678 Urinary Tract Issues

I have had UTIs every few weeks for the past year. My doctor treated them with a mini-dose of Macribid for 3 months. They came back two weeks later and are still continuing. Any suggestions? I am in my late 70s.

For radio show Sat. May 3rd.....I have IC (interstitial cystitis) This painful chronic disease has changed my life...Pain, urgency, frequency, painful intercourse, waking every 30 min, to an hour at night to use the bathroom. Going 15 to 25 times a day. I've become depressed, anti-social. I do take Elmirion, prosed, enablex. Is there any cure in the near future. Most people I know look at my problem as a bladder infection. People aren't familiar with IC.

Marilyn

I have had UTI's frequently in the past to the point where my gynecologist would give me a prescription of antibiotics to take with me just in case. I haven't had one in a long time. But I do believe that people can be more prone to them.

But so can animals. My cat had the same problem recently and they managed her diet. She was on a high pH very acidic diet for three months to break up crystals in her urine and is now on a maintenance diet. She was checked just recently and her urine is ok. So all this being said, what is the connection between UTIs and diet. Thanks

what does cloudy urine mean??? i drink 7-8 glasses of water a day... blood work is normal and so is the urine report...

My 8 year old daughter wets her pants about once a day. She has been to a urologist and a pediatric urologist. She does not have a physical problem. Any ideas would be appreciated.

Question for Dr. Kavaler: Any advice about stress incontinence (as opposed to urge incontinence)? Any effective exercises or meds?

I was prescribed Oxytrol patches with oxybutynin. Can this cause memory problems?

I listened to the broadcast and felt that Interstitial Cystitis was not addressed fully. The drug Elmiron only leaves 20% in the bladder to attempt to fix the lining. It almost sounded that if we take care of ourselves it would go away. I have had IC for 17 years and have done just about every treatment and nothing has resolved this issue. I would like to see a show devoted totyally to IC. There are so many of us out there waiting foe answers.

I'm wondering if Dr. Kavaler has any advice regarding Interstitial Cystitis, a condition I was diagnosed with about a year ago.

I'm thirty years old, and I have persistent symptoms of a bladder infection, but my doctors tell me that only diet can make a real difference. My diet has drastically changed, leaving me feeling tired often, I'm sure because I can no longer eat many vegetables, highly concentrated soy products, etc. and I'm probably missing out on lots of important vitamins and nutrients. But vitamin capsules irritate my bladder.

Furthermore, because I am a vegetarian, not eating soy is especially problematic. I'm wondering if 1) the condition is something real and specific or just a catch-all term for an unknown problem and 2) if I'll likely have this the rest of my life, as two different doctors have told me. Any suggestions regarding this condition?

Many thanks!

I'd like to ask Dr. Kavaler a question if I may. Two years ago, I had a transurethral resection of a very small (less than 2.5cm) transitional cell bladder cancer. I was given the option of having bladder instillation chemotherapy, which after discussing benefits and risks with my urologist, I declined. I have been having cystoscopies every three months to evaluate for recurrant tumor...nothing so far. My urologist advised taking increased doses of Vitamins A, E and B6 to decrease risk of recurrance.

My question: is there literature to support this and what is your opinion about vitamin therapy?
Thank your for your time.

I was pleased and disappointed in this morning's show on UTI's. Your guest gave very good information however I got the feeling you were steering her away from discussing the effects of estrogen on urogenital problems. Since all these problems are increased at menopause the hormone connections are very important and it would have been very informative to here the latest research in this area.

I was prescribed Oxytrol patches with oxybutynin. Can this cause memory problems? I am in my late 70s.

Great show May 3rd. Question concerning my 10 year old daughter who has suffered urge incontinence, bladder infections, UTIs for 6 years. We have consulted several Pediatricians, a Urologist and Physical Therapist, changed diet, performed exercises for pelvic floor muscle strength, medication-oxybutinin, Detrol 2 and 4 mg. Nothing has helped and accidents occur daily with pretty embarrassing results. Any suggestions would be greatly appreciated.
Thanks, Nancy

Please pass on this message to Dr. Kavaler. Dr. Kavaler I would like to recommend you become familiar with the work of Dr. Vliet (Her Place, Arizona). She is specializes in treating women with difficult to treat problems. You can listen to her radio show at her web site. I believe you are both science based doctors and could benefit from one another's expertise. Thank you for the show this morning.

