How does anxiety affect bladder control. What triggers the urge to urinate during stressful situations. Why do people experience frequent urination when anxious. Can anxiety cause overactive bladder symptoms. What are effective ways to manage anxiety-related urinary urgency.

The Link Between Anxiety and Frequent Urination

Many people experience an urgent need to urinate when feeling anxious or stressed. This phenomenon, while common, can be embarrassing and disruptive. Understanding the connection between anxiety and bladder function can help individuals better manage this symptom and reduce its impact on daily life.

The Fight-or-Flight Response and Urinary Urgency

One of the primary reasons for anxiety-induced frequent urination is the body’s fight-or-flight response. This automatic reaction to stress affects various bodily functions, including bladder control.

• The bladder is closely connected to the body’s fear system
• Anxiety can override normal bladder signals
• Bladder muscles may contract during stress, increasing pressure
• The fight-or-flight response may stimulate increased urine production

During periods of calm, the bladder gradually fills with urine from the kidneys, and the body sends signals to the brain indicating when it’s time to urinate. However, when anxiety strikes, this process is disrupted. The brain may override these signals, leading to confusion about whether it’s actually necessary to use the bathroom.

Heightened Body Awareness and Its Impact on Urination

Another factor contributing to frequent urination during anxiety is increased body awareness. When experiencing anxiety, individuals often become hyper-aware of their physical sensations, including the need to urinate.

Selective Attention and Perceived Urgency

Anxiety can cause people to apply a “selective filter” to their bodily sensations, focusing intensely on the feeling of needing to urinate. This heightened awareness may lead to an exaggerated perception of urgency, even when the actual need to urinate is not as pressing as it feels.

Is the urge to urinate during anxiety always accurate? Not necessarily. The brain’s heightened focus on bodily sensations can create a false sense of urgency, making individuals believe they need to use the bathroom more frequently or urgently than they actually do.

The Psychological Impact of Anxiety-Induced Frequent Urination

The constant worry about needing to use the bathroom can significantly impact an individual’s quality of life and exacerbate existing anxiety. This cycle can lead to increased stress and social discomfort, particularly in situations where bathroom access may be limited or inconvenient.

Social and Professional Consequences

Anxiety-induced frequent urination can have far-reaching effects on various aspects of life:

• Disruption of work or school activities
• Avoidance of social situations
• Decreased confidence in public speaking or performances
• Increased overall anxiety and stress levels

How does anxiety-related frequent urination affect daily life? It can lead to constant worry about bathroom access, disrupt concentration during important tasks, and cause individuals to avoid social situations or activities they would otherwise enjoy.

Medical Considerations for Anxiety-Related Urinary Symptoms

While anxiety can certainly cause frequent urination, it’s important to rule out any underlying medical conditions that may be contributing to these symptoms. Consulting with a healthcare provider can help determine if there are any physical factors at play.

Potential Medical Causes of Frequent Urination

• Urinary tract infections (UTIs)
• Overactive bladder syndrome
• Interstitial cystitis
• Prostate issues in men
• Pelvic floor dysfunction

Should you see a doctor for anxiety-related urinary symptoms? If frequent urination is significantly impacting your quality of life or if you’re unsure whether anxiety is the sole cause, it’s advisable to consult with a healthcare professional to rule out any underlying medical conditions.

Management Strategies for Anxiety-Induced Frequent Urination

Fortunately, there are several strategies that can help manage anxiety-induced frequent urination. These approaches focus on addressing both the anxiety itself and the urinary symptoms.

Cognitive Behavioral Therapy (CBT)

CBT is a highly effective treatment for anxiety disorders and can also help manage associated symptoms like frequent urination. This therapy helps individuals identify and change negative thought patterns and behaviors related to anxiety.

How can CBT help with anxiety-related urinary urgency? CBT can teach individuals to:

• Recognize that frequent urination is a symptom of anxiety, not a separate problem
• Challenge the belief that they need to urinate as urgently or frequently as they feel
• Develop coping strategies to manage anxiety in triggering situations
• Reduce overall anxiety levels, which can in turn decrease urinary symptoms

Mindfulness and Relaxation Techniques

Practicing mindfulness and relaxation can help individuals manage anxiety and reduce its impact on bladder function. These techniques can help calm the body’s stress response and increase awareness of true physical needs.

