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MoonDragon's Womens Health Information
Disorders
INCONTINENCE, URGE

(Urge Urinary Incontinence)


For Informational Use Only.
For more detailed information, contact your health care provider
about options that may be available for your specific situation.





  • Urge Incontinence Description
  • Urge Incontinence Frequent Signs & Symptoms
  • Urge Incontinence Causes
  • Urge Incontinence Risk Factors
  • Urge Incontinence Preventive Measures
  • Urge Incontinence Prognosis - Expected Outcome
  • Urge Incontinence Potential Complications
  • Urge Incontinence Medical Diagnosis
  • Urge Incontinence Conventional Medical Treatment
  • Urge Incontinence Medications
  • Urge Incontinence Activity Recommendations & Restrictions
  • Diet, Nutrition & Lifestyle Recommendations
  • Notify Your Health Care Provider
  • Incontinence Supplies & Supplement Products




  • URGE INCONTINENCE DESCRIPTION

    Urge incontinence is the inability to control the bladder once the urge to urinate occurs resulting in urinary leakage. It may occur alone or sometimes with stress incontinence (involuntary loss of urine on coughing, straining, sneezing, etc.). It is also known as overactive bladder; Detrusor instability, Detrusor hyperreflexia; Irritable bladder; Spasmodic bladder; and Unstable bladder.

    More than 13 million people in the United States, male and female, young and old, experience incontinence. It is often temporary, and it always results from an underlying medical condition.

    The prevalence of urinary incontinence increases with age and affects women more often than it does men. Women experience incontinence twice as often as men. Pregnancy and childbirth, menopause, and the structure of the female urinary tract account for this difference. But both women and men can become incontinent from neurologic injury, birth defects, strokes, multiple sclerosis, and physical problems associated with aging.

    Older women, more often than younger women, experience incontinence. But incontinence is not inevitable with age. Incontinence is treatable and often curable at all ages. If you experience incontinence, you may feel embarrassed. It may help you to remember that loss of bladder control can be treated. You will need to overcome your embarrassment and see your health care provider to learn if you need treatment for an underlying medical condition.

    Incontinence in women usually occurs because of problems with muscles that help to hold or release urine. The body stores urine, water and wastes removed by the kidneys, in the bladder, a balloon-like organ. The bladder connects to the urethra, the tube through which urine leaves the body.

    Urinary incontinence is not a condition in itself, but rather a symptom of a problem with the lower urinary tract. The body stores urine (water and wastes removed from the kidneys) in the bladder, a balloon-like organ. The bladder connects to the urethra, the tube through which urine leaves the body. During urination, muscles in the wall of the bladder contract, forcing urine out of the bladder and into the urethra. At the same time, sphincter muscles surrounding the urethra relax, letting urine pass out of the body. Incontinence will occur if the bladder muscles suddenly contract or muscles surrounding the urethra suddenly relax.

    pelvic floor muscles

    Urge incontinence is a strong, sudden need to urinate, followed by a bladder contraction, which results in leakage.


    COMMON TYPES OF URINARY INCONTINENCE

    URINARY STRESS INCONTINENCE: Stress incontinence occurs when coughing, laughing, sneezing, or other movements that put pressure on the bladder result in urine leakage. Pelvic floor muscles support the bladder. If these muscles weaken, the bladder can move downward, pushing slightly out of the bottom of the pelvis. This prevents muscles that ordinarily force the urethra shut from squeezing as tightly as they should. As a result, urine can leak into the urethra during moments of physical stress. Stress incontinence also occurs if the muscles that do the squeezing weaken. Causes of urinary stress incontinence include physical changes resulting from pregnancy, childbirth and menopause. It is the most common form of incontinence in women and is treatable.

    MoonDragon's Womens Health Disorders: Stress Incontinence

    URINARY URGE INCONTINENCE: People who lose urine for no apparent reason while suddenly feeling the need or urge to urinate suffer from urge incontinence. The most common cause of urge incontinence is inappropriate bladder contractions. Medical professionals describe such a bladder as "unstable," "spastic" or "overactive." Some health care providers may call this condition "reflex incontinence" if it results from overactive nerves controlling the bladder. Urge incontinence can mean that the bladder empties during sleep, after drinking a small amount of water or when a sufferer touches water or hears it running (as when washing dishes or hearing someone else taking a shower). Causes of urinary urge incontinence include involuntary actions of bladder muscles that occur because of damage to the nerves of the bladder, nervous system (spinal cord and brain) or the muscles themselves. Multiple sclerosis, Parkinson's disease, Alzheimer's disease, stroke and injury can harm bladder nerves or muscles. Urge incontinence may be due to prostate problems in men. Difficulty urinating in men may also be due to prostate inflammation. It is often necessary to use a bathroom as frequently as every 2 hours, and bed-wetting is common. With urge incontinence, sometimes a large amount of urine is released. Accidental urination can be triggered by:
    • Sudden change in position or activity.
    • Hearing or touching running water.
    • Drinking a small amount of liquid.
    FUNCTIONAL INCONTINENCE: This is characterized by an uncontrollable urge to empty the bladder before you can reach the bathroom. It can be caused by stress; changes in environment, such as having to stay in the hospital and not being able to get to the bathroom in time; and mobility restrictions.

    REFLUX INCONTINENCE: Some individuals are not aware when their bladders are full, and this loss of sensation can lead to urine leakage. This is reflex incontinence, and it is most often due to spinal cord injury or other neurological impairment.

    TOTAL INCONTINENCE: Total incontinence is the unpredictable loss of urine at all times. It can be caused by neurological dysfunction, abdominal surgery, spinal cord injury, or anatomical defect.

    Incontinence is most common in people over 50 years of age, but loss of bladder control can occur at any age, especially in pregnant women. It is wrong to assume that loss of bladder control is an inevitable part of getting older. It is also wrong to assume that nothing can be done about this problem.


    THE TYPES OF URINARY INCONTINENCE

    Stress
     

    Leakage of small amounts of urine during physical movement (coughing, sneezing, exercising).

    Urge
     

    Leakage of large amounts of urine at unexpected times, including during sleep.

    Functional
     

    Untimely urination because of physical disability, external obstacles, or problems in thinking or communicating that prevent a person from reaching a toilet.