Question for Dr. E. Kavaler: Starting as a teenager, I have had stress incontinence where I leak when I sneeze, cough, and exercise.

I am almost 40 now and in the last few months, I have suddenly experienced urine leakage not resulting from sneezing or exercising; I can just be sitting down and then I feel myself leaking. The amount is enough to fill up a pantyliner during the course of the day.

Can you help me understand what's going wrong with my body to suddenly experience leakage without "stress" and how can I treat it?

Druing a tramatic divorce I slowly was not able to urinate. Finally when at a hospital for what I thought was a heart attack, I could not urinate. They catheritized me.

The urologist office referred to me as the 'divorcee who could not pea.'

They gave me a self catheritizeing tube.
They wanted to do a microwave technique to allow me to urinate. Later I was told that I was lucky not to be able to get it done as it is ineffective.

So I am still on flowmax. If I miss a pill, there is no problem. Fortunately, libido has returned after two years.

Should I try to get off the pill, thinking that the urination problem was just from traumatic stress syndrome?

Do you think birth control pills or the type (estrogen to progestin ratio) makes ladies who are likely to get UTI's any more or less likely to get UTI's? Are there any BC pills that you think help the situation?

Unfortunately,I only caught the last 15 minutes of your show this morning. I have been having below-the-belt problems since last summer. My abdomen feels full and very tight all of the time, even on an empty stomach. I have very inconsistent bowel habits and have become focused on keeping myself emptying as often as I think I should be.

I also have a constant mild to moderate vaginal burning, have the urge to urinate frequently, although I can hold it for long periods, but once I empty, it is usually smaller amounts than I've been used to in the past. I also start dribbling urine when I get out of bed in the morning before I can get to the toilet - very frustrating and embarrassing, I'm only 36!!!

I have been to my gynecologist for a vaginal ultrasound, this past winter, in which they found small ovarian cysts, they were gone by the time of my follow-up ultrasound. I then went for a gastroscopy and colonoscopy, both were negative.

I have gone to a walk-in twice this spring with symptoms of UTI. The first time they found trace amounts of blood and ketones and protein, I was given Cipro with no effect. My second visit they found traces of bacteria and blood and lower than normal pH levels, I was given Macrobid with no effect. I've also treated myself twice for a yeast infection.

My gynecologist, whom I visited again last week for my annual, says everything looks good, I may be suffering from bladder spasms, and he gave me samples of Enablex, which don't seem to be helping thus far. I have an appointment with a urologist in mid-June at which point I feel I'll have covered all of the bases!

Do you have any suggestions? Something has definitely changed since last summer. I can deal with the bowel problems, but the racing to the bathroom, and almost not making it, the constant feeling of having to urinate, and the dribbling in the morning, the constant vaginal burning - I'm having a very difficult time accepting these as "normal". Please help!!!

My 80-year-old mother cannot empty her bladder due to cystocele (fallen bladder). This has resulted in constant/chronic bladder infections for more than a year. [Her GYN extracts 2 - 4+ cups of urine via catheter after Mom has emptied her bladder to best of her ability!] The GYN will conduct 'bladder tests' next week, and plans to operate (inserting a graft) on 27 May. I'm curious to know whether Dr. Kavaler has any comment on this problem and the GYN's approach.

In response to the first question regarding the use of macrobid for three months, only to have the infections come back:
Suppression doses of antibiotics, which is a very low dose every night to prevent recurrences, is very effective in many women. The amount of time that any single person needs to stay on the antibiotics is not fixed. It sounds like you may need to stay on it for another three month period. I would discuss that option with your physician.

Great show today - as always! In fact, I contacted the program director at WBUR in Boston to ask if they would consider you in the Boston radio market. Any response from them? As a snow bird, I really hate not being able to listen to your show when I go north.

Oh well, my question for today regarding urinating urgency. Perhaps you could forward this to the Doctor's email for an answer. I am a 65 year old woman, very healthy, good diet, exercise, and do not take any medicines, however, I do have what I consider a bladder problem. Specifically, After emptying what seems like a full bladder, within ten minutes I have the urgency to go again. I do, a fair amount comes out, then a short time later I need to go again. I notice this problem earlier in the day.

