Floor exercises highly effffffffffffective for women with overactive bladder

Dr. Keith Roach

Question: I’m a 33-yearold woman with an overactive bladder. It was keeping me awake at night with painful spasms telling me I had to “go” every 45 minutes. I took oxybutynin for a while, but it stopped helping.

I recently was prescribed Myrbetriq, but I’ve noticed sudden, signifificant hair loss. Since I’m not on any other medications, the Myrbetriq is the only culprit.

My urologist suggested a surgical procedure that would connect an electrode to my bladder, but I feel like I’m entirely too young for such an invasive approach. My urologist gave me a bladder-irritant diet list (food for thought), but I want to know if there are other options. — Anon.

Answer: Overactive bladder affffffffffffects many people. So before even getting to medication treatment, it’s worthwhile to note a couple of things.

While you’re not on other medicines, there are some that can cause symptoms of overactive bladder. Caffffffffffffeine, which we don’t think of as a medicine, causes bladder spasms in some women, and it should be stopped at least temporarily to see if that helps. I agree with avoiding bladder irritants in food. Weight loss and smoking cessation can help. A urine test to evaluate for infection is appropriate.

If no other cause is found, I usually try pelvic flfloor exercises before prescribing medication; women who learn how to do them properly are more satisfified with this treatment than with medications. A trained physical therapist dramatically improves the effffffffffffectiveness of this therapy, and I have had women report success using vaginal weights or biofeedback techniques. These techniques often are used in conjunction with bladder training, using a voiding diary and gradually increasing time between voids. This process takes weeks.

If medications are needed, then oxybutynin is a reasonable fifirst options, Q: opinion

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