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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 a doctor 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.
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.
MoonDragon's Obgyn Information: 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 doctors 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 stress incontinence include physical changes resulting from pregnancy, childbirth and menopause. It is the most common form of incontinence in women and is treatable. 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. 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.
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).
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 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.
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:
- Alzheimer's disease
- Diabetes mellitus
- Multiple sclerosis
- Parkinson's disease
- Ruptured intervertebral disk
- Stroke
- Syphilis
- Traumatic brain or upper spinal-cord injury
- Tumors located in the brain or spinal cord
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.
RISK INCREASES WITH
Central nervous system disorders (stroke, Parkinson's).
Obesity.
Surgery that may traumatize the urethra.
Injury of the urethra from any cause.
PREVENTIVE MEASURES
Eat a normal, well-balanced diet and 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.
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 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.
KEGEL EXERCISE: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.
EXPECTED OUTCOME
There are several different forms of treatment available, some still experimental. If the first treatment techniques don't 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.
Instant improvement is unusual. Perseverance and patience are usually required to see improvement. A small number of people need surgery to control their symptoms.
POSSIBLE COMPLICATIONS
Skin problems.
Urinary tract infections.
Social isolation due to concern about embarrassment. Physical complications are rare, but psychosocial problems may arise, particularly if incontinence results from an inability to get to the bathroom when urgency arises.
TREATMENT
GENERAL MEASURES
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.
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.
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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 1/2 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:Help for Incontinence People
P.O. Box 54
Union, SC 29379
(803) 579-7900
or
Simon Foundation
(800) 23-SIMON
MEDICATION
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 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 (Ditropan®XL) 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®), 1-8 mg, once daily
- Tamulosin hydrochloride (Flomax®), 0.4-0.8 mg, once daily
- Terazosin hydrochloride (Hytrin®), 1-10 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 2-4 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
Antibiotics may be prescribed if there is a complicating urinary tract infection.
ACTIVITY
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
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.
- Multivitamin and 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.
URINARY INCONTINENCE SUPPLEMENTAL PRODUCTS
Information, supplements and products for urinary incontinence, the involuntary release of urine.
NUTRITIONAL SUPPLEMENTS
NUTRIENTS Supplement Suggested Dosage Comments Very Important Free-Form Amino Acid Complex As directed on label. Helps to strengthen bladder muscle. Use a product made from a vegetarian source. Branched Chain Amino Acid Powder, Now Foods, 12 oz., Branched Chain Amino Acids, Free Form, 120 Caps Important Calcium
And
Magnesium1,500 mg daily.
750 mg daily.To aid in controlling bladder spasms. Just An Ounce Calcium & Magnesium Liquid Supplement, Almond Flavor, 16 oz. Helpful Vitamin E 200 IU daily or 400 IU every other day. Use d-alpha-tocopherol form. Vitamin E d-alpha tocopherol, Nature's Way, 400 IU, 100 Softgels Vitamin A
Plus
Natural beta-carotene
Or
Carotenoid complex (Betatene)As directed on label. If you are pregnant, do not exceed 10,000 IU daily. Antioxidants that enhance immunity and to aid in normalizing bladder muscle function. Vitamin A, 10,000 IU, 100% Natural, Nature's Way, 100 Softgels, Beta Carotene (Natural Dunaliella salina), Nature's Way, 100% Nature, 25,000 IU, 100 Softgels, Multi-Carotene Antioxidant Complex, Nature's Way, 60 Softgels Zinc 80 mg daily. Do not exceed a total of 100 mg daily form all supplements. Important for improved bladder function. Also enhances the immune system. Use zinc gluconate lozenges or OptiZinc for best absorption. Zinc (Chelated), 100% Natural, Nature's Way, 30 mg, 100 Caps, Zinc Lozenges W/ Echinacea & Vitamin C, Nature's Way, 23 mg, 60 Lozenges, Zinc Ionic Mineral Supplement, Fully Absorbable, 100 +/- ppm, 16 fl. oz. Potassium 99 mg daily. Aids in balancing sodium and potassium in the body. Potassium, 100% Natural, Nature's Way, 99 mg, 100 Caps, Potassium Ionic Mineral Supplement, Fully Absorbable, 340 +/- ppm, 16 fl. oz.
Opuntia (Prickly Pear), Nature's Way 250mg - 100 Caps
Nature's Way Opuntia prickly pear flowers (Opuntia ficus-indica) were traditionally used as medicine for male urinary discomforts. It was also used externally as an ointment.Vitamin C 1000 with Bioflavonoids, Nature's Way, 100% Natural, 1000mg - 250 Vcaps
Nature's Way Vitamin C with Bioflavonoids provides antioxidant protection for many of the body's important enzyme systems.U I Check, Urinary Incontinence Product, 100% Natural, 500mg - 60 Caps
U-I-Check consists of 38 natural herbs to relieve the Low-Yang symptoms including: involuntary urine leaks such as Urinary Incontinence, Bed-Wetting, etc. related to symptoms of aging and stress.Kidney Bladder Formula w/ Uva Ursi, Nature's Way 465mg - 100 Caps
Nature's Way Kidney Bladder Formula contains Uva Ursi ( Bearberry ) and Juniper berry, two historically popular for kidney and bladder complaints.Kidney / Bladder Formula Tincture, 100% Organic - 2 fl. oz.
