DEAR DR. DONOHUE: I have to run to the bathroom all day long. If I don’t make it in time, I have an accident. This has made me so nervous that I have given up on all thoughts of a social life. It’s ruining my life. If we go to a restaurant, I must have a table near the restrooms, or I won’t sit down. What can be done? I’ll try anything. — P.G.
ANSWER: Your condition is an overactive bladder. Sudden, inappropriate and forceful contractions of the bladder wall muscles make it imperative for you to rush to the bathroom or you lose control of urine. Such bladder muscle contractions shouldn’t occur until the bladder is full or nearly full. For some reason, your bladder reacts violently when it’s only partially full. Conditions like a bladder infection can be a cause. Often, however, muscle contractions take place without any cause ever being found. You have to see a doctor who can look for things that are easily treated, like an infection.
If no cause is discovered, then you can reprogram your bladder to not react like this when it’s only partially filled. For two days, time the intervals between bathroom visits. Add 5 minutes to the shortest interval and hold off on urinating for that time interval for a week. On week two, increase the interval by 15 minutes. Keep this up for a month, and then increase the interval by half an hour. Every two weeks, add another half hour to the interval between bathroom visits. When you reach three hours, you can stop.
You also can ask your doctor for prescription medicines that quiet bladder muscles. Detrol, Sanctura, Vesicare and Enablex are names of some of these medicines.
Another technique involves injecting the bladder muscles with Botox. Botox weakens the force of bladder muscle contractions and allows you to hold urine for more-normal intervals.
In extreme circumstances, a gynecologic urologist can advise you if a battery-operated device attached to the bladder is something you could consider. It stops frequent, unwanted and unneeded bladder contractions.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him at P.O. Box 536475, Orlando, FL 32853-6475.
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