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Overactive Bladder: When You Have to Go, Go, Go

WebMD Health News
Reviewed by Gary D. Vogin, MD

April 13, 2001 -- Kim Dunn knew there was something wrong when she had to use the bathroom every 15 minutes. "When I went, it seemed like I had to go really, really bad," she tells WebMD. "I knew that wasn't a normal pattern."

But the 45-year-old resident of Gardena, Calif. suffered with the symptoms for nearly five years before she got some help. Though she had sometimes mentioned the problem to her doctor, she rarely pressed the issue and the symptoms were never treated.

"When I went to the doctor I would mention it," she says, "but they never did anything about it -- maybe because it was never the main reason I went to the doctor."

Finally, a little over a year ago, Dunn saw an advertisement for a clinical trial of drugs to treat overactive bladder. She sought some information, and received a written test to determine if she was a candidate. "That was the first time I knew what I had," Dunn tells WebMD. "It turned out I was a lovely candidate."

Experts say that Dunn is not alone -- either in her symptoms or in the failure to get them addressed. An estimated 17 million Americans may have overactive bladder resulting in a frequent need to urinate, greater than normal urgency and -- sometimes -- incontinence. Many cases go unrecognized and untreated, often because patients are reluctant to talk about it.

"People are embarrassed about this," Daniel S. Elliott, MD, an assistant professor of urology at the Mayo Clinic in Rochester, Minn., tells WebMD. "They don't talk about it to their doctor, even though it's a very common problem, far more common than asthma. This is very definitely a quality-of-life issue. Some patients lock themselves in their house because they are too embarrassed to go out."

Yet Elliott and others say overactive bladder can be successfully treated -- with drugs or a host of nondrug strategies including exercises to train the bladder muscles, or a combination of both.

The clinical trial Dunn participated in was a 12-week study of two of the most commonly used medications -- Ditropan XL and Detrol -- to treat overactive bladder. At 37 centers around the country, 378 patients received one of the two medications and were followed for 12 weeks to compare safety and effectiveness.

Results of the trial indicate that the Ditropan XL was as just good as Detrol in terms of side effects but significantly better in resolving symptoms, according to a report that appears in the April edition of Mayo Clinic Proceedings.

"There are now two very fine medications that can help patients who have significant problems with overactive bladder, urinary frequency and urgency, and urge incontinence -- in which patients are not able to get to the bathroom in time," says Rodney A. Appell, MD, author of the report. "Ditropan was shown to be more effective than the Detrol and had an equal ability to reduce the side effects usually associated with medication."

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