What mindfulness techniques can help with anxiety-induced frequent urination?

• Deep breathing exercises
• Progressive muscle relaxation
• Meditation
• Body scan techniques
• Mindful awareness of physical sensations

By focusing on the present moment and practicing these techniques, individuals can learn to distinguish between genuine physical needs and anxiety-induced sensations.

Physical Approaches to Managing Frequent Urination

In addition to psychological strategies, there are several physical approaches that can help manage anxiety-induced frequent urination.

Pelvic Floor Exercises

Strengthening the pelvic floor muscles can improve bladder control and reduce the frequency and urgency of urination. Kegel exercises are a common and effective way to strengthen these muscles.

How do you perform Kegel exercises?

1. Identify the correct muscles by stopping urination midstream
2. Tighten these muscles for 5 seconds, then relax for 5 seconds
3. Repeat this process 10-15 times, 3 times a day
4. Gradually increase the duration of contractions as strength improves

Regular practice of pelvic floor exercises can lead to improved bladder control and reduced anxiety about urinary urgency.

Bladder Training Techniques

Bladder training involves gradually increasing the intervals between urination to improve bladder capacity and control. This technique can help reduce the frequency of urination and improve confidence in bladder control.

How does bladder training work?

1. Keep a diary of urination frequency and timing
2. Gradually increase the time between bathroom visits
3. Use relaxation techniques to manage urges
4. Stick to a consistent urination schedule
5. Gradually increase bladder capacity over time

Lifestyle Modifications to Support Bladder Health

Certain lifestyle changes can complement other management strategies and help reduce anxiety-induced frequent urination.

Fluid Management

While it’s important to stay hydrated, managing fluid intake can help control urinary frequency. Consider the following tips:

• Avoid excessive fluid intake, especially before bedtime or important events
• Limit caffeine and alcohol consumption, as these can increase urine production
• Spread fluid intake evenly throughout the day
• Monitor the types of fluids consumed, opting for water over diuretic beverages

Dietary Considerations

Certain foods and beverages can irritate the bladder and exacerbate urinary symptoms. What dietary changes can help manage frequent urination?

• Reduce intake of acidic foods and beverages
• Limit spicy foods, which can irritate the bladder
• Avoid artificial sweeteners, which may increase urinary frequency
• Incorporate bladder-friendly foods like pears, bananas, and whole grains

Seeking Professional Help for Anxiety and Urinary Symptoms

If anxiety-induced frequent urination significantly impacts daily life or if self-management strategies prove ineffective, it may be time to seek professional help.

Mental Health Support

Consulting with a mental health professional can provide valuable support in managing anxiety and its associated symptoms. A therapist or counselor can offer personalized strategies and treatments, such as:

• Cognitive Behavioral Therapy (CBT)
• Exposure therapy for anxiety related to bathroom access
• Stress management techniques
• Medication options, if appropriate

Urological Evaluation

In some cases, a urologist may be consulted to rule out any underlying bladder or urinary tract issues. A urological evaluation may include:

• Physical examination
• Urinalysis to check for infections or other abnormalities
• Bladder function tests
• Imaging studies, if necessary

When should you consult a urologist for frequent urination? If symptoms persist despite anxiety management, if there’s pain or discomfort associated with urination, or if there are other concerning urinary symptoms, it’s advisable to seek a urological evaluation.

Empowering Yourself: Building Confidence and Reducing Anxiety

Managing anxiety-induced frequent urination involves more than just addressing the physical symptoms. It’s also about building confidence and reducing overall anxiety levels.

Developing Coping Strategies

Creating a toolkit of coping strategies can help manage anxiety in various situations. Some effective strategies include:

• Positive self-talk and affirmations
• Visualization techniques
• Gradual exposure to anxiety-inducing situations
• Establishing a support network of friends and family
• Engaging in regular physical exercise

Embracing Self-Compassion

Being kind to oneself and practicing self-compassion can significantly reduce anxiety and its associated symptoms. How can self-compassion help with anxiety-induced frequent urination?

