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Dr Basu
Dr Basu, Experienced Specialist
Category: Medical
Satisfied Customers: 38915
Experience:  MD
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I suffered an AVM in July of last year and recently suffer

Customer Question

Hello, I suffered an AVM in July of last year and recently suffer from urinary incontinence when I laugh. Never have I had this problem before, even after having 2 children by C section. I am 40 years of age since May. Any advice on what I shoyld do to improve my situation?
JA: Do you keep personal medical records to help track this?
Customer: No
JA: Is there anything else the Doctor should know before I connect you? Rest assured that they'll be able to help you.
Customer: No
Submitted: 16 days ago.
Category: Medical
Expert:  Dr Basu replied 16 days ago.

Hi there,
I am an experienced Medical Specialist.
I am here to address your concerns and provide great service.

You likely have urge urinary incontinence.

Urge incontinence occurs when you have a sudden urge to urinate. In urge incontinence, the urinary bladder contracts when it shouldn't, causing some urine to leak through the sphincter muscles holding the bladder closed. Other names for this condition are: overactive bladder (OAB) bladder spasms.

Your doctor may recommend less invasive treatments to start with and move on to other options if these techniques fail to help you.

Behavioral techniques

Your doctor may recommend:

  • Bladder training, to delay urination after you get the urge to go. You may start by trying to hold off for 10 minutes every time you feel an urge to urinate. The goal is to lengthen the time between trips to the toilet until you're urinating only every 2.5 to 3.5 hours.
  • Double voiding, to help you learn to empty your bladder more completely to avoid overflow incontinence. Double voiding means urinating, then waiting a few minutes and trying again.
  • Scheduled toilet trips, to urinate every two to four hours rather than waiting for the need to go.
  • Fluid and diet management, to regain control of your bladder. You may need to cut back on or avoid alcohol, caffeine or acidic foods. Reducing liquid consumption, losing weight or increasing physical activity also can ease the problem.

Pelvic floor muscle exercises

Female pelvic floor musclesOpen pop-up dialog box

Male pelvic floor musclesOpen pop-up dialog box

Your doctor may recommend that you do these exercises frequently to strengthen the muscles that help control urination. Also known as Kegel exercises, these techniques are especially effective for stress incontinence but may also help urge incontinence.

To do pelvic floor muscle exercises, imagine that you're trying to stop your urine flow. Then:

  • Tighten (contract) the muscles you would use to stop urinating and hold for five seconds, and then relax for five seconds. (If this is too difficult, start by holding for two seconds and relaxing for three seconds.)
  • Work up to holding the contractions for 10 seconds at a time.
  • Aim for at least three sets of 10 repetitions each day.

To help you identify and contract the right muscles, your doctor may suggest that you work with a pelvic floor physical therapist or try biofeedback techniques.

Medications

Medications commonly used to treat incontinence include:

  • Anticholinergics. These medications can calm an overactive bladder and may be helpful for urge incontinence. Examples include oxybutynin (Ditropan XL), tolterodine (Detrol), darifenacin (Enablex), fesoterodine (Toviaz), solifenacin (Vesicare) and trospium chloride.
  • Mirabegron (Myrbetriq). Used to treat urge incontinence, this medication relaxes the bladder muscle and can increase the amount of urine your bladder can hold. It may also increase the amount you are able to urinate at one time, helping to empty your bladder more completely.
  • Alpha blockers. In men who have urge incontinence or overflow incontinence, these medications relax bladder neck muscles and muscle fibers in the prostate and make it easier to empty the bladder. Examples include tamsulosin (Flomax), alfuzosin (Uroxatral), silodosin (Rapaflo), and doxazosin (Cardura).
  • Topical estrogen. Applying low-dose, topical estrogen in the form of a vaginal cream, ring or patch may help tone and rejuvenate tissues in the urethra and vaginal areas.
Customer: replied 16 days ago.
Thank you
Expert:  Dr Basu replied 16 days ago.

welcome