the risk and benefits of these medications.

Neuromodulation Therapy: InterStim Therapy works with the sacral nerves, which control the bladder and muscles related to bladder control. InterStim Therapy is a proven treatment option that targets the communication problem between the brain and the nerves that control the bladder. These treatments deliver harmless electrical impulses to nerves that can change how the nerves work. Specialists use this type of therapy only for some patients when medications or behavioral therapies don’t work, or when patients have serious side effects from medications.

Botox Injections: Injections of botulinum toxin, better known as Botox®, can help patients who don’t respond to other treatments. The injections into the bladder muscle may help keep it from contracting too often.

Surgical: For women with significant OAB disruption of their lives there are some surgical options. Bladder slings are suspensions using your body’s tissue, or synthetic material such as mesh, to create a hammock around your bladder neck and the tube (urethra) that carries urine from the bladder. The sling provides support to keep the urethra closed — especially when you cough or sneeze. Surgical procedures are performed by different specialists – urologist, gynecologist and urogynecolgist.

If you suffer with OAB, please talk to your medical provider.
There is help that can improve your symptoms and the quality of your life!



References:
http://www.mayoclinic.com/health/urinary-incontinence-surgery/WO00126
http://www.medicinenet.com/overactive_bladder/article.htm
https://www.pelvicexercises.com.au/
http://www.ncbi.nlm.nih.gov/pubmed/12682771

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