• Reduces self-criticism and negative self-talk
• Encourages a more balanced perspective on physical sensations
• Promotes relaxation and reduces overall stress levels
• Enhances emotional resilience in challenging situations

By cultivating self-compassion, individuals can develop a more positive relationship with their bodies and reduce the impact of anxiety on bladder function.

This Is Why You Always Have To Pee When You’re Anxious

Laura, a 32-year-old from New York, had spent months planning and preparing for her first major trade show as a fashion designer. This was where she’d launch her collection to an arena full of potential buyers and boutique owners — and she wanted every last detail to be perfect. But when the day finally arrived and it came time for Laura to present her line, she was overcome with nerves.

“It was my first time at a trade show, I didn’t know what to expect and felt so exposed in this big space and on the spot,” said Laura, who wished to withhold her last name in order to discuss her mental health. “When I get nervous or anxious, I get an extreme urge to pee, so that whole day I was just freaking myself out that I was going to pee.”

Anecdotally speaking, having to go to the bathroom — or at least feeling like you have to — is actually a pretty common symptom of anxiety. Although there isn’t a ton of research to explain exactly why our bladders let loose when anxiety strikes, health experts have tossed around a couple theories. Here’s what some had to say about why so many of us feel the urge to go and what to do about it:

Our fight-or-flight response is probably making us pee more.

PeopleImages via Getty Images

When you’re calm and relaxed, your bladder gradually fills up with urine from the kidneys. Throughout the day, your body sends signals to your brain that either say, “Hey, it’s time to go to the bathroom!” or “We’re all good, you can hold it a bit longer.”

When you start to feel anxious, however, things don’t run as smoothly. This is largely due to the fact that our bladders are closely connected to our body’s fear system — aka our “fight-or-flight” response. When that response activates, our brain tends to override all those lovely signals telling us whether or not it’s actually time to pee. At the same time, our bladder muscles contract, which puts more pressure on the bladder and sends us running for the bathroom.

“So when you feel anxious, your body’s fear response can be triggered, overwhelming your bladder’s mechanisms for retaining urine, causing you to want to urinate,” Ashwini Nadkarni, an associate psychiatrist with Brigham and Women’s Hospital and an instructor of psychiatry at Harvard Medical School, told HuffPost.

On top of all that, some experts suspect that the fight-or-flight response could also put our kidneys into overdrive, causing them to produce more urine than usual, according to LiveScience.

We’re more in tune with our body when we’re anxious.

Cavan Images via Getty Images

When we feel anxiety, we also tend to become hyper-aware of our own body and how we feel in our own skin, health experts suspect. For example, every heartbeat may feel like your chest is pounding, you may zero in on your breathing or you could have an overwhelming urge to urinate.

“[People will] apply a ‘selective filter’ and focus on the feeling that they’re going to pee, when in fact, objectively, they might not actually pee or pee as much as they think,” Nadkarni said.

In other words, yes, you may have to pee — but it’s probably not as much of an emergency as you think it is. Your brain is just tricking you in the moment.

The good news: There are ways to manage it.

Aleksandr Sumarokov / EyeEm via Getty Images

Needless to say, the last thing you want to be worried about when you’re well, worried, is trying to find a toilet. Anxiety is disruptive and distracting enough without having to think about your bladder, too.

“If it happens once in a while, for example before a job interview or going on a blind date, the level of disruption can be minimal. If it is happening more frequently, it may be worth thinking through your overall stress levels,” said Jessy Warner-Cohen, a health psychologist at the Long Island Jewish Medical Center in New Hyde Park, New York.

The good news is that there are some strategies you can take up to try to tame your bladder. Many mental health professionals recommend practicing cognitive behavioral therapy, or CBT, to help manage anxiety ― and thus, your bladder ― on a more regular basis. CBT can also help people understand that frequent urination is simply a byproduct of their anxiety and also that they probably don’t have to pee as much as they think they do, Nadkarni explained.

