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Washington Women’s Center Lecture Focuses on Treatments for Urinary Frequency

April 22, 2011

Are you hesitant to go places where you aren’t sure there are bathrooms nearby? Is it difficult for you to sit through long business meetings, movies or sporting events? Do you wake up two or more times at night needing to urinate?

"Overactive bladder syndrome is an uncomfortable and embarrassing problem that can dramatically affect your quality of life, causing you to limit your work or social activities," says Dr. Mark Saleh, a urologist on the medical staff at Washington Hospital. "Fortunately, symptoms of urinary urgency and the leakage of urine known as ‘urge incontinence’ that can occur as a result of overactive bladder aren’t necessarily a normal part of aging, and there are treatments that can help, including self-help remedies and lifestyle changes."

Dr. Saleh notes that overactive bladder syndrome affects over 30 million people in the U.S., the majority of whom are women. "Overactive bladder affects women more frequently than men because of the anatomy of the female urinary tract," he says. "Women also are more likely to experience urinary leakage. Pregnancy, childbirth and the hormonal changes associated with menopause can contribute to the problem."

To help women learn about the possible causes and treatments for urinary frequency, the Washington Women’s Center will be presenting "Sorry, Gotta Run!" a Lunch and Learn lecture featuring Dr. Saleh on Wednesday, May 11 from noon to 1 p.m. The free lecture will take place at the Washington Women’s Center Conference Room located at 2500 Mowry Avenue (Washington West), Suite 145. Register online at www.whhs.com

Symptoms and Causes

According to Dr. Saleh, some of the symptoms of overactive bladder syndrome include:

· Urinary urgency – the sudden, strong need to urinate immediately.

· Urinary frequency – having to urinate more than eight times a day or two or more times at night.

· Nocturia – waking at night to urinate.

· Urge incontinence – unexpectedly and involuntarily passing urine after suddenly feeling a strong urge to urinate.

"In most cases, overactive bladder syndrome is ‘idiopathic,’ meaning we don’t really know what causes it," he explains. "Identifiable causes can include urinary tract infections, bladder stones or cancer, endometriosis or chronic pelvic inflammatory disease.

 

"There are also ‘neurogenic’ causes of overactive bladder, such as spinal cord injuries, stroke, Parkinson’s disease, dementia and multiple sclerosis," he adds. "Trauma to the pelvic area due to an accident or major pelvic surgery such as a radical hysterectomy or colon cancer surgery may also result in overactive bladder."

Diagnostic Testing & Treatment Options

The first step in treating overactive bladder is to see your doctor.

"You may need only a simple urine test to check for signs of infection or blood in the urine," says Dr. Saleh. "Your doctor also should ask about any medications you are taking that could possibly contribute to the problem, such as diuretics prescribed for fluid retention, congestive heart failure or high blood pressure."

Testing also might include a cystoscopy, in which a scope is inserted to examine the structure of the bladder for inflammation, stones, tumors or something else that is irritating the bladder. In addition, the doctor may order urodynamics testing to test the function of the bladder and surrounding muscles.

"Urodynamics testing is a simple office procedure," Dr. Saleh explains. "We insert a catheter to fill the bladder with sterile water. Then we measure the bladder’s capacity, the volume and rate of voiding and other factors. This type of testing is often done when we suspect a neurogenic cause for overactive bladder."

If your symptoms are not severe, you may be able to find relief from overactive bladder by making a few simple lifestyle changes:

· Limit your intake of fluids, especially beverages that contain alcohol or caffeine, which are bladder irritants.

· Limit your fluid intake at specific times, such as before you go to bed or before a long car drive or big meeting.

· Avoid letting your bladder get too full. It may help to establish a set schedule for "timed voiding" to urinate before you get the urge.

· Lose weight if you are overweight since weight loss may improve the symptoms of both overactive bladder and stress incontinence, which is urine leakage that can happen when the pelvic floor muscles have been weakened.

"Practicing ‘Kegel’ exercises to strengthen the pelvic floor muscles may or may not help with urinary frequency, but they can help with stress incontinence caused by lack of strength in those muscles," Dr. Saleh says.

If your physician has ruled out urinary tract infections, bladder stones, tumors or other problems, and self-help treatments have failed to improve your symptoms, medications may be prescribed to help correct the problem.

"The most common medications prescribed for overactive bladder are called anticholinergics, which control the nerve receptors in the bladder that stimulate it to contract," Dr. Saleh explains. "With these medications, we try to bring the bladder back to a normal activity level – not to prevent the bladder from contracting completely."

While minimally invasive surgery to lift the bladder with a "sling" is sometimes performed for cases of stress incontinence, surgery to treat overactive bladder is performed only in rare cases for people with severe symptoms who don’t respond to other treatments.

"Our success rate for treating overactive bladder without surgery is very good," says Dr. Saleh. "Many people are embarrassed to talk with their doctors about their overactive bladder symptoms, but it’s important that you do. There’s no need for you to suffer in silence."

Learn More About the Washington Women’s Center
The Washington Women’s Center offers a variety of health screenings, diagnostic and educational programs that are tailored to meet a woman’s needs. The Center is located at 2500 Mowry Avenue, Suite 150, in Fremont. For more information, call (510) 608-1301 or visit us online at www.whhs.com/womenscenter

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