Last week it was particularly troublesome - during my golf lesson, I was unable to spread my legs to assume my golf position for fear of wetting my pants, so I sat out the rest of the lesson until I could rush to the bathroom. Some nights I get up every 2-3 hours to void. Other days I can go 8 hours with no problem at all. The problem is not constant but seems to fluctuate. Is it diet, sex, age, prolapse. Some suggestions please, I don't want to go on medicine. It's not better or worse, just annoying and unpredictable. Any thoughts on the matter would be greatly appreciated.
Many thanks, Gerry

I'm 51. I consider my daytime urinary frequency to be "normal," but since about my mid-30s, I have to "go" every time I wake up at night. In fact, I can "go," get back in bed, and if I don't fall asleep right away (i.e., within just a few minutes), I'll feel the need to "go" again--although sometimes I may actually pee less than a tablespoon.
What causes this? Can anything be done for it?

Dear Dr. In listening to your comments on the Peoples Pharmacy this morning (show 678) you mentioned bladder meds that had some effect on memory cells on the brain. Would you be kind enough to indicate the meds that do affect brain cells and the most current ones that don't.
Thank you. SB

I'm in my 60s, and I used to have UTIs 3-4 times a year, despite my drinking large quantities of water daily. This was a life-long problem.

My current family doctor finally suggested several years ago that I see a urologist (the male urologist I saw treats only women). He suggested that I stop drinking soda pop (carbonated drinks such as colas); I was drinking, on average, one per day - sometimes none, almost never more than one. He also stated that caffeine affects some women (I don't drink coffee, so that wasn't a factor for me). He also recommended cranberry juice.

I stopped drinking soda pop, and yes, I really missed it at first, but I got used to it. I hate the taste of cranberry juice, so I tried taking cranberry capsules twice daily. The combination of these two behavior changes seems to have worked. I've only had one UTI in the last three years. That happened when the formulation of the cranberry capsules I was taking was changed, and it took a couple of months for me to find an appropriate substitute brand and dosage. Would I like to drink a Pepsi or a root beer every now and then? Yes, of course, but I SO much DON'T miss the infections! :)

Rado show 678 mentioned the drug VESICARE, but I did not hear what was said about this drug. Can you please tell me what I missed? Thank you.

Years ago I had frequent bladder infections. One time I was vacationing in Florida and visited a urogolist who found e -coli in my urine. Now I not only wipe completely from front to back as I always have done, I use baby wipes( I carry them with me) and have never had another problem.

Dr. Kavaler spoke of drugs that cross into the brain. What cognitive deficits are the possible symptoms?
Specifically, what might Datril cause as a cognitive side effect?
What are the names again please of the three newest drugs that do not present this issue.
Is there a good resource for more information? Thank you.

What is a urethral caruncle and how can it be treated safely. Is this a common problem?

I suffered for more than 10 years from chronic bladder infections. I was prescribed one antibiotic after another. I was placed for a couple of years on prophylactic antibiotics (for prevention) and still the bladder infections continued to recur. I drank cranberry juice until I would almost gag at the thought of it. I almost earned an honorary chair in my doctor's waiting room.

Finally, I got sick of all the antibiotics. Instead of the antibiotics, I started a regimine of taking Cystex and Cranactin before sexual activity and emptying my bladder afterwards. In over ten years, I have only had one bladder infection since. Dr. K. said cranberry supplements are not standardized. Most are not. However, Cranactin reports that it is the "first commercial cranberry supplement to tested for and guaranteed to contain cranberry's bacterial antiherence activity. The CranActin supplement is supported by pharmacokinetic and clinical research."

I don't know if this information can help anyone else...I can only hope so. Dr. K. is wonderful in giving women control of their own antibiotics but believe me, most physicians do not relinquish that control. I know Dr. K. also said women should not have to empty their bladder after sex, but given the alternative and given doctors who required an office visit and urine test before they would provide relief, it was an inconvenience I was willing to accept. The constant fear of recurrence, pain, inconvenience, and cost was a powerful motivator.

Dr. Kavaler, I listened with interest to your show today. I've suffered from painful urination for more than 10 years, and have difficulty in emptying my bladder because of it. I also experience extreme headache (short duration) when I urinate, something like a "brain freeze."