According to Warner-Cohen, practicing mindfulness techniques can also help. “Recognize that the sensations you are feeling are typical and you are actually safe,” Warner-Cohen said. “Engage in ‘belly breathing,’ slow breaths in and out, and focus on your breathing instead of whatever else is happening.”

Additionally, pelvic muscle exercises may help with bladder training, which can control how much you urinate, according to Fara Bellows, a urologist at The Ohio State Wexner Medical Center. Bellows also recommended limiting fluid intake — especially caffeinated beverages like coffee or tea — before doing anything that may make you feel anxious.

If you try these things and still struggle with holding it in, you may actually have a condition like “overactive bladder,” in which case you truly cannot control what’s going on with your bladder. If you suspect you may have a more serious issue, a urologist or your doctor can help determine why your bladder doesn’t want to cooperate and insists on calling all the shots.

“Living With” is a guide to navigating conditions that affect your mind and body. Each month, HuffPost Life will tackle very real issues people live with by offering different stories, advice and ways to connect with others who understand what it’s like. In May, we’re covering anxiety in honor of Mental Health Awareness Month. Got an experience you’d like to share? Email [email protected].

How anxiety could explain why you need to pee all the time

In a normally functioning bladder, the organ fills with urine like an expanding balloon. This urine is kept in the bladder by your urethral sphincters, of which there are two. One of these muscles is controlled with your thoughts, but you have no control over the other one, it is part of autonomic nervous system control.

Eventually, your bladder fills up to the point where it starts sending signals to your brain that you need to go to the bathroom. At this point, you are still able to voluntarily control whether you empty your bladder or not. Once you make time to go to the bathroom, your brain signals both the urethral sphincter and pelvic floor muscles to relax, and prompts another muscle that makes up the bladder, the detrusor muscle, to contract, squeezing urine out of your bladder.

Urinary frequency

Urinary frequency is defined as urinating more frequently than considered normal by either a person or their caregiver,¹ which has traditionally been defined as passing urine more then about seven times during the day. There can be many causes for feeling as though you need to empty small amounts of urine very often throughout the day. These include urinary tract infections UTIs), chronic constipation, pelvic organ prolapse, alcohol, tea, coffee, smoking, being overweight, medication side effects, and medical problems that affect your nervous system. If you have any condition that could be playing a part such as diabetes or multiple sclerosis, or your urinary frequency has any associated symptoms, it is important to see your doctor to see if there is a simple, correctable cause.

Can anxiety play a role in urinary frequency?

When you are anxious you may also feel the need to pee. Unfortunately, there aren’t that many clinical studies looking into anxiety and urinary frequency. However, the bladder’s ability to contract itself is controlled by the nervous system. Emotions such as anxiety can be interpreted by the brain as the presence of a threat, which generates the body’s stress response — the bladder is supplied with nerves from the same nervous system. Given all of the above, it stands to reason then you can have urinary symptoms associated with anxiety.

Studies have shown that a higher proportion of women with overactive bladder do suffer from anxiety, and those that do tend to have worse symptoms

Why this occurs is poorly understood, although some treatable conditions or factors, such as diabetes, may contribute to its development, and it is really important to ensure that any medical causes that might need treatment are ruled out before deciding that your symptoms are related to anxiety.

How is anxiety related to bladder symptoms?

To understand how anxiety and bladder symptoms are related, it helps to understand how emotions work on the body. If, for example, you were suddenly faced with a stressor, such as being chased by a dog, your emotions would generate a stress response in your body — the fight or flight response. Among other things, you may notice your pulse pounding rapidly in your ears, that your mouth feels dry, you may feel a bit shaky and not hear much going on around you, and you may feel sweaty.

This is all the result of a cascade of hormones that the body releases to respond to an acutely stressful situation, preparing you to fight a danger or run away. These hormones also act on the bladder, causing the muscles to relax and the bladder to empty. This is why, in films or novels, you find that when a person gets scared they wet their pants.

