Treatment of overactive or neurogenic bladder
Treatment of overactive or neurogenic bladder
from h-b-f.info
The means and the method chosen for management and treatment of neurogenic or overactive bladder depend on the underlying cause and severity of the symptoms that affect life quality. Other factors that may dictate the kind of therapy are the person's medical history, age and psychological state. The appropriate treatment for overactive or neurogenic bladder will be determined by an urologist, after a detailed medical history is taken, a clinical examination is done and necessary laboratory test, including urinalysis, are performed. The above actions are required, in order underlining causative medical conditions or any further complications to be identified and addressed accordingly. In a case of a secondary infection, for instance, antibiotics may be prescribed. In other cases, different medications may be used or biofeedback and surgery may be the most preferable options.
In cases of persisting overactive or neurogenic bladder, a healthcare provider may ask for more specialized diagnostic procedures, such as urodynamic and endoscopic tests, in order further data to be collected and the treatment plan to be revised.
Medications for overactive or neurogenic bladder.
Medicines are prescribed to ease the severity of urge incontinence and to control the bladder function. When it comes to treatment of overactive or neurogenic bladder there are numerous kinds of medications that can be used alone or in combination.
Anticholinergic, antimuscarinic, antispasmodic agents.
These drugs block the attachment of a neurotransmitter called acetylcholine to specific sites on the bladder muscle and can prevent inappropriate contractions.
Propantheline (Pro-Banthine). This drug used to be the prominent pharmacological choice for urge incontinence treatment, since it is relatively inexpensive and effective. This medication may cause dry mouth, stomach discomfort, constipation, flushing, headache, blurred vision, drowsiness, reduced sweating or thirst. Nowadays, propantheline is hardly used and it has been replaced by other medications as you will read below.
Tolterodine tartrate (Detrol) and Oxybutynin chloride (Ditropan) are drugs that make the smooth muscle of the bladder to relax. These two medications are the most widely used for overactive or neurogenic bladder treatment. Patients should expect improvement in terms of symptoms within a month. The two drugs have widely replaced Pro-Banthine, since they cause far fewer side-effects. However, constipation and dry mouth may occur. Patients with angle closure glaucoma should not take these medicines.
Apart from Detrol, other brand-names for tolterodine tartrate are Tolterodina and Tolterodinum.
Tricyclic antidepressants.
Tricyclic antidepressants, such as Elavil or Endep, have also been tried to treat overactive or neurogenic bladder due to their ability of relaxing the relevant smooth muscle or restraining the organ's contraction. These medications are prescribed in lower dosages, than they would be used for depression treatment. Tricyclic antidepressants are used for their numerous pharmaceutical effects. Apart from the pain relief and sedative properties, these agents have the ability to decrease urinary To the topfrequency. Side-effects may include dry mouth, anorexia, fatigue, dizziness, blurred vision, insomnia, constipation, nausea and occasional fluctuations of blood glucose.
The most common tricyclic antidepressants used to treat overactive or neurogenic bladder are the Elavil, Endep, Surmontil, Tofranil and Sinequan.
We strongly recommend generic forms of a medicine, whenever they are available, rather than brand-names.
Surgical treatment for overactive or neurogenic bladder.
The aim of any surgical treatment of overactive or neurogenic bladder is to increase the urine accommodation in the bladder and to decrease the pressure in this organ. The option of surgery is chosen in cases that medications have not helped and for patients who have severe inappropriate bladder contractions and are exhausted by such a situation.
Augmentation cystoplasty or bladder augmentation is the most popular surgical treatment of overactive and neurogenic bladder. With this reconstructive surgical method, intestinal segments (sigmoid colon) are removed and added to the bladder wall to increase its capacity and to reduce the pressure, during urine storage.
Possible complications are similar to any of those caused by an extensive surgery in the abdominal area. Such complications can be bowel obstruction, hernia, blood clots, pneumonia and infections.
In post surgical period, there is a possibility of development of urinary fistula, which is an abnormal tube-like passage that results in pathologic, lateral urine discharge, urinary tract infection and significant difficulty in urination.
Diet for treatment of overactive or neurogenic bladder.
In some cases, a pattern of controlled intake of fluids is recommended, apart from any other treatments of overactive or neurogenic bladder. This method aims to spread the fluids intake during the day. This can prevent the bladder to accommodate a large amount of urine at once.
Certain foods can make the bladder more functional than normal and can lead to more frequent urination. Therefore, foods or beverages, like coffee, tea, fizzy drinks, citrus fruits and spicy dishes are recommended to be avoided, if possible.
Biofeedback therapy for overactive or neurogenic bladder treatment.
Biofeedback therapy aims to make the patient aware of signs of incontinence incidents. By this method the person is trained to delay urination, if needed, and to discharge the content of the bladder properly. Biofeedback therapy has been proved effective in 75% of the cases. Occasionally, electrical stimulation and biofeedback therapy may be used in combination for treatment of overactive or neurogenic bladder. Kegel exercises can be very beneficial, as well.
For more information about causes, incidence, symptoms and diagnosis of the condition try the Overactive and Neurogenic Bladder page.