    Overflow
     

    Unexpected leakage of small amounts of urine because of a full bladder.

    Mixed
     

    Usually the occurrence of stress and urge incontinence together.

    Transient
     

    Leakage that occurs temporarily because of a condition that will pass (infection, medication).





    URGE INCONTINENCE FREQUENT SIGNS & SYMPTOMS

    An individual's ability to hold urine and maintain continence depends on the normal function of the lower urinary tract, the kidneys, and the nervous system. The person must have a physical and psychological ability to recognize and appropriately respond to the urge to urinate. The bladder's ability to fill and store urine requires a functional sphincter muscle to control the flow of urine out of the body and a stable bladder wall muscle (detrusor). The process of urination involves two phases:
    • Filling & Storage Phase: During the filling and storage phase, the bladder stretches so it can hold the increasing amount of urine. The bladder of an average person can hold 350 mL to 550 mL of urine. Generally, a person feels like they need to urinate when approximately 200 mL of urine fills up in the bladder. The nervous system tells you that you need to urinate, and also allows the bladder to continue to fill.


    • Emptying Phase: The emptying phase requires that the detrusor muscle contract, forcing urine out of the bladder. The sphincter muscle must relax at the same time, so that urine can flow out of the body.

    Involuntary loss of urine occurs almost immediately after feeling a slight urge to urinate. The volume of lost urine may range from a few drops to complete bladder emptying. Undesired bladder muscle contractions may occur from neurological problems and bladder irritation.

    Symptoms of Urge Incontinence include:
    • Sudden and urgent need to urinate (urinary urgency).
    • Frequent urination, in the daytime and at night.
    • Abdominal distension or discomfort.
    • Involuntary loss of urine.





    URGE INCONTINENCE CAUSES

    Urge incontinence is leakage of urine due to bladder muscles that contract inappropriately. Often these contractions occur regardless of the amount of urine that is in the bladder. Urge incontinence may result from neurological injuries (such as spinal cord injury or stroke), neurological diseases (such as multiple sclerosis), infection, bladder cancer, bladder stones, bladder inflammation, or bladder outlet obstruction.

    In men, urge incontinence may be due to neurologic disease or bladder changes caused by benign prostatic hypertrophy (BPH) or bladder outlet obstruction from an enlarged prostate.

    The majority of cases of urge incontinence are idiopathic, which means a specific cause cannot be identified.

    Although urge incontinence may occur in anyone at any age, it is more common in women and the elderly.

    BLADDER ABNORMALITIES & NEUROLOGICAL PROBLEMS

    Two bladder abnormalities commonly cause urge incontinence. The most common is a neurogenic bladder (overactive type), which is caused by brain or spinal cord injury or disease that interrupts nerve conduction above the sacrum and results in loss of bladder sensation and motor control. There are several neurological diseases and disorders associated with a neurogenic bladder, including the following: Chronic urinary tract infection, bladder stones, and polyps can irritate the bladder and cause detrusor muscle instability, leading to urge incontinence. Detrusor muscle instability without a known cause is also common. It has been suggested that, in these cases, an unidentified dysfunction in muscle or nerve tissue is responsible.

    Diuretics increase the amount of urine released from the body. They are commonly used to treat high blood pressure (hypertension) and fluid build-up in the body (edema). Rapid-acting diuretics increase the urgency and frequency of urination in some people, especially the elderly and bedridden. Modifying dosage may alleviate symptoms.

    MoonDragon's Womens Health Disorders: Cystitis (Bladder Infection)
    MoonDragon's Womens Health Disorders: Interstitial Cystitis (Bladder Wall Inflammation)
    MoonDragon's Womens Health Disorders: Urethritis (Urethra Inflammation)





    URGE INCONTINENCE RISK FACTORS

  • Central nervous system disorders (Stroke, Parkinson's).

  • MoonDragon's Health & Wellness Disorders: Parkinson's Disease
    MoonDragon's Health & Wellness Disorders: Stroke

  • Obesity.

  • MoonDragon's Womens Health Disorders: Obesity

  • Surgery that may traumatize the urethra.
  • Injury of the urethra from any cause.





  • URGE INCONTINENCE PREVENTIVE MEASURES

  • Eat a normal, well-balanced diet.
  • Exercise regularly to build and maintain muscle strength.
  • Drink plenty of water.
  • Avoid alcoholic beverages, caffeine, soda pop and simple sugars.
  • Do not smoke.
  • Achieve and maintain a healthy weight.

  • MoonDragon's Womens Health Disorders: Obesity
    MoonDragon's Nutrition Information - Diets: Weight Controlled Diet
    MoonDragon's Nutrition Information - Diets: Weight Loss Diet

  • Do not put off emptying the bladder when the urge is evident. Try to empty the bladder every 3 to 4 hours.
  • Early initiation of bladder retraining techniques may be useful in reducing the severity of symptoms.

  • KEGEL EXERCISE

    Kegel exercises are effective in strengthening or retrain pelvic floor muscles and sphincter muscles, which can reduce or cure stress leakage. Learn and practice Kegel Exercises before symptoms of stress incontinence begin.
      The purpose of kegel exercises is to recognize, control and develop the muscles of the pelvic floor. These are the ones used to strengthen these muscles so you can control or relax them completely:

    • To identify which muscles are involved, alternately start and stop urinating when using the toilet.

    • Practice tightening and releasing these muscles while sitting, standing, walking, driving, watching TV or listening to music. For awhile, you may experience some pelvic pain.

    • Tighten the muscles a small amount at a time, "like an elevator going up to the 10th floor." Then release very slowly, "one floor at a time."

    • Tighten the muscles from front to back, including the anus, as in the previous exercise.

    • Practice exercises every morning, afternoon and evening. Start with 5 times each, and gradually work up to 20 to 30 each time.





    URGE INCONTINENCE PROGNOSIS - EXPECTED OUTCOME

    There are several different forms of treatment available, some still experimental. If the first treatment techniques do not work, get medical advice about alternatives. How well you do depends on your symptoms, an accurate diagnosis, and proper treatment. Many people must try different therapies (some at the same time) to reduce symptoms. Discuss your options for your particular needs with your health care provider.

