I am 52, female. How do I manage my bladder problems?

Question

Hello doctor,

I am 52 and having embarrassing bladder problems that are ruining my life. I have to urinate every 30 minutes during the day and get up four to five times at night. Sometimes I get such a sudden urge that I do not make it to the bathroom in time. It is humiliating, and I have started wearing pads just in case. I avoid drinking water at work and will not go to movies or long meetings anymore.

My primary care doctor prescribed Oxybutynin, but it makes my mouth so dry that I can barely swallow food. I tried bladder training exercises, but they do not seem to help much. Sleep deprivation from getting up all night is making me irritable and affecting my work performance. My husband is understanding, but I feel like this is impacting our relationship too. I am only 52 and feel like I am losing my independence over this condition.

Are there other medications with fewer side effects?
What about those bladder injections I heard about?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

This incontinence is common in the elderly age group, especially after the age of 50. Bladder exercises can help to an extent, but not completely. Have you got yourself checked to understand the cause of this incontinence? You may need a mixture of bladder training and medication to control this. In your relationship, if your husband is understanding, then there is no need to worry. Many people over the age of 50 have these issues, so do not worry. It will not affect your relationship if your husband is understanding of the condition.

Use of bladder training, like trying to hold off for 10 minutes every time you feel an urge to urinate. The goal is to lengthen the time between trips to the toilet until you are urinating only every 2.5 to 3.5 hours. This has helped in many cases. You should schedule trips to the toilet so that you avoid going at regular intervals, which will train your body to void during selected intervals. Also, if you can void, stop and restart, so that you completely clear the urine available in the bladder, which will help to reduce the number of times you go to the toilet.

In medicines, I believe you are already on anticholinergic medicines like Oxybutynin. The other medicines in this group are Tolterodine, Darifenacin, Fesoterodine, Solifenacin, and Trospium chloride, which are effective but have their own side effects, like increased sensation of thirst, which can be overcome by drinking small quantities of water or wetting the lips with water frequently.

Interventional therapies that may help with incontinence include bulking material injections, where a synthetic material is injected into tissue surrounding the urethra, which helps to keep the urethra closed and reduce urine leakage. This procedure is for the treatment of stress incontinence and is generally less effective than more invasive treatments such as surgery. It may need to be repeated more than once.

Injections of OnabotulinumtoxinA into the bladder muscle may benefit people who have an overactive bladder and urge incontinence. OnabotulinumtoxinA is generally prescribed as needed. Nerve stimulators are devices that use painless electrical pulses to stimulate the nerves involved in bladder control, known as sacral nerves. Stimulating the sacral nerves can control an overactive bladder and urge incontinence.

There are many more surgical procedures, like using an artificial sphincter, sling surgery, and others, but again, these are done as and when required by the patient. I suggest that you get your cause identified, and we can appropriately manage the condition. So do not worry about it, it is a curable condition, and appropriate management will help to reduce the embarrassment that you are facing.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.