I've been diagnosed with IC, treated with Flomax, Prelief, changed my diet for months at a time, taken prosed, and had 3 dilitation treatments -- barbaric, yes; effective, no. I still have difficulty urinating, it's painful and at times, it just about takes the top of my head off. I've seen women urologists, men urologists, neurologists, primary care physicians, and gyn specialists. I can say that it's no better than 10 years ago and maybe worse. Is there anything at all I can do other than just live with it?

Great show - as always!

My 92 yr. old step-mother has severe dementia, type 2 diabetes, and frequent UTIs. She wears diapers (incontinent) and lives currently in a nursing/rehab home after discharge from hospital. Two weeks ago her blood sugar was 471, she had a UTI and kidneys producing too much acid. (These UTIs really throw her off -- almost comatose. With her dementia, it's hard for her caregivers to catch the UTIs before they happen.) From emergency room, she was admitted for a week in hospital. Better now.

If I can convince her MD, is it OK to put her on a preventive antibiotic schedule as you mentioned on the show?

If so, which one and what dose and length of time might be best?

Thanks so much for any help,
Lydia

I have been treated for over-active bladder. My problem comes a week prior to my period and during my period. If I bend over to change pants, get out of the car after sitting for awhile, I need to go immediately regardless of how much liquid I have taken in. I have had cologen implants, been to Duke--the only suggestions have been to do kegal exercises and biofeedback. Any other suggestions? I am 51 and have have this for 4 years.

My 21 year old daughter was just diagnosed with Interstitial Cystistis. The urologist prescribed Elavil (25mg) a day.

Should she get another opinion?

I'm almost 54 and have been taking Detrol for a year for urge incontinence. It's been like a miracle drug for me. Now I'm concerned I may need to change. Have the studies on Detrol referenced the period of time the women were taking the drug? Should I talk to my GYN now about an immediate change? Thank you.

I heard your answer today during the show that yogurt is not helpful to treat vaginal issues.

My 2 year old granddaughter experiences repeated and severe redness, and a doctor told my daughter to give her yogurt, and they were yeast infections.

We had a laugh today when I told her that unless she was putting the yogurt in Veda's vaginal area at night, that this was not helping!

Do you have enough information to make any [preventive and/or treatment] suggestions? Diet? Vaseline on the area? My daughter does not want to use antibiotics, and has struggled sometimes through these episodes.

Thank you for your work. As a frequent sufferer of UTI's (and I am in my 50's), it was very helpful today.

Thank you for reading the long post.

Regards- CZ

Answer to Maria from Dr. Kavaler:

Unfortunately, or maybe fortunately, the human urinary tract is not very similar to the cat's. Alkalinzing the urine is very difficult and not safe for the kidneys. Beside the fact that changing the urinary pH may not prevent infections. Dietary modifications have not been shown to make much of difference in preventing infections. Healthy is always better! Ekavaler

Answer to Sharon from Dr. Kavaler:

Cloudy urine has no relevance to urinary tract health. The urine can change based on diet and fluid. If the bladder is inflamed or irritated, white blood cells can slough into the urine and cause it to look whitish. Many women will report cloudy or different colored urine with normal urine analysis and cultures. We have no explanation for it.

Answer to JH from Dr. Kavaler:

Young girls can experience something called giggle incontinence, which is stress incontinence precipated by a laugh. They usually outgrow it and it is not a serious problem. It is difficult for me to tell if that is what your daughter is experiencing. Other leakage issues in children occur as well, but they are less common. Perhaps she can go for a few sessions of physical therapy with a pelvic floor expert who can teach her how to contract her muscles and hold her urine. This is very effective in children. I would recommend that you discuss this idea with the pediatric urologist with whom you originally consulted. EKavaler

You suggest minimum & frequent usage of anti-biotics for uti, but isn't that a major cause of drug resistance and the rise of 'super bugs'? I heard no comment on this possibility or potential hazard.