    Instant improvement is unusual. Perseverance and patience are usually required to see improvement. A small number of people need surgery to control their symptoms.





    URGE INCONTINENCE POTENTIAL COMPLICATIONS

  • Skin problems.
  • Urinary tract infections.
  • Social isolation due to concern about embarrassment.
  • Physical complications are rare.
  • Psychosocial problems may arise, particularly if incontinence results from an inability to get to the bathroom when urgency arises.





  • URGE INCONTINENCE MEDICAL DIAGNOSIS

    Any underlying cause for urge incontinence should be identified and treated. A physical examination will include examination of the abdomen and rectum. Women will also have a pelvic exam. Men will also have a genital exam, possibly with a prostate check. In most cases the physical exam reveals nothing abnormal. If there are neurologic causes, other neurologic abnormalities may be found. Tests include the following:
    • Post-void residual (PVR) to measure amount of urine left after urination.
    • Urinalysis or urine culture to rule out urinary tract infection.
    • Urinary stress test (the patient stands with a full bladder and coughs).
    • Pad test (after placement of a pre-weighed sanitary pad, patient exercises, then pad is weighed to determine urine loss).
    • Pelvic or abdominal ultrasound.
    • X-rays with contrast dye.
    • Cystoscopy (inspection of the inside of the bladder)
    • Urodynamic studies (measurement of pressure and urine flow).
    • EMG (myogram) - rarely needed.
    Further tests will be performed to rule out other types of incontinence. These tests may include the "Q-tip test," which measures the change in the angle of the urethra at rest and when straining. An angle change of greater than 30 degrees often indicates significant weakness of the muscles that support the bladder, which is common in stress incontinence.





    URGE INCONTINENCE CONVENTIONAL MEDICAL TREATMENT

    There are several different approaches that may be used in managing and treating urge incontinence. If evidence of infection is found in urine culture, antibiotics will be prescribed. The choice of a specific treatment will depend on the severity of the symptoms and the extent that the symptoms interfere with lifestyle. There are three main approaches to treatment: medication, retraining, and surgery.

  • Treatment may involve bladder training techniques, medication, surgery, exercises and use of special aids to ease discomfort.

  • A planned schedule for emptying the bladder is helpful. Prompting by a caregiver will help.

  • Absorbent pads or diapers may be worn.

  • Keep a daily diary of fluid intake and urination frequency. This will help assess progress.

  • Use bedside commodes, urinals, and bedpans if necessary.

  • A pessary (support device) made of rubber or other material to fit inside the vagina to support the uterus and lower muscular layer of the bladder is helpful for some.

  • Frequently it is necessary to have urodynamic testing (studies of the actual urine flow), either in the health care provider's office or a special clinic, to evaluate the incontinence and confirm it is stress related and not a combination of stress and urge incontinence.

  • Learn and practice Kegel Exercises.

  • Surgery to tighten relaxed or damaged muscles that support the bladder.

  • Biofeedback behavioral training may be recommended.

  • SURGERY

    Surgery is recommended only after other treatment options have proven unsuccessful.

    The goal of any surgery to treat urge incontinence is aimed at increasing the storage ability of the bladder while decreasing the pressure within the bladder. Surgery is reserved for patients who are severely debilitated by their incontinence and who have an unstable bladder (severe inappropriate contraction) and poor ability to store urine.

    Augmentation cystoplasty (bladder augmentation) is the most frequently performed surgical procedure for severe urge incontinence of a small, hyperactive, or non-resilient bladder. In this reconstructive surgery, a segment or segments of the bowel (intestine) is or are added to the bladder to increase bladder size and allow the bladder to store more urine. It helps to reduce the muscle-squeezing ability of the bladder (autoaugmentation). Segments from the last part of the small intestine (ileum), the first part of the large intestine (cecum), or the junction between the small and large intestines (ileocecum) can be used to enlarge the bladder. The bladder is opened at the dome and cut on right angles on each side. The bowel segment is joined to the bladder with sutures. People who are unable to perform self-catheterization (i.e., placement of a urinary catheter by the patient) or who have a kidney disorder, bowel disease, or urethral disease are not candidates for bladder augmentation.

    In autoaugmentation, the smooth muscle that contracts the bladder to expel urine (detrusor) is cut out of the dome of the bladder, leaving the mucous membrane intact. This results in reduced muscle contraction and improved function in an overactive bladder.

    Possible complications include those of any major abdominal surgery, including bowel obstruction, blood clots, infection, and pneumonia. Other postoperative complications include urine leakage, continued incontinence, and kidney problems. There is a risk of developing urinary fistula (abnormal tubelike passages that result in abnormal urine drainage), urinary tract infection, and difficulty urinating.

    Long term risks include bladder stones, bladder cancer, and incontinence during and after pregnancy. Augmentation cystoplasty is also linked to a slightly increased risk of developing tumors.

    SACRAL NERVE STIMULATION

    InterStim therapy is a reversible treatment for people with urge incontinence caused by overactive bladder who do not respond to behavioral treatments or medication. InterStim is an implanted neurostimulation system that sends mild electrical pulses to the sacral nerve, the nerve near the tailbone that influences bladder control muscles. Stimulation of this nerve may relieve the symptoms related to urge incontinence. Prior to implantation, the effectiveness of the therapy is tested on a outpatient basis with an external InterStim device. For a period of 3 to 5 days, the patient records voiding patterns that occur with stimulation. The record is compared to recorded voiding patterns without stimulation. The comparison demonstrates whether the device effectively reduces symptoms. If the test is successful, the patient may choose to have the device implanted. The procedure requires general anesthesia. A lead (a special wire with electrical contacts) is placed near the sacral nerve and is passed under the skin to a neurostimulator, which is about the size of a stopwatch. The neurostimulator is placed under the skin in the upper buttock. Adjustments can be made at the health care provider's office with a programming device that sends a radio signal through the skin to the neurostimulator. Another programming device is given to the patient to further adjust the level of stimulation, if necessary. The system can be turned off at any time. Possible adverse effects include the following:
    • Change in bowel function.
    • Infection.
    • Lead movement.
    • Pain at implant sites.
    • Unpleasant stimulation or sensation.
    You will need to find a urologist in your area who is familiar with this procedure.