Use the Kidney Bladder Formula for Auto-immune Diseases, Bladder, Cancer, Cold Sores and deposits.Urinary Formula w/ Cranberry Fruit, 480mg (per cap) - 100 Caps
Urinary formula uses concentrated cranberry fruit, to maintain a healthy urinary tract and Dandelion leaf, traditionally used for supporting regular urination.Prostate Formula w/ Saw Palmetto - 60 Caps
Prostate Formula promotes prostate health by utilizing a host of beneficial supplements. Including, Saw Palmetto extract, a widely researched phyto-medicine that promotes prostate health. Zinc, an essential nutrient abundantly found in reproductive and prostate fluids, and Dandelion leaf, a popular herb traditionally used for supporting regular urination.Leak Control, Incontinence Treatment, TCM Formula Ludi Kongquan, 100% Natural, 500mg - 60 Caps
A formulation of Chinese herbs used to strengthen the urinary muscles and enhance urine withholding power providing help for those suffering from incontinence.Prostol Prostate Formula Nature's Way - 120 Softgels
Prostol is the only prostate proven to be a "dual enzyme inhibitor," and to be more effective than Saw Palmetto alone.Cranberry Extract STD w/ Ester C, Nature's Way 400mg - 120 Tabs
Cranberry Extract with Ester is primarily useful for female adults and those with chronic or recurrent urinary tract infection. used to prevent urinary tract infection and relieve cramps and spasms. It also helps maintain a healthy urinary tract by inhibiting the adhesion of E. coli bacteria to the lining of the bladder.Vitamin A, 10,000 IU, 100% Natural - 100 Softgels
Nature's Way Vitamin A is an important nutrient in maintaining cell membrane integrity. It also plays an important role in proper bone formation, reproduction and vision.Manganese Ionic Mineral Supplement, Fully Absorbable, 30 +/- ppm - 16 fl. oz.
WaterOz Ionic Manganese is a pure liquid Manganese supplement. Manganese, also called the "brain mineral," is important in the utilization of all mental facilities/functions.Saw Palmetto Standardized Extract, 160mg - 60 Softgels
A liposterolic extract of the fruit of Saw Palmetto is the most popular herbal supplement for the promotion of prostate health in Europe. Saw Palmetto is the ideal supplement for men interested in supporting normal urinary flow.Grape Seed Extract, Standardized, Nature's Way 100mg - 30 Caps
Grape seeds (Vinis vinifera) are an excellent source of oligomeric proanthocyanidins (OPCs) and have been the subject of clinical research in France for their antioxidant activity. Antioxidants play an important role in the development of collagen including skin, connective tissue and vascular walls.Fem-Mend Formula w/ Blessed Thistle, Nature's Way 430mg - 100 Caps
Fem-Mend combines herbs like Uva Ursi, Cramp bark, Blessed thistle and others made for women to maintain a healthy lifestyle. The herbs found in Nature's Way Fem-Mend are used in herbal combinations world-wide and are valued by the modern women who use them.Horsetail Herb Grass, Nature's Way 440mg - 100 Caps
Horsetail herb is rich in "beauty" nutrients that nourish the nails, skin, hair, bones and the body's connective tissue. It is also benefits the glands and urinary tract. Horsetail helps heal fractured bones because of its rich supply of nutrients.Corn Silk, Nature's Way 425mg - 100 Caps
Corn Silk (Zea mays) was used traditionally as a mild diuretic. It is often included in herbal preparations for the bladder and urinary tract. Used by Native Americans for urinary complaints.Energy Drink, Ola Loa Vitamin Energy Supplement Powder Drink Mix, Orange Repair - 30 Packets
Ola Loa is the most extensive vitamin and mineral supplement available in a great tasting effervescent energy drink.
Mountain Rose Bulk Herbs
Mountain Rose Aromatherapy Oils
Mountain Rose Herbs, Aromatherapy Oils A-B
Mountain Rose Herbs, Aromatherapy Oils C-E
Mountain Rose Herbs, Aromatherapy Oils F-L
Mountain Rose Herbs, Aromatherapy Oils M-P
Mountain Rose Herbs, Aromatherapy Oils Q-Z
Mountain Rose Herbs, Aromatherapy Oils: Oil Blends & Resins
Mountain Rose Herbs, Aromatherapy Oils: Diffusers, Nebulizers, & Burners
Mountain Rose Herbs, Aromatherapy Oils: Oil Kits
Click Here To Visit Herbal Remedies Product Page
HELPFUL INCONTINENCE PRODUCTS
(Amazon.com has approximately 2,500 products listed under incontinence. I have tried to select an assortment of various products. If you don't see something in a correct size or brand, most likely they have it, but I didn't include it here for lack of space. You can contact me if you have specific needs and I will try to locate it and send you the link to the product. You can email me at moondragon2@aol.com. Put incontinence products needed in the subject line.)
NOTIFY YOUR MIDWIFE OR 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.
Symptoms don't improve after 3 months of Kegel exercises and medicines, or symptoms become intolerable and you wish to consider surgery.
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
