There are treatments for overactive bladder

DEAR DR. ROACH »

Is there a cure for overactive bladder?

— R.H.

DEAR READER » The underlying reason for overactive bladder is not well understood, and although there are medications to treat symptoms, there is not a cure for the condition.

The main symptoms of overactive bladder are urinary symptoms, especially urgency (the need to go RIGHT AWAY), increased urinary frequency (this may include symptoms at night), and incontinence. Before considering medication, there are other treatments to try. These include weight loss if appropriate, pelvic floor exercises, bladder training and, in women, evaluation for vaginal atrophy. In men, it can sometimes be difficult to separate prostate symptoms from overactive bladder.

It may be treated with anticholinergic drugs such as oxybutynin. These are modestly effective, but can have side effects such as dry mouth. Recent studies have also implicated anticholinergic drugs as a possible factor in dementia. For these reasons, anticholinergic drugs are used only when necessary and at the lowest effective dose.

Another medicine option in the beta-3 drug mirabegron (Myrbetriq). It can increase blood pressure and should not be used in a person with uncontrolled high blood pressure. Otherwise it is safe and about as effective as the anticholinergic drugs.Botulinum toxin and nerve stimulators are sometimes used in people can’t take or tolerate the medication. Surgery is considered as a last resort.

DEAR DR. ROACH » Is it advisable or inadvisable to take naproxen sodium at the time of COVID-19 vaccination to alleviate potential side effects of the vaccine?

— B.S.

DEAR READER » Although some studies have shown that people who get a fever reducer such as acetaminophen (Tylenol) at the time of a vaccine have lower antibody titers, not all studies have shown this, and those that have still showed an adequate antibody level. Booster vaccines showed a “robust” response.

Having had the Pfizer COVID-19 vaccine myself and in observing many of my colleagues, I would say very few have had systemic side effects, such as fever, bad enough to be concerning. A sore arm has generally been the worst. Anecdotally, however, the second vaccine does seem to cause more side effects, perhaps a bit more than a typical flu vaccine but less than the new shingles vaccine.