    BLADDER RETRAINING

    Management of urge incontinence usually begins with a program of bladder retraining. Occasionally, electrical stimulation and biofeedback therapy may be used in conjunction with bladder retraining. A program of bladder retraining involves becoming aware of patterns of incontinence episodes and relearning skills necessary for storage and proper emptying of the bladder. Bladder retraining consists of developing a schedule of times when you should try to urinate, while trying to consciously delay urination between these times. One method is to force yourself to wait 1 to 1.5 hours between urinations, despite any leakage or urge to urinate in between these times. As you become skilled at waiting, gradually increase the time intervals by 1/2 hour until you are urinating every 3 to 4 hours.

    BIOFEEDBACK AND ELECTRICAL STIMULATION

    For people who are unsure if they are performing Kegel exercises correctly, biofeedback and electrical stimulation may be used to help identify the correct muscle group to work. Biofeedback is a method of positive reinforcement in which electrodes are placed on the abdomen and the anal area. Some therapists place a sensor in the vagina (for women) or the anus (for men) to assess contraction of the pelvic floor muscles. A monitor will display a graph showing which muscles are contracting and which are at rest. The therapist can help identify the correct muscles for performing Kegel exercises. About 75 percent of people who use biofeedback to enhance performance of Kegel exercises report symptom improvement, with 15 percent considered cured. Electrical stimulation involves using low-voltage electric current to stimulate the correct group of muscles. The current may be delivered using an anal or vaginal probe. The electrical stimulation therapy may be performed in the clinic or at home. Treatment sessions usually last 20 minutes and may be performed every 1 to 4 days. Another form of electrical stimulation called sacral neuromodulation involves the placement of a "bladder pacemaker," which stimulates the bladder nerves. This device may provide excellent relief of symptoms for those who do not respond to other therapies.

    BOTOX

    An experimental therapy involves injecting botulinum toxin (Botox) into the bladder muscle to help stop the involuntary contracts that lead to urge incontinence. Early study results suggest this is a promising treatment option for those who do not respond to other therapies.

    MONITORING

    Urinary incontinence is a chronic (long-term) problem. Although you may be considered cured by various treatments, you should continue to see your provider to evaluate the progress of your symptoms and monitor for possible complications of treatment.

    Additional Urge Incontinence Information is available from:
      National Association For Continence (NAFC)
      P.O. Box 1019
      Charleston, SC 29402-1019
      Toll Free Phone: 1-800-BLADDER
      Phone: 1-843-377-0900
      Fax: 1-843-377-0905
      Email: memberservices@nafc.org
      Website: www.nafc.org

      The Simon Foundation for Continence
      Post Office Box 815
      Wilmette, Illinois 60091 USA
      Toll Free Phone: 1-800-23-SIMON (237-4666)
      Chicago HQ Office Phone: 847-864-3913
      Chicago HQ Office Fax: 847-864-9758
      Website: www.simonfoundation.org





    URGE INCONTINENCE MEDICATIONS

    Medications used to treat urge incontinence are aimed at relaxing the involuntary contraction of the bladder and improving bladder function. There are several types of medications that may be used alone or in combination:
    • Anticholinergic agents (oxybutynin, tolterodine, enablex, sanctura, vesicare, oxytrol).
    • Antispasmodic medications (flavoxate).
    • Tricyclic antidepressants (imipramine, doxepin).
    • Oxybutynin (Ditropan) and tolterodine (Detrol) are medications to relax the smooth muscle of the bladder. These are the most commonly used medications for urge incontinence and are available in a once-a-day formulation that makes dosing easy and effective.
  • An antispasmodic drug is flavoxate (Urispas). However, studies have shown inconsistent benefit in controlling symptoms of urge incontinence.

  • Tricyclic antidepressants have also been used to treat urge incontinence because of their ability to inhibit or "paralyze" the bladder smooth muscle. Possible side effects include fatigue, dry mouth, dizziness, blurred vision, nausea, and insomnia.

  • Anticholinergic drugs to stimulate muscle contractions may be prescribed. The most common side effects of anticholinergic medicines are dry mouth and constipation. The medications cannot be used by patients with narrow angle glaucoma.


  • Anticholinergic and alpha-1-adrenergic blocking agents have proven to be effective in some patients with urge incontinence. Anticholinergic agents relax smooth muscle tissue and have an antispasmodic effect on overactive bladder.

    ANTICHOLINERGIC AGENTS

    Propantheline bromide (Pro-Banthine) is prescribed to stop bladder muscle contractions (overactive bladder). Typical dosage is 7.5 to 30 mg taken without food three to five times per day.

    Oxybutynin chloride (DitropanXL) relaxes bladder smooth muscle. It is prescribed to treat urge incontinence caused by overactive bladder.

    The oxybutynin transdermal system (Oxytrol) is a thin, flexible, clear patch that is applied to the skin of the abdomen or hip, twice weekly, to treat overactive bladder. This treatment delivers oxybutynin continuously through the skin into the bloodstream and relieves symptoms for up to 4 days.

    Patients who have urinary or gastric retention, uncontrolled narrow-angle glaucoma, and those with hypersensitivity to oxybutynin should not use the oxybutynin transdermal system.

    Hyoscyamine sulfate (Levbid, Cytospaz) is an antispasmodic prescribed for urge incontinence caused by overactive or neurogenic bladder. Typical dosage is one or two 0.375 mg tablets taken every 12 hours. This drug should not be taken by patients with obstructive urinary tract disorders (e.g., enlarged prostate), glaucoma (i.e., eye disease characterized by increased intraocular pressure), or severe inflammation of the large intestine (ulcerative colitis).

    Tricyclic antidepressants (TCAs) have anticholinergic effects that reduce nighttime incontinence and help manage urge incontinence. TCAs include doxepin hydrochloride (Sinequan), desipramine hydrochloride (Norpramin), nortryptyline hydrochloride (Pamelor), and imipramine pamoate (Tofranil-PM). The usual dose of Tofranil is 10 to 25 mg taken one to three times per day for a total of 25 to 75 mg daily.

