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Suggest Treatment For Urinary Incontinence Caused Due To Spastic Bladder
Question: I had a prostectomy years ago it caused me to not be able to retain my water. That became controlable but recently returned with spasems which made it very painful to try to hold my water even when my bladder is almost empty. I take imipramine which prevents the slow leek but does not prevent the spasems. What should i do?
Brief Answer:
spastic bladder
Detailed Answer:
Hi,
Thank you for contacting HCM. Different measures that may help you with spastic bladder includes.
1. scheduled urination at every 1.5 to 2 hours.
2. Please Consult your doctor regarding Kegel exercise which may help with relaxation of bladder and help you with the bladder spasms.
3. One group of drugs that are used is anticholinegics. They include tolterodine tartrate (Detrol LA), oxybutynin chloride (Ditropan), darifenacin (Enablex), oxybutynin (Oxytrol), trospium chloride (Sanctura XR), and solifenacin (Vesicare). A common side effect is dry mouth. Out of these you used Sanctura which you say doesn't help the leak. You may combine the use of anticholinergic a different one from the list with the alpha blocker such as terazosin which relaxes the bladder and helps it to completely empty it. Terazosin can cause orthostatic hypotension.
4. The problem with combining anticholinergic with imipramine is the increased anticholinergic activity which has to be monitored very closely so that is not a very good combination to use.
5.Electrical stimulation implant (Inter-Stim). This is placed under the skin to deliver gentle electrical pulses to the bladder at regularly timed intervals. Your doctor may recommend this therapy if you have severe bladder spasms and urge incontinence that does not get better with other treatments.
You should consult a nephrologist regarding these options which would better suit you. Thank you
Dr. Khan
spastic bladder
Detailed Answer:
Hi,
Thank you for contacting HCM. Different measures that may help you with spastic bladder includes.
1. scheduled urination at every 1.5 to 2 hours.
2. Please Consult your doctor regarding Kegel exercise which may help with relaxation of bladder and help you with the bladder spasms.
3. One group of drugs that are used is anticholinegics. They include tolterodine tartrate (Detrol LA), oxybutynin chloride (Ditropan), darifenacin (Enablex), oxybutynin (Oxytrol), trospium chloride (Sanctura XR), and solifenacin (Vesicare). A common side effect is dry mouth. Out of these you used Sanctura which you say doesn't help the leak. You may combine the use of anticholinergic a different one from the list with the alpha blocker such as terazosin which relaxes the bladder and helps it to completely empty it. Terazosin can cause orthostatic hypotension.
4. The problem with combining anticholinergic with imipramine is the increased anticholinergic activity which has to be monitored very closely so that is not a very good combination to use.
5.Electrical stimulation implant (Inter-Stim). This is placed under the skin to deliver gentle electrical pulses to the bladder at regularly timed intervals. Your doctor may recommend this therapy if you have severe bladder spasms and urge incontinence that does not get better with other treatments.
You should consult a nephrologist regarding these options which would better suit you. Thank you
Dr. Khan
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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