Overactive bladder common

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Overactive bladder and other urinary problems may be much more common than previously thought, according to a new survey of patients waiting to see their primary care doctors.

Sixty percent of men and nearly half of women in the study reported having overactive bladder, which is characterized by frequent trips to the bathroom to urinate, getting up at night to urinate, and some degree of incontinence, Dr. Miriam Vincent of SUNY Downstate Medical Center in Brooklyn, New York, and her colleagues found.

First sign of diabetes
Vincent told Reuters Health she and her team were "shocked" by how many patients reported urinary problems. These problems are not only troubling for the patients themselves, the researcher said.

Urinary incontinence, she noted, is a leading reason for people being placed in nursing homes by relatives who no longer want to care for them at home.

Moreover, Vincent pointed out, urinary incontinence may be the first sign of diabetes in some people.

How the survey was done
Vincent and her team passed out 325 questionnaires on urinary symptoms to patients visiting a family medicine outpatient clinic, and received 311 complete responses. About three-quarters of the study participants were women, and about three-quarters were African American.

Among men, 60.5 percent reported having overactive bladder, as did 48.3 percent of women. Obese women were more likely to have these symptoms, especially if they were younger than 55. Three-quarters of the men with overactive bladder had incontinence, while 82.9 percent of women with overactive bladder symptoms reported urine leakage.

The prevalence of overactive bladder was double that found by previous studies, Vincent and her team note.

Pinpointing the cause essential
Vincent also noted that companies that make drugs for treating overactive bladder have been marketing them heavily, and while these drugs can be effective, they also have side effects.

For example, she noted, they are not indicated for people with glaucoma or slow heart rate, and can cause dry mouth and constipation.

Pinpointing the cause of a person's urinary problems is essential before appropriate treatment can be initiated, the researcher said. Some people have incontinence due to inactivity of the nerves controlling bladder function, and may need to drain their own urine with a catheter.

For people with incontinence related to pelvic muscle weakness, exercises called Kegels may be helpful, she added, while for men incontinence related to swelling of the prostate can be treated with drugs or surgery.

People who have urinary problems should tell their doctor, Vincent advised. Even though it's not perfect, she added, "there is some help out there".(Anne Harding/Reuters Health)

SOURCE: BMC Family Practice, published online January 23, 2009.

Read more:
Always running to the loo?

February 2009

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