    Side effects associated with anticholinergics include the following:
    • Confusion
    • Constipation
    • Dizziness
    • Drowsiness
    • Dry mouth
    • Headache
    • Nausea
    • Nervousness
    • Rapid heart rate (tachycardia)
    • Urinary retention
    • Visual blurring
    ALPHA-1-ADRENERGIC BLOCKING AGENTS

    These agents are used to treat benign prostatic hyperplasia (BPH), which compresses the male urethra and obstructs urine flow resulting in overflow and urge incontinence. Alpha blockers relax striated and smooth muscle, decreasing urethral resistance and relieving symptoms. Three drugs commonly prescribed for treatment of BPH and associated incontinence include the following:
    • Doxazosin mesylate (Cardura), 1 to 8 mg, once daily
    • Tamulosin hydrochloride (Flomax), 0.4 to 0.8 mg, once daily
    • Terazosin hydrochloride (Hytrin), 1 to 10 mg, once daily
    Side effects commonly experienced with these drugs include dizziness, fatigue, and headache.

    MUSCARINIC RECEPTOR ANTAGONIST

    Tolterodine tartrate (DetrolLA) blocks nerve receptors that control bladder contraction and reduces urinary frequency and urgency in overactive bladder and urge incontinence. The typical dose is 2 to 4 mg, twice daily.

    Patients who have an adverse reaction to the drug or who have the following conditions should not use this medication.
    • Urinary retention
    • Gastric retention
    • Narrow-angle glaucoma


    ANTIBIOTIC THERAPY

  • Antibiotics may be prescribed if there is a complicating urinary tract infection. If antibiotics are prescribed, be sure to include fresh active culture yogurt in your diet or taking an Acidophilus supplement to replace needed intestinal bacteria used in digestion of food that was destroyed along with the bad bacteria causing your UTI.





  • URGE INCONTINENCE ACTIVITY RECOMMENDATIONS & RESTRICTIONS

    No restrictions. However, it is helpful to try to keep the bladder as empty as possible.

  • Frequent restroom visits should be done.
  • Watch fluid intake when outside of home, traveling, or where a restroom is not conveniently available.
  • Avoid stressful situations where loss of urine may occur such as bending, lifting, rising from a sitting position, etc.
  • People with urge incontinence may find it helpful to avoid activities that irritate the urethra and bladder, such as taking bubble baths or using caustic soaps in the genital area.





  • DIET, NUTRITION & LIFESTYLE RECOMMENDATIONS

  • Eliminate your intake of foods that may irritate the bladder. Decrease amount of caffeine, alcohol, spicy foods, and highly acidic foods such as citrus fruits and juices. Coffee is a natural diuretic and alcohol (especially beer) may increase the need for frequent urination. Avoid carbonated beverages, and simple sugars.

  • Start a weight loss program if being overweight is a problem.

  • Controlled fluid intake in addition to other therapies may be helpful in the management of urge incontinence. The goal of this program is to distribute the intake of fluids throughout the course of the day, so the bladder does not need to handle a large volume of urine at one time. Do not drink large quantities of fluids with meals - limit your intake to less than 8 ounces at one time. Sip small amounts of fluids between meals. Stop drinking fluids approximately 2 hours before bedtime.

  • Avoid high volume of fluid intake in situations where access to bathroom facilities is limited (airplane or road trips, shopping).

  • BENEFICIAL DIETARY SUPPLEMENTS

  • Vitamin C with Bioflavonoids help with the formation of collagen, which is important for those suffering from incontinence.
  • Vitamin A helps the body produce collagen and can also encourage the strength of cartilage.
  • Manganese is needed for healthy bones, cartilage and skin.
  • Amino Acids helps strengthen the bladder muscle.
  • Multi-Vitamin and Multi-Mineral Supplements supplies all necessary nutrients and relieves stress.
  • MSM and SAM-e normalize the bladder lining.
  • Kava Kava is an anti-spasmodic traditionally used by Hawaiians for urinary difficulties. It can help ease bladder contractions and acts as a sedative.
  • Cranberry is an acidic known to benefit the bladder.
  • Saw Palmetto has shown exceptional results for bladder control problems in both males and females.
  • Zinc is effective in improving bladder function.


  • NUTRITIONAL SUPPLEMENTS

    The following nutrients are important for healing once appropriate local treatment has been administered. Unless otherwise specified, the following recommended doses are for adults over the age of 18. For children between the ages of 12 and 17, reduce the dose to 3/4 the recommended amount. For children between the ages of 6 and 12 years old, reduce the dose to 1/2 the recommended amount. For children under 6 years old, use 1/4 the recommended amount.

    NUTRIENTS
    Supplement
    Suggested Dosage
    Comments
    Very Important
    Cranberry
    1 quart pure, unsweetened cranberry juice daily. If pure juice is unavailable, cranberry capsules may be substituted. Take capsules with a large glass of water. Acidifies the urine and inhibits bacterial growth.

  • Cranberry Herbal Products
  • Free-Form Amino Acid Complex
    As directed on label. Helps to strengthen bladder muscle. Use a product made from a vegetarian source.

  • Amino Acid Complex Supplement Products
  • Corn Silk (Cornsilk)
    2 capsules daily. Have a diuretic effect and reduce bladder spasms.

  • Cornsilk Herbal Products
  • Important
    Calcium
    And
    Magnesium
    1,500 mg daily.

    750 mg daily.
    Reduces bladder irritability and aids in controlling bladder spasms.

    Aids in the stress response and works best when balanced with calcium. Use magnesium chelate form.

  • Calcium Supplement Products
  • Magnesium Supplement Products
  • MultiVitamin & Mineral Complex
    As directed on label. For essential balanced vitamins and minerals. All nutrients are needed in balance for healing and tissue repair. Essential for normal cell division and function. Use a high potency, hypoallergenic form.


  • Multivitamin Supplement Products
  • Mineral Complex Supplement Products
  • Potassium
    99 mg daily. Replaces potassium lost as a result of frequent urination. Aids in balancing sodium and potassium in the body.

