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Suggest Treatment For Overactive Bladder With UTIs And Depression

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Posted on Fri, 11 Apr 2014
Question: Hi, I was diagnosed with an OAB(over active bladder) two years ago. I feel urgency and frequency to urinate sometimes since then. But for the past two months or so I've had a blowing abdomen from just outside of my navel and above my pubic bone with sometimes changes into burning or pains. I have been suffering from lack of energy, loss of appetite and have felt really thirsty and constantly have a dry mouth. I've also feel urgency to urinate sometimes. Could you please advise what kind of doctor(speciality) I should see to look into my problem? By the way, I've checked my urine for many times since I was diagnosed with an OAB, but every time, the result is negative. No bacteria found. Recently, my urine seems to be yellow but no blood or pain when I urinate.
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Answered by Dr. Shafi Ullah Khan (1 hour later)
Brief Answer: OAB needs management, Other symptoms will poof Detailed Answer: Thank you for asking! Overactive bladder has always the strings attached of such presentations of urinary tract infections (UTIs), skin infections and irritation and Anxiety depression. Thats all because of your overly active bladder and until and unless it is managed you will continue having these symptoms. There are many ways to get this detrusor fellow down in its phasic pressures.. Lets talk some. There are 3 main treatment approaches are as follows : 1-Pharmacologic therapy (eg, anticholinergic/antimuscarinic agents) 2-Behavioral therapy (eg, bladder training, biofeedback, pelvic floor muscle therapy, and pelvic floor electrical stimulation) 3-Surgical therapy (eg, neuromodulation and augmentation cystoplasty [rarely necessary]). According to AUA/SUFU guideline , three lines of defences are advised to combat the OAB . They are 1-First-line therapy: Behavioral therapies and education should be offered first; starting antimuscarinic therapies at the same time as behavior therapies may prove clinically beneficial 2-Second-line therapy: Antimuscarinics; extended-release preparations should be used instead of immediate-release preparations when possible; transdermal oxybutynin can also be used 3-Third-line therapy: Sacral neuromodulation or peripheral tibial nerve stimulation (PTNS) for carefully selected patients with severe refractory OAB symptoms or those who are not candidates for second-line therapy and are willing to undergo a surgical procedure; intradetrusor injection of onabotulinumtoxinA is another option. You need -Scheduled toileting -Prompted voiding -Improved access to toilets -Management of fluids and diet -Use of disposable absorbent pads or garments Eliminate dietary caffeine and take adequate dietary fiber. Remember that avoidance of certain foods and beverages (eg, alcohol, spicy foods, nuts, chocolate, high-potassium foods, carbonated and caffeinated beverages) will improve the symptoms of OAB . make a table to see if any foods on the list elicit a particular response and systematically try eliminating one at a time and see if there is any improvement in your symptoms. Adequate fluid intake is important because many persons with OAB restrict fluids in hopes of voiding less; however, concentrated urine will act as a bladder irritant and increase the odds for the symptoms you are currently having. Not always a bacteria is required to indicate a bladder infection. New approaches like neurokinin receptor antagonists, alpha-adrenoceptor antagonists, nerve growth factor inhibitors, gene therapy, and stem cell–based therapies are of considerable interest and you should discuss them with your urologist. You need to stay in touch with your urologist and no new specialty is needed here.You may Consult with a pelvic floor physical therapist.Discuss the options of Anticholinergics(oxybutynin, tolterodine,trospium, darifenacin,solifenacin, fesoterodine), Beta3-adrenergic agonists like Mirabegron /Myrbetriq, Neuromuscular Blockers, Botulinum Toxins like OnabotulinumtoxinA /Botox, Tricyclic antidepressants like imipramine & doxepin and hormones like estrogen. Intra bladder instillation of hyaluronic acids will also help the associated comorbidities of Bladder irritation and UTI like symptoms. I hope it helps. DOnt forget to close the discussion please. May the odds be ever in your favour. S Khan
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shafi Ullah Khan

General & Family Physician

Practicing since :2012

Answered : 3613 Questions

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Suggest Treatment For Overactive Bladder With UTIs And Depression

Brief Answer: OAB needs management, Other symptoms will poof Detailed Answer: Thank you for asking! Overactive bladder has always the strings attached of such presentations of urinary tract infections (UTIs), skin infections and irritation and Anxiety depression. Thats all because of your overly active bladder and until and unless it is managed you will continue having these symptoms. There are many ways to get this detrusor fellow down in its phasic pressures.. Lets talk some. There are 3 main treatment approaches are as follows : 1-Pharmacologic therapy (eg, anticholinergic/antimuscarinic agents) 2-Behavioral therapy (eg, bladder training, biofeedback, pelvic floor muscle therapy, and pelvic floor electrical stimulation) 3-Surgical therapy (eg, neuromodulation and augmentation cystoplasty [rarely necessary]). According to AUA/SUFU guideline , three lines of defences are advised to combat the OAB . They are 1-First-line therapy: Behavioral therapies and education should be offered first; starting antimuscarinic therapies at the same time as behavior therapies may prove clinically beneficial 2-Second-line therapy: Antimuscarinics; extended-release preparations should be used instead of immediate-release preparations when possible; transdermal oxybutynin can also be used 3-Third-line therapy: Sacral neuromodulation or peripheral tibial nerve stimulation (PTNS) for carefully selected patients with severe refractory OAB symptoms or those who are not candidates for second-line therapy and are willing to undergo a surgical procedure; intradetrusor injection of onabotulinumtoxinA is another option. You need -Scheduled toileting -Prompted voiding -Improved access to toilets -Management of fluids and diet -Use of disposable absorbent pads or garments Eliminate dietary caffeine and take adequate dietary fiber. Remember that avoidance of certain foods and beverages (eg, alcohol, spicy foods, nuts, chocolate, high-potassium foods, carbonated and caffeinated beverages) will improve the symptoms of OAB . make a table to see if any foods on the list elicit a particular response and systematically try eliminating one at a time and see if there is any improvement in your symptoms. Adequate fluid intake is important because many persons with OAB restrict fluids in hopes of voiding less; however, concentrated urine will act as a bladder irritant and increase the odds for the symptoms you are currently having. Not always a bacteria is required to indicate a bladder infection. New approaches like neurokinin receptor antagonists, alpha-adrenoceptor antagonists, nerve growth factor inhibitors, gene therapy, and stem cell–based therapies are of considerable interest and you should discuss them with your urologist. You need to stay in touch with your urologist and no new specialty is needed here.You may Consult with a pelvic floor physical therapist.Discuss the options of Anticholinergics(oxybutynin, tolterodine,trospium, darifenacin,solifenacin, fesoterodine), Beta3-adrenergic agonists like Mirabegron /Myrbetriq, Neuromuscular Blockers, Botulinum Toxins like OnabotulinumtoxinA /Botox, Tricyclic antidepressants like imipramine & doxepin and hormones like estrogen. Intra bladder instillation of hyaluronic acids will also help the associated comorbidities of Bladder irritation and UTI like symptoms. I hope it helps. DOnt forget to close the discussion please. May the odds be ever in your favour. S Khan