Thank you for featuring Dr. Kavaler on your show. I am a woman in my 60s who requests "a seat on the aisle." Because of my frequency problem, I went to a male Urologist two years ago who gave me samples of "Enable". When I asked what the side effects were, he stated "dry mouth." After one week of taking this drug, I became extremely constipated. Since there was no information on the samples, I called my pharmacist who stated that the number 1 side effect of "Enable" was constipation. I was so discouraged that when I went back to this physician I gave him back the samples and stated that I would rather go frequently than suffer extreme constipation, and that the drug did not work after two weeks. I have not had the courage to seek further help on this problem, so I am hoping Dr. Kavalers' book will help. Thanks

Answer to Evelyn From Dr. Kavaler:

Stress incontinence is when urine squirts out during activity, such as coughing, laughing, sneezing, or jumping. It is primarily treated with surgery, but exercises can be helpful. Kegel exercises done three times a day can strengthen the pelvic muscles. No medications are available to treat stress incontinence.

Answer to MEA From Dr. Kavaler:

Oxytrol patches are a method of delivering oxybutynin through the skin as opposed to through the stomach, as would occur with pills. The importance of the different delivery system, meaning the skin, is that the medication is not broken down into the same metabolites as it would be if it were ingested. So, it probably does not affect the memory to the same degree as oral oxybutynin, but it has not been directly studied.

Answer to Susan from Dr. Kavaler:

You are totally right that not enough information is out there regarding interstitial cystitis. I did not mean to imply that you will get better if you take care of yourself. What I should have said more clearly, was that all I can suggest is that when a flare occurs, try to be careful with what you can control--like exercise, good diet and sleep. Of course, it is difficult to do anything doing a flare, except crawl into bed. But, I wanted to reassure women that it can be managed and treated, even if it can't be cured.

Answer to Carrie from Dr. Kavaler:

First of all, you are not alone in your story. I can't tell you how many women are as confused and frustrated as you are, to say nothing of the physicians with whom these women consult! Dietary modifications can be helpful for interstitial cystitis, but with moderation. I would recommend that you reintroduce soy into your diet because you need the protein. Vegetables are essential as well, for bowel function and their nutrients. Perhaps you can try taking Prelief before eating soy if you feel that it is irritating your bladder. Generally, it will take one to two days to notice if a food will cause a flare.
In anwser to your first question, interstitial cystitis is a constellation of symptoms. It is a real disease and women who suffer from it describe very similar and consistent experiences. Unfortunately, our knowledge of the disease has not allowed us to find diagnostic markers that can confirm the presence of the condition, but the research is being done.

Dr. Kevaler did not mention the possible role of excess vitamin A in urinary urgency. I had a severe bout of urinary urgency in the early 1990s. I was very close to starting on a drug for this when I went on a week-long business trip to a conference. I dreaded sitting through the meetings.

The first morning, I discovered that I'd forgotten to pack my vitamins. The second day of the conference, I realized that I was socializing through the breaks, and not running to the ladies room.

When I returned home and started taking my vitamins, the problem came back. I stopped taking the vitamins, and did a semi-controlled experiment with equivalent doses of the vitamins in the multi-vitamin I was taking. I did three day trials with each, and the problem was definitely corrrelated with the vitamin A.

I have avoided multi-vitamins with excessive vitamin A since then, and have had no problems.

I have also read the NIH reports on various vitamins and possible effects of overdoses. Excess Vitamin A leaches calcium from the bones, so I wonder why there are not more warnings against taking excess Vitamin A, and also why many multi-vitamins have such extremely high levels of Vitamin A.

Thank you so much Dr. Kavaler, for continuing to take questions after the show. I am a 58 year old African American woman I have had 4 successful births and 5 unsuccessful ones. I had a hysterectomy when I was 24 years old. I did the Keglig exercises from the time I was very young but now I am having trouble with bladder control. I also think you should know that up until 2yrs ago I was able to go to the bathroom twice per day with no problems One of the reasons for the increase in my going is Benicar 20 mg with HCT for high blood pressure. I’ve put on about 30 pounds after I stopped smoking 19 months ago. My going to the bathroom seemed to get worse after that.

I have taken to wearing a light days panty liner to prevent leakage onto my clothes and to keep the order down. Is there anything I can do?

Answer to Anna:
Vitamin therapy to prevent the recurrence of bladder cancer has not been studied or proven. A healthy diet will provide you with the nutrients that you need, so additional vitamins are probably not necessary. However, supplemental vitamins are not harmful, so you can't go wrong either way. Most importantly, you need to continue with your surveillance cystoscopies.