  • Potassium Supplement Products
  • Vitamin A
    10,000 IU daily. Antioxidants that enhance immunity and to aid in normalizing bladder muscle function. For essential balanced vitamins and minerals

  • Vitamin A Supplement Products
  • And
    Beta-Carotene & Carotene Complex
    15,000 IU daily. Antioxidants that enhance immunity and to aid in normalizing bladder muscle function. For essential balanced vitamins and minerals.

  • Beta Carotene Supplement Products
  • Carotene Complex Supplement Products
  • Vitamin B Complex
    50 to 100 mg twice daily, with meals. Amounts of individual vitamins in a complex will vary. Do not exceed a total of 100 mg Vitamin B-3 (Niacin) in any one day until healing is complete. B vitamins that improved circulation, build red blood cells, and aid liver function. Anti-stress vitamins, especially important for normal brain function. Needed for tissue repair. Necessary for proper digestion. High doses are necessary if antibiotics are used. Sublingual forms are recommended.

  • Vitamin B-Complex Supplement Products
  • Vitamin C
    Plus
    Bioflavonoids
    Vitamin C: 2,000 to 5,000 mg daily and up in divided doses.

    Bioflavonoids: 1,000 mg daily.
    Vitamin C with Bioflavonoids help with the formation of collagen, which is important for those suffering from incontinence. A powerful antiviral agent. Produces antibacterial effect through acidification of urine. Important in immune function.

  • Vitamin C Supplement Products
  • Bioflavonoid Supplement Products
  • Vitamin E
    200 IU daily or 400 IU every other day. Combats infecting bacteria. Use d-alpha-tocopherol form.

  • Vitamin E Supplement Products
  • Zinc
    80 mg daily. Do not exceed a total of 100 mg daily from all supplements. Important for improved bladder function and in tissue repair. Also enhances immunity. Use zinc gluconate lozenges or OptiZinc for best absorption.

  • Zinc Supplement Products





  • NOTIFY YOUR HEALTH CARE PROVIDER

  • If you or a family member has symptoms of urge incontinence and are causing you problems.
  • Pelvic discomfort or burning with urination occurs, or if symptoms occur daily.
  • Signs of infection: fever, pain on urination, frequent urination or a general ill feeling.
  • If symptoms do not improve after 3 months of Kegel exercises and medicines.
  • If symptoms become intolerable and you wish to consider surgery.
  • New, unexplained symptoms develop. Drugs used in treatment may produce side effects.

  • MoonDragon's Womens Health Disorders: Cystitis (Bladder Infection)
    MoonDragon's Womens Health Disorders: Stress Incontinence
    MoonDragon's Womens Health Disorders: Interstitial Cystitis (Bladder Wall Inflammation)
    MoonDragon's Womens Health Disorders: Urethritis (Urethra Inflammation)
    MoonDragon's Womens Health Procedures: Cystoscopy
    MoonDragon's Womens Health Procedures: Kegel Exercises
    MoonDragon's Health & Wellness Disorders: Bed Wetting
    MoonDragon's Health & Wellness Disorders: Parkinson's Disease
    MoonDragon's Health & Wellness Disorders: Prostate Cancer
    MoonDragon's Health & Wellness Disorders: Prostatitis






    URINARY INCONTINENCE & BLADDER HEALTH SUPPLEMENT PRODUCTS


    Information for help with bladder infection and cystitis, a condition that occurs when bacteria (usually E. coli that is normally found in the colon) enters the bladder. Products for urinary tract infection, urinary detox and urinary support.

  • Acidophilus Supplement Products
  • AHCC Supplement Products
  • Alfalfa Herbal Products
  • Almond (Sweet) Herbal Oil
  • Amino Acids Complex Products
  • Angelica Herbal Products
  • Anantmul Herbal Products
  • Apple Cider Vinegar Products
  • Apricot Kernel Herbal Oil Products
  • Avocado Herbal Oil Products
  • Bath Therapy Products
  • Bedwetting Supplies Products
  • Beet Herbal Products
  • Beta Carotene Supplement Products
  • Bio-Chlor-Dox Supplement Products
  • Bifidus Supplement Products
  • Bioflavonoids Supplement Products
  • Birch Herbal Products
  • Buchu Herbal Products
  • Burdock Herbal Products
  • Butchers Broom Herbal Products
  • Calcium Products
  • Calcium-Magnesium Complex Products
  • Calendula Herbal Products
  • Carotene Complex Supplement Products
  • Cayenne Herbal Products
  • Celery Herbal Products
  • Chamomile Essential Oil Products
  • Chlorophyll Herbal Products
  • Colloidal Silver Supplement Products
  • Copper Supplement Products
  • Cornsilk Herbal Products
  • Couchgrass Herbal Products
  • Cranberry Herbal Products
  • Cysteine Amino Acid Products
  • Dandelion Herbal Products
  • Diuretic Supplement Products
  • D-Mannose Supplement Products
  • Echinacea Herbal Products
  • Elecampane Herbal Products
  • Essiac Herbal Products
  • Fluid Retention Supplement Products
  • Garlic & Kyolic Garlic Herbal Products
  • Garlicin Supplement Products
  • Gokshura Herbal Products
  • Goldenrod Herbal Products
  • Goldenseal Herbal Products
  • Grapeseed Herbal Oil Products

  • Gravelroot Herbal Products
  • Honeybush Herbal Products
  • Horsetail Herbal Products
  • Hydrangea Herbal Products
  • Incontinence Pads Products
  • Jojoba Herbal Oil Products
  • Juniper Essential Oil Products
  • Juniper Herbal Products
  • Kava Kava Herbal Products
  • Kidney-Bladder Supplement Products
  • Kidney Supplement Products
  • Licorice Herbal Products
  • Magnesium Supplement Products
  • Manganese Supplement Products
  • Marshmallow Herbal Products
  • Molybdenum Supplement Products
  • MSM Supplement Products
  • Multimineral Supplement Products
  • MultiVitamin Supplement Products
  • Nettle Herbal Products
  • Parsley Herbal Products
  • Peach Detox Herbal Products
  • Peppermint Herbal Products
  • Peppermint Essential Oil Products
  • pH Neutral Bath Soap
  • Potassium Supplement Products
  • Prickley Pear Herbal Products
  • Prostactive Supplement Products
  • Prostate Support Formula Products
  • Rose Hips (Rosehips) Herbal Products
  • SAM-3 Supplement Products
  • Sandalwood Essential Oil Products
  • Saw Palmetto Herbal Products
  • Sesame Herbal Oil Products
  • Shilajit Herbal Products
  • Spearmint Herbal Products
  • Theraclear Antiparasite Formula Products
  • Triphala Herbal Products
  • Unscented Soap Products
  • Uva Ursi Herbal Products
  • Vitamin A Supplement Products
  • Vitamin B-Complex Supplement Products
  • Vitamin C Supplement Products
  • Vitamin E Supplement Products
  • Watermelon Herbal Products
  • Whey Supplement Products
  • Wild Carrot Herbal Products
  • Zinc Supplement Products


