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Getting Personal about Overactive Bladder

Posted Aug 24 2008 1:49pm
PATRICIA S.: I had trouble maintaining the control of my bladder, and also, then, I got so that I couldn't even tell when I really need to go.

ANNOUNCER: When Patricia started having symptoms of overactive bladder several years ago, at first she thought they were just a normal part of aging.

PATRICIA S.: One of the embarrassing thing is going through the checkout line with those pads. Even though, you know, the people at the checkout line have no interest in what you're buying, but you still get this feeling that everybody's looking at you.

ANNOUNCER: Patricia finally decided to seek help. Her doctor prescribed estrogen cream, to reduce tissue irritation in the pelvic area. The doctor recommended that Patricia do exercises that would strengthen some key, pelvic muscles. And the doctor prescribed an oral medication, of a type known as anticholinergics.

JOSEPH G. OUSLANDER, MD: The drugs we usually prescribe for overactive bladder are anticholinergic medications. They interfere with a chemical that is released by nerves around the bladder, that cause the bladder to contract, that's called acetylcholine. Anticholinergics block the action of that natural chemical on the bladder to delay bladder contraction or inhibit bladder contraction. So you have a longer time between the time when you feel your bladder's full and when you actually have to void.

PATRICIA S.: The medicine helped with my not having to go so often, but it didn't help me understand how my bladder was full.

I had to get up and go to the bathroom a lot of times. And, if I didn't wake up enough, I would, you know, have some incontinence problems then. And it was very, very hard making myself wake up that many times, because then you're tired the next day

ANNOUNCER: In retirement, Patrica moved to a new city, to be with family. She sought help from a new doctor, Joseph Ouslander.

JOSEPH G. OUSLANDER, MD: I assessed her during a physical exam to see if she could do a pelvic muscle exercise properly and she couldn't. So I sent her to our physical therapist who specializes in teaching women how to use their pelvic muscles properly.

ANNOUNCER: Dr. Ouslander also prescribed estrogen cream, and he ordered a change of medications, to a stronger anticholinergic that had more options in choice of doses.

JOSEPH G. OUSLANDER, MD: Well, anticholinergic drugs for overactive bladder are like drugs you use for other conditions like arthritis or high blood pressure. Some people respond better to one than another.

ANNOUNCER: Learning how to do the pelvic exercises properly, plus the switch in medicines really helped.

PATRICIA S.: Now I know before I go that I have to go, which is a big relief. And I only have to get up a couple of times now in the night to go and not so often. It's made such a difference to me; the fact that I can tell when my bladder is full now, it makes such a difference.

ANNOUNCER: Patricia's had some minor problems with a dry mouth, a common side effect with anticholinergics. And she's trying to cut down on coffee, which Dr. Ouslander explained could contribute to bladder problems. But her life has changed.

PATRICIA S.: We had gone to a play and I hadn't gone to the bathroom before the play started and I thought, "Well, I'll go at intermission." Well, the first half of the play was a very long period of time and then I was so afraid and I knew I had to go, but I was able to make it, and make it down and stand in that long line of women and get there without having an accident, and that wouldn't have been possible before.

JOSEPH G. OUSLANDER, MD: Patricia's done very well. I think number one, she's satisfied with her treatment and that's the most important thing, if the patient is satisfied, if they have realistic goals. She can go places where she couldn't go before. She doesn't have to wear any pads to protect herself from incontinence episodes. She doesn't get up as frequently at night to urinate, her sleep is better. So her quality of life is greatly improved.

PATRICIA S.: One thing I would tell women is that it is a common problem and that they shouldn't feel embarrassed about it and the best thing that they can do is get help.

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