Answer to MF:
Menopause has a big effect on the tissues of the the vagina, urethra, and bladder. The exact effect is not known, but, clearly, things change when the hormonal environment is altered. In terms of UTIs, estrogen acidifies the vaginal tissues, thus altering the balance of bacteria. When there is less estrogen, there is less acidity and the flora changes. Oral hormonal replacement does not alter the vaginal pH, only hormonal creams can do that. If you are interested in using hormonal creams, discuss it with your gynecologist.

I also agree that The People's Pharmacy should do a show on IC. So many women suffer from this disease and the public needs to be educated more. 6 years ago when I started my journey to find out what was causing my problems, I was told it was all in my head! It was 2 years before I found a Dr. that diagnosed me with IC. 4 years of Elmiron hasn't helped me. I have found support@ www.ic-network.com

Answer to Nancy from Dr. Kavaler:

IT SOUNDS LIKE YOUR DAUGHTER NEEDS A FULL WORK-UP BY A TRAINED PEDIATRIC UROLOGIST. URODYNAMIC TESTING, ALSO CALLED CYSTOMETRICS, WOULD HELP DETERMINE THE UNDERLYING PROBLEM LEADING TO HER INCONTINENCE AND UTIS. IF SHE HAS ALREADY BEEN THROUGH THIS TESTING AND MEDICATION IS INDICATED, SHE MANY NEED TO TRY ANOTHER ONE OF THE SEVEN CHOICES THAT WE HAVE. THE LAST RESORT WOULD BE A BLADDER PACEMAKER, WHICH MAY HELP CONTROL THE LEAKAGE AND ALLOW HER TO EMPTY BETTER, PREVENTING THE RECURRENT UTIS.

answer to JT from Dr. Kavaler:

THE TWO MOST COMMON TYPES OF URINARY LEAKAGE IN WOMEN ARE STRESS INCONTINENCE AND URGE INCONTINENCE. STRESS INCONTINENCE OCCURS WITH ACTIVITIES SUCH AS COUGHING, LAUGHING, AND SNEEZING. URGE INCONTINENCE IS PRECIPITATED BY A SUDDEN URGE TO URINATE. IN SOME CASES, NO URGE IS SENSED AND THE URINE JUST COMES OUT. MOST WOMEN HAVE A COMBINATION OF STESS AND URGE INCONTINENCE. IT SOUNDS LIKE YOU MAY HAVE DEVELOPED URGE INCONTINENCE, WHICH IS AN ALMOST AN INEVITABLE RESULT OF AGING. TREATMENTS INCLUDE FLUID MODIFICATION, EXERCISES, AND MEDICATION, IF NECESSARY.

Answer to ALAN from Dr. Kavaler:

STRESS PLAYS A BIG ROLE IN URINARY BEHAVIOR. TENSION CREATES PELVIC MUSCLE SPASMS. THESE TIGHT MUSCLES CAN SQUEEZE AROUND THE URETHRA, CREATING ON OBSTRUCTED OUTFLOW. I SUSPECT THAT YOU HAVE SOME DEGREE OF PROSTATIC ENLARGEMENT AS WELL OR ELSE THE FLOMAX WOULD NOT BE WORKING. BEFORE YOU STOP THE FLOMAX, IT WOULD BE WISE TO CONSULT A UROLOGIST SO THAT HE CAN BE SURE THAT YOU WON'T GO INTO URINARY RETENTION ONCE YOU STOP THE PILL. MICROWAVE THERAPY FOR THE PROSTATE IS A TEMPORARY RELIEF OF PROSTATIC BLOCKAGE. IT DOES NOT SOUND LIKE YOU NEED ANY INVASIVE THERAPIES IF YOU BARELY NEED THE FLOMAX.

answer to MMH from Dr. Kavaler:

IT SOUNDS TO ME LIKE YOU MAY HAVE "PELVIC FLOOR DYSFUNCTION". THAT IS A COMMON BUT LITTLE-RECOGNIZED CONDITION IN WHICH THE MUSCLES THAT SUPPORT THE PELVIC FLOOR TIGHTEN AROUND THE URETHRA, THE VAGINA, AND/OR THE RECTUM. YOU MAY HAVE SPASMS SURROUNDING ALL THREE STRUCTURES THAT TRAVERSE THESE MUSCLES. THE TREATMENT IN MUSCLE RELAXANTS AND PHYSICAL THERAPY, WITH A SPECIALIST IN PELVIC FLOOR ISSUES.