  • QUALITY SUPPLIES & PRODUCTS


    FTC Advertising & Affilate Disclosure: This website has an affiliate relationship with certain merchants selling products and we recieve commissions from those sales to help support this website. Any products listed here are not listed by any rating system. We do not rate any product or post any feedback about products listed here. We leave this to the individual merchants to provide. We do not provide product prices or shopping carts since you do not order these products directly from us, but from the merchant providing the products. We only provide the link to that merchant webpage with all related product information and pricing. The products are listed here by merchant, product use, quantity size or volume, and for nutritional supplements - dosage per unit. All product descriptions are provided by the merchant or manufacturer and are not our descriptive review of the product. We do not endorse any specific product or attest to its effectiveness to treat any health condition or support nutritional requirements for any individual.


    BATHERAPY PRODUCTS

    Batherapy Mineral Bath Salts helps relief tension and fatigue. Ingredients include Epsom Salt and Siberian Fir Oil. Therapeutic properties of epsom salt to soothe and ease away tension. Siberian Fir Oil to energize and dispel the feeling of tiredness. Creates a rejuvenating spa bath experience. Softens skin and leaves you feeling relaxed and refreshed. Queen Helene brand has been a leader in quality and beauty products for professional and personal use since 1930. Our products are inspired by nature's finest ingredients because they are safer, and often more effective, than harsh chemicals and unnecessary additives. We are proud to have created a full line of affordable and effective body care products that are still passed on from generation to generation.

    AMAZON PRODUCTS

    Amazon: Batherapy Beauty & Personal Care Products


    Amazon: Batherapy Mineral Bath Salts, Original Scent, Queen Helene, 20 lbs.



    Amazon: Batherapy Mineral Bath Salts, Original Scent, Queen Helene, 5 lbs



    Amazon: Batherapy Natural Mineral Bath Salts, Lavender Scented, Queen Helene, 5 lb.



    Amazon: Batherapy Natural Mineral Bath Salts, Original Scent, Queen Helene, 2 lb.



    Amazon: Batherapy Natural Mineral Bath Salts, Lavender Scented, Queen Helene, 1.5 oz. Package (Case of 12)



    Amazon: Batherapy Natural Mineral Bath Salts, Original Scent, Queen Helene, 1.5 oz. Package (Case of 12)



    Amazon: Baththerapy Sport Natural Mineral Bath Powder, Queen Helene, 16 oz.



    Amazon: Batherapy Mineral Bath Liquid, Original Scent, Queen Helene, 16 oz. (Pack of 3)



    Amazon: Baththerapy Mineral Bath Liquid Sport, Queen Helene, 16 oz. (Pack of 6)








    MoonDragon's Womens Health Index

    | A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z |






    Health & Wellness Index





    AROMATHERAPY: ESSENTIAL OILS DESCRIPTIONS & USES


    Allspice Leaf Oil
    Angelica Oil
    Anise Oil
    Baobab Oil
    Basil Oil
    Bay Laurel Oil
    Bay Oil
    Benzoin Oil
    Bergamot Oil
    Black Pepper Oil
    Chamomile (German) Oil
    Cajuput Oil
    Calamus Oil
    Camphor (White) Oil
    Caraway Oil
    Cardamom Oil
    Carrot Seed Oil
    Catnip Oil
    Cedarwood Oil
    Chamomile Oil
    Cinnamon Oil
    Citronella Oil
    Clary-Sage Oil
    Clove Oil
    Coriander Oil
    Cypress Oil
    Dill Oil
    Eucalyptus Oil
    Fennel Oil
    Fir Needle Oil
    Frankincense Oil
    Geranium Oil
    German Chamomile Oil
    Ginger Oil
    Grapefruit Oil
    Helichrysum Oil
    Hyssop Oil
    Iris-Root Oil
    Jasmine Oil
    Juniper Oil
    Labdanum Oil
    Lavender Oil
    Lemon-Balm Oil
    Lemongrass Oil
    Lemon Oil
    Lime Oil
    Longleaf-Pine Oil
    Mandarin Oil
    Marjoram Oil
    Mimosa Oil
    Myrrh Oil
    Myrtle Oil
    Neroli Oil
    Niaouli Oil
    Nutmeg Oil
    Orange Oil
    Oregano Oil
    Palmarosa Oil
    Patchouli Oil
    Peppermint Oil
    Peru-Balsam Oil
    Petitgrain Oil
    Pine-Long Leaf Oil
    Pine-Needle Oil
    Pine-Swiss Oil
    Rosemary Oil
    Rose Oil
    Rosewood Oil
    Sage Oil
    Sandalwood Oil
    Savory Oil
    Spearmint Oil
    Spikenard Oil
    Swiss-Pine Oil
    Tangerine Oil
    Tea-Tree Oil
    Thyme Oil
    Vanilla Oil
    Verbena Oil
    Vetiver Oil
    Violet Oil
    White-Camphor Oil
    Yarrow Oil
    Ylang-Ylang Oil
    Aromatherapy
    Healing Baths For Colds
    Aromatherapy
    Herbal Cleansers
    Using Essential Oils


