Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Recurrent Overactive Bladder Despite Taking Medication?
Question: Hello Dr. Sasanka,
Hope your are doing well.
This is regarding my wife who has over reactive bladder due to spinal cord injury since 2008. We visited you in Feb 2014 when you suggested Darifinacin 15 mg along with CISC and controlled water intake. This worked and there was almost no incontinence till now. The incontinence seems to be back since last 1 week. The bladder capacity seems to be significantly reduced. Earlier it could hold for 2-4 hours, which is reduced to 1 hour now. We tried reducing water intake (both quantity and frequency) but that does not help. Do you think the medication stopped working ? Requesting your suggestion for the next steps to control incontinence.
Hope your are doing well.
This is regarding my wife who has over reactive bladder due to spinal cord injury since 2008. We visited you in Feb 2014 when you suggested Darifinacin 15 mg along with CISC and controlled water intake. This worked and there was almost no incontinence till now. The incontinence seems to be back since last 1 week. The bladder capacity seems to be significantly reduced. Earlier it could hold for 2-4 hours, which is reduced to 1 hour now. We tried reducing water intake (both quantity and frequency) but that does not help. Do you think the medication stopped working ? Requesting your suggestion for the next steps to control incontinence.
Brief Answer:
Most likely change of bladder dynamics
Detailed Answer:
Hi,
I think your wife might need to get a repeat if her urodynamics, before which a few basic tests to exclude infection, and to check if her kidneys are swollen, and us the creatinine levels normal. With time, changes in nerve repair are bound to happen, and its manifestation would be a reduction in capacity, and a reduced compliance. Let's hope things are OK. So I suggest at the minimum, an ultrasound of KUB with post void urine evaluation, a serum creatinine, complete urine analysis, culture and sensitivity of urine analysis if required.
Most likely change of bladder dynamics
Detailed Answer:
Hi,
I think your wife might need to get a repeat if her urodynamics, before which a few basic tests to exclude infection, and to check if her kidneys are swollen, and us the creatinine levels normal. With time, changes in nerve repair are bound to happen, and its manifestation would be a reduction in capacity, and a reduced compliance. Let's hope things are OK. So I suggest at the minimum, an ultrasound of KUB with post void urine evaluation, a serum creatinine, complete urine analysis, culture and sensitivity of urine analysis if required.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Really appreciate the quick response.
Can we do all the tests at Star Hospital or you recommend some other place ? Is Urodynamics test available too ? I hope you are still available to meet in Star Hospitals.
Thanks.
Can we do all the tests at Star Hospital or you recommend some other place ? Is Urodynamics test available too ? I hope you are still available to meet in Star Hospitals.
Thanks.
Brief Answer:
Urodynamics to be done elsewhere
Detailed Answer:
Hi again,
We still do not have urodynamics facility at our place. But you are welcome to visit our hospital for the initial review and clinical assessment, following which we can take a call as to whether she needs further evaluation.
Regards.
Urodynamics to be done elsewhere
Detailed Answer:
Hi again,
We still do not have urodynamics facility at our place. But you are welcome to visit our hospital for the initial review and clinical assessment, following which we can take a call as to whether she needs further evaluation.
Regards.
Above answer was peer-reviewed by :
Dr. Sonia Raina
Thanks Dr. Sasanka.
It seems like the bladder capacity is back to normal since past 48 hours, no episode incontinence. The only thing changed is the weather i.e. no rain since 48 hours and it's relatively warm.
Do you think weather (rainy/cold) can be factor ? She is also not getting enough sunlight, can that be related too ?
It seems like the bladder capacity is back to normal since past 48 hours, no episode incontinence. The only thing changed is the weather i.e. no rain since 48 hours and it's relatively warm.
Do you think weather (rainy/cold) can be factor ? She is also not getting enough sunlight, can that be related too ?
Brief Answer:
Yes, could be weather related as well
Detailed Answer:
Hi again,
What you have said is very likely. Incontinence tends to be higher in colder and wet climates. If your wife us comfortable and has normal capacity, not leaking urine, and no fever, there us no reason to change the he meds. Hope her constipation is improved
Regards.
Yes, could be weather related as well
Detailed Answer:
Hi again,
What you have said is very likely. Incontinence tends to be higher in colder and wet climates. If your wife us comfortable and has normal capacity, not leaking urine, and no fever, there us no reason to change the he meds. Hope her constipation is improved
Regards.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Sonia Raina
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