Answer to RC from Dr. Kavaler:

YOUR GYN IS DOING ALL OF THE THINGS THAT I WOULD DO. THE ONLY QUESTION I WOULD ASK IS WHETHER OR NOT YOUR MOTHER WOULD BE A CANDIDATE FOR A PESSARY. A PESSARY IS A RUBBER RING, SIMILAR TO A DIAPHRAGM, THAT IS INSERTED VAGINALLY IN THE PHYSICIAN'S OFFICE. IT HOLDS THE BLADDER UP, REPLACING IT BACK INTO ITS ORIGINAL ANATOMIC POSITION. CONCEPTUALLY, SURGERY WILL DO THE SAME THING. THE GRAFT SUPPORTS THE BLADDER UNDER THE VAGINAL SKIN. PESSARIES NEED TO BE REMOVED, CLEANED, AND REINSERTED EVERY TWO TO THREE MONTHS BY A PHYSICIAN, OR BY YOUR MOTHER, IF SHE IS AGILE ENOUGH. IT IS WORTH A DISCUSSION AND MAYBE, EVEN A TRIAL WITH ONE, BECAUSE IT IS CERTAINLY LESS INVASIVE THAN SURGERY. PRIOR TO ANY OPERATION, HER BLADDER NEEDS TO BE TESTED TO BE SURE THAT IT WILL EMPTY BETTER AFTER THE SURGERY THAN BEFORE. ONE CANNOT ASSUME THAT SUPPORTING THE BLADDER WITH INSURE BETTER EMPTYING.

Answer to Gerry From Dr. Kavaler:

AS WE ALL GET OLDER, OUR BLADDERS TEND TO BECOME MORE IRRITABLE, AS YOURS IN BECOMING. YOUR SYMPTOMS DO NOT SOUND ALARMING OR UNUSUAL, BUT THEY DO SOUND INCONVENIENT AND BOTHERSOME. MANY OPTIONS ARE AVAILABLE TO CONTROL YOUR CONDITION. THE FIRST IS FLUID MANAGEMENT; DRINK LESS WHEN YOU PLAN TO BE AWAY FROM A BATHROOM. THE SECOND IS PELVIC MUSCLE EXERCISES, SPECIFICALLY KEGEL EXERCISES. FINALLY, MEDICATION MAY BE HELPFUL. IN YOUR CASE, I THINK YOU WOULD DO VERY WELL WITH THE FIRST TWO, NOT NECESSITATING THE THIRD. YOU ARE HEALTHY, ATHLETIC, AND MOTIVATED, SO YOU ARE AN EXCELLENT CANDIDATE FOR EXERCISE THERAPY. ASK YOUR GYNECOLOGIST FOR GUIDANCE IN THIS ARE.

Answer to VW from Dr. Kavaler:

NEARLY EVERYONE WHO AWAKENS AT NIGHT WILL EMPTY THEIR BLADDERS BEFORE RETURNING TO BED. THE ANTICIPATION OF NEEDING TO GET UP AGAIN CAUSES YOUR PELVIC MUSCLES, WHICH SURROUND THE URETHRA, TO SPASM. THE RESULT IS A SENSE OF NEEDING TO URINATE WITHOUT A FULL BLADDER. ONCE THE PATTERN BEGINS, IT CAN BE DIFFICULT TO BREAK. RELAXATION EXERCISES, DISTRACTING YOURSELF WITH MUSIC, AND REDUCING YOUR FLUIDS BEFORE BED ARE ALL HELPFUL STRATEGIES.

Answer to SB:
THE NEWER GENERATION OF BLADDER PILLS ARE LESS LIKELY TO CAUSE MEMORY CHANGES. THESE MEDICATIONS INCLUDE ENABLEX, SANCTURA, AND VESICARE. THE ONLY ONE THAT HAS BEEN TESTED IN WOMEN OVER 65 AND HAS SHOWN NOT TO ALTER MEMORY IS ENABLEX (DARAFENACIN). THE OTHER MEDICATIONS THAT ARE SIMILAR TO ENABLEX ARE SANCTURA AND VESICARE. SANCTURA SHOULD NOT HAVE ANY IMPACT ON BRAIN FUNCTION BECAUSE IT IS TOO BIG TO PASS THROUGH THE BLOOD-BRAIN BARRIER. VESICARE HAS NOT BEEN EVALUATED FOR ITS EFFECT ON COGNITIVE FUNCTION.