    AROMATHERAPY: HERBAL & CARRIER OILS DESCRIPTIONS & USES


    Almond, Sweet Oil
    Apricot Kernel Oil
    Argan Oil
    Arnica Oil
    Avocado Oil
    Baobab Oil
    Black Cumin Oil
    Black Currant Oil
    Black Seed Oil
    Borage Seed Oil
    Calendula Oil
    Camelina Oil
    Castor Oil
    Coconut Oil
    Comfrey Oil
    Evening Primrose Oil
    Flaxseed Oil
    Grapeseed Oil
    Hazelnut Oil
    Hemp Seed Oil
    Jojoba Oil
    Kukui Nut Oil
    Macadamia Nut Oil
    Meadowfoam Seed Oil
    Mullein Oil
    Neem Oil
    Olive Oil
    Palm Oil
    Plantain Oil
    Plum Kernel Oil
    Poke Root Oil
    Pomegranate Seed Oil
    Pumpkin Seed Oil
    Rosehip Seed Oil
    Safflower Oil
    Sea Buckthorn Oil
    Sesame Seed Oil
    Shea Nut Oil
    Soybean Oil
    St. Johns Wort Oil
    Sunflower Oil
    Tamanu Oil
    Vitamin E Oil
    Wheat Germ Oil





    HELPFUL RELATED MOONDRAGON NUTRITION BASICS LINKS

  • MoonDragon's Nutrition Basics Index
  • MoonDragon's Nutrition Basics: Amino Acids Index
  • MoonDragon's Nutrition Basics: Antioxidants Index
  • MoonDragon's Nutrition Basics: Enzymes Information
  • MoonDragon's Nutrition Basics: Herbs Index
  • MoonDragon's Nutrition Basics: Homeopathics Index
  • MoonDragon's Nutrition Basics: Hydrosols Index
  • MoonDragon's Nutrition Basics: Minerals Index
  • MoonDragon's Nutrition Basics: Mineral Introduction
  • MoonDragon's Nutrition Basics: Dietary & Cosmetic Supplements Index
  • MoonDragon's Nutrition Basics: Dietary Supplements Introduction
  • MoonDragon's Nutrition Basics: Specialty Supplements
  • MoonDragon's Nutrition Basics: Vitamins Index
  • MoonDragon's Nutrition Basics: Vitamins Introduction


  • NUTRITION BASICS ARTICLES

  • MoonDragon's Nutrition Basics: 4 Basic Nutrients
  • MoonDragon's Nutrition Basics: Avoid Foods That Contain Additives & Artificial Ingredients
  • MoonDragon's Nutrition Basics: Is Aspartame A Safe Sugar Substitute?
  • MoonDragon's Nutrition Basics: Guidelines For Selecting & Preparing Foods
  • MoonDragon's Nutrition Basics: Foods That Destroy
  • MoonDragon's Nutrition Basics: Foods That Heal
  • MoonDragon's Nutrition Basics: The Micronutrients: Vitamins & Minerals
  • MoonDragon's Nutrition Basics: Avoid Overcooking Your Foods
  • MoonDragon's Nutrition Basics: Phytochemicals
  • MoonDragon's Nutrition Basics: Increase Your Consumption of Raw Produce
  • MoonDragon's Nutrition Basics: Limit Your Use of Salt
  • MoonDragon's Nutrition Basics: Use Proper Cooking Utensils
  • MoonDragon's Nutrition Basics: Choosing The Best Water & Types of Water





  • RELATED MOONDRAGON HEALTH LINKS & INFORMATION

  • MoonDragon's Nutrition Information Index
  • MoonDragon's Nutritional Therapy Index
  • MoonDragon's Nutritional Analysis Index
  • MoonDragon's Nutritional Diet Index
  • MoonDragon's Nutritional Recipe Index
  • MoonDragon's Nutrition Therapy: Preparing Produce for Juicing
  • MoonDragon's Nutrition Information: Food Additives Index
  • MoonDragon's Nutrition Information: Food Safety Links
  • MoonDragon's Aromatherapy Index
  • MoonDragon's Aromatherapy Articles
  • MoonDragon's Aromatherapy For Back Pain
  • MoonDragon's Aromatherapy For Labor & Birth
  • MoonDragon's Aromatherapy Blending Chart
  • MoonDragon's Aromatherapy Essential Oil Details
  • MoonDragon's Aromatherapy Links
  • MoonDragon's Aromatherapy For Miscarriage
  • MoonDragon's Aromatherapy For Post Partum
  • MoonDragon's Aromatherapy For Childbearing
  • MoonDragon's Aromatherapy For Problems in Pregnancy & Birthing
  • MoonDragon's Aromatherapy Chart of Essential Oils #1
  • MoonDragon's Aromatherapy Chart of Essential Oils #2
  • MoonDragon's Aromatherapy Tips
  • MoonDragon's Aromatherapy Uses
  • MoonDragon's Alternative Health Index
  • MoonDragon's Alternative Health Information Overview
  • MoonDragon's Alternative Health Therapy Index
  • MoonDragon's Alternative Health: Touch & Movement Therapies Index
  • MoonDragon's Alternative Health Therapy: Touch & Movement: Aromatherapy
  • MoonDragon's Alternative Therapy: Touch & Movement - Massage Therapy
  • MoonDragon's Alternative Health: Therapeutic Massage
  • MoonDragon's Holistic Health Links Page 1
  • MoonDragon's Holistic Health Links Page 2
  • MoonDragon's Health & Wellness: Nutrition Basics Index
  • MoonDragon's Health & Wellness: Therapy Index
  • MoonDragon's Health & Wellness: Massage Therapy
  • MoonDragon's Health & Wellness: Hydrotherapy
  • MoonDragon's Health & Wellness: Pain Control Therapy
  • MoonDragon's Health & Wellness: Relaxation Therapy
  • MoonDragon's Health & Wellness: Steam Inhalation Therapy
  • MoonDragon's Health & Wellness: Therapy - Herbal Oils Index





  • MOONDRAGON'S MERCHANT VENDORS & PRODUCTS




    Starwest Botanicals












    Educational materials and health products are available through Amazon.com.
    Use the search box provided below to search for a particular item.














    Kalyx.com Herbs, Foods, Supplements, Bath & Body


    Chinese Herbs Direct


    Ayurvedic Herbs Direct


    Pet Herbs Direct


    ShareASale Merchant-Affiliate Program








    MOONDRAGON'S REALM - WEBSITE DIRECTORY


    A website map to help you find what you are looking for on MoonDragon.org's Website. Available pages have been listed under appropriate directory headings.




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