Reviewed by Melinda Ratini on October 01, 2014


Anne Wiskind, MD, urogynecologist, Peachtree Gynecology; medical director of the Center for Comprehensive Pelvic Health, Piedmont Hospital. American Urogynecologic Society. National Association for Continence. The Simon Foundation for Continence.

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Video Transcript

Narrator: To observe this 63-year-old grandmother you'd never know she has incontinence.

Nancy, Overactive Bladder Patient: It's almost like gravity pulling, I have to go to the bathroom, and when I have to go, I have to go! And you might not be in the right place and so you have accidents.

Narrator: There are two main types of incontinence:

Dr. Anne Wiskind, MD: One is stress incontinence, usually the leakage with coughing, sneezing, jumping, lifting, stepping off a curb, which is usually due to either a lack of support to the urethra, which is the tube that connects the bladder to the outside or just a very weak sphincter muscle. Come this way and we’ll get the nurses to take your vital signs.

Narrator: The other is urge incontinence that can occur with overactive bladder – or OAB – it's the type Nancy has.

Dr. Anne Wiskind, MD: An overactive bladder or urge incontinence is usually when people have a normal urethra, or a normal anatomy but the bladder muscle contracts when they don't want it to. How has your bladder been with the travel?

Nancy, Overactive Bladder Patient: My bladder sometimes cooperates and sometimes it doesn't.

Narrator: Overactive bladder is a medical problem – and it can be treated.

Dr. Anne Wiskind, MD: A lot of patients will come in and say gosh I had no idea, I just thought it was a normal part of aging and then somebody told me it wasn’t and there was something I could do.

Narrator: Dr. Wiskind advises women to start with behavioral or lifestyle changes that include: timed voids – that is, scheduling regular bathroom trips… Cutting down on caffeinated beverages and alcohol… limiting spicy and acidic foods…and doing regular pelvic floor exercises, or kegels. Once behavioral changes have been adopted, medications can be very effective.

Pharmacist: This medication is to treat an overactive bladder. It works like a smooth muscle relaxant.

Narrator: These medications are known as anticholinergics.

Dr. Anne Wiskind, MD: The bladder muscle wall is filled with cholinergic fibers so these try to help the bladder muscle wall relax and not be so spastic.

Narrator: There are many anticholinergic medications available. How do you know which option is best?

Dr. Anne Wiskind, MD: You don't You really end up sort of going down the line and figuring out which one works There are so many different studies out there and they really show all work about the same.

Narrator: Doctors may also prescribe tricyclic antidepressants or antiduretics. If lifestyle changes and medications don't help, other treatments such as electrical stimulation and surgery may be recommended.

Dr. Anne Wiskind, MD: Is the medication ok?

Narrator: Nancy has made the behavioral changes suggested by her doctor and takes medication… She's also found other ways to live with OAB – to avoid the pull of gravity she avoids long walks and may relax with a book if she knows she'll have a night out.

Nancy, Overactive Bladder Patient: Just don't let it stop you from doing what you want to do.

Dr. Anne Wiskind, MD: There's lots of options and lots of things we can do and sometimes it's very, very simple things that can be done to really improve the quality of life.

Narrator: For WebMD, I'm Rhonda Rowland.