Answer to Paula from Dr. Kavaler:

IT CAN BE SURPRISING HOW SMALL CHANGES CAN MAKE A BIG DIFFERENCE. IT IS ENCOURAGING FOR OTHER WOMEN TO HEAR THAT YOU WERE ABLE TO FIND A MANAGEMENT STRATEGY THAT IS SAFE, EFFECTIVE, AND IN YOUR CONTROL.

Answer to Marvin from Dr. Kavaler:

VESICARE IS ONE OF THE NEWER MEDICATIONS THAT WORKS ON BLADDER CONTROL. IT IS INDICATED FOR PEOPLE WHO SUFFER FROM URGENCY, FREQUENCY, AND URGE INCONTINENCE, WHICH IS DESCRIBED AS THE LEAKAGE OF URINE PRECIPITATED BY AN URGE TO URINATE. IT IS SAFE FOR THE CARDIOVASCULAR SYSTEM. IT IS TAKEN ONCE PER DAY WITH OR WITHOUT FOOD. THE MAIN SIDE EFFECT IN DRY MOUTH.

Answer to DD from Dr. Kavaler:

THE STUDY THAT HAS BEEN CITED HAS NOT YET BEEN PUBLISHED IN A PEER REVIEWED JOURNAL, SO I AM NOT CLEAR ON THE STUDY METHODS THAT WERE USED. THIS CLASS OF MEDICATIONS IS VERY EFFECTIVE AND NECESSARY FOR SOME PEOPLE WHO ARE LIMITED BY THEIR BLADDER ISSUES. THEREFORE, I DON'T WANT TO OVERSTATE THE MEMORY CHANGES SEEN BY THESE RESEARCHERS. THE NEWER MEDICATIONS THAT ARE AVAILABLE ARE ENABLEX, VESICARE, AND SANCTURA.

Answer to RN from Dr. Kavaler:

A URETHRAL CARUNCLE IS ANALAGOUS TO A HEMORRHOID ON THE RECTUM. IT IS A BLOOD VESSEL THAT BULGES OUT OF THE URETHRAL OPENING. IT IS CAUSED BY PRESSURE DURING EITHER URINATATION OR DEFECATION. IT CAN BLEED, JUST LIKE A HEMORRHOID. IT IS NOT CANCEROUS.

Please help me find citations for articles published in respected peer reviewed medical journals that address the cognitive impairment risks in children using anti-diuretecs for bedwetting that Dr. Kavaler discussed. Am also interested in documentation that use of anti-diuretics is counter-indicated in children with a history of blood in their urine. I am particularly interested in this information as it pertains to the use of Desmopressin. Thanks!

I cured mine with D-Mannose from the health food store. Nothing else helped and I did not want a drug or antibiotic.

I have been given a perscription for Detrol LA for my bladder "stress."

I have glaucoma. Can I safely take this or any other medication for my bladder? Or do I have to decide between eye health or wet panties?

Wow. I have so much to add. I have had IC for my entire life-well for as long as I can remember-30 yrs! No one could diagnose me until about 2 years ago! IC is a horrible disease for a child to experience b/c it makes no sense.

Anyway, the best advice i can give to anyone experiencing CONSISTENT symptoms of burning/pain (mine was often to the point of immobility & scary sweating fits)-CHANGE YOUR DIET! there is no better way. don't listen to anyone that says you have to undergo surgery or take a bunch of meds! extract ALL of the acidic food from your diet. once you do that & u see a change in your symptoms, u can start adding things back in slowly. it WILL be a constant battle. I was given macrobid and many other meds from doctors b/c they had no idea what was going on-my urine samples always showed up clean! nothing worked!!!

DESERT HARVEST ALOE VERA pills (u can find them on the web) were awesome. expensive, but once you take them for a while, they will start to repair your bladder-NATURALLY! no joke, it actually works. i really hope this helps-my journey has been a long one. i just hope that parents who have children suffering from this, learn about the issue as soon as possible so unnecessary suffering may be avoided!