When you suffer from anxiety, your fight or flight response tends to be activated when there is no clear danger present. On a neurobiological level, the need to urinate is controlled by three different nerve pathways. The first, the autonomic nervous system, manages involuntary control. Its two branches (the sympathetic and the parasympathetic nervous systems) supply the internal sphincter and detrusor muscle respectively with nerves.

This pathway is managed in the brain by a centre called the pontine micturition centre, but once we are toilet trained we can override this to a certain extent by voluntary thought. This voluntary control supplies the external sphincter muscle with nerves, but it can be overridden by the limbic system – the connection of neurons that transmit emotions (including anxiety) for processing by the brain.²

Studies have shown that a higher proportion of women with overactive bladder do suffer from anxiety, and those that do tend to have worse symptoms.³ Furthermore, a smaller study has suggested that anxiety is a risk factor for overactive bladder, although there is insufficient information about whether or not anxiety-reducing medication improves bladder symptoms. ⁴

Another study found that “patients with anxiety report more severe bladder symptoms, worse quality of life, and more psychosocial difficulties compared to overactive bladder (OAB) patients without anxiety. There are positive correlations between the severity of anxiety symptoms and OAB/incontinence symptoms”.⁵

Other symptoms you may notice if your urinary frequency is related to anxiety may be a stress response in other parts of your body — such as a dry mouth, racing heart, tunnel vision, or a ringing in your ears. Pay close attention to the situations or triggers that give rise to these feelings.

A study found that “patients with anxiety report more severe bladder symptoms, worse quality of life, and more psychosocial difficulties compared to overactive bladder (OAB) patients without anxiety. There are positive correlations between the severity of anxiety symptoms, and OAB/incontinence symptoms”

Keeping a diary of when you go to the bathroom, how much urine you pass when you get there, what medications you are on, what you’ve had to drink during the day, and any other pertinent surrounding situational factors can help your doctor zero in on the cause of your symptoms.

What can you do to manage urinary frequency?

First of all, it is extremely important to ensure there isn’t a medical problem causing it, and your doctor will discuss any other symptoms with you and look at your medical history. Examples of conditions that can cause urinary frequency include diabetes, MS, Parkinson’s, dementia, stroke, bladder tumours and bladder stones.

If your urinary frequency is determined to be secondary to your experience of anxiety, it can help to visit a licensed counsellor to look at both the underlying cause of your anxiety as well as getting cognitive behaviour tips for the management of secondary symptoms.

Other simple lifestyle changes can reduce your need to visit the bathroom so frequently, such as removing bladder irritants like caffeine and alcohol, reducing your weight if you are overweight, and stopping smoking.

Finally, since humans are able to learn new behaviours and responses, it is possible to train your bladder to not respond to your emotional nervous system’s signals. Bladder training, for example, is a reliable technique that has been shown to improve symptoms,^6,7 and involves bringing back your desire to pee into voluntary control. It is done in a stepwise fashion over time.

If you are finding you need to pee all the time, and believe it could be related to anxiety, then it is important to visit your GP, as there are plenty of solutions that can help. Incontinence is a very common condition, and there is no need to just put up with it.

Last updated September 2020
Next update due 2023
 
Author’s disclaimer: This content is designed to provide general information and is not a substitute for medical advice. Medical opinion, practice and routine may vary from country to country and may change from time to time. The author is not liable for the results of misuse or inappropriate application of the information. If you are an individual who chooses to access this information, you should not rely on the information as professional medical advice or use it to replace any relationship with your doctor or other qualified healthcare or social care professional. For medical concerns, including decisions about medications and other treatments, individuals should always consult their doctor or, in serious cases, seek immediate assistance from emergency personnel. Individuals with any type of medical condition are specifically cautioned to seek professional medical advice before beginning any sort of health treatment. Individuals with specific queries or concerns should seek appropriately qualified medical advice. Clinicians must use their own judgement when interpreting this information and deciding how best to apply it to the treatment of patients.

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RACGP – Adult male stress and urge urinary incontinence

Background

Male urinary incontinence adversely affects health-related quality of life and is associated with significant psychosexual and financial burden. The two most common forms of male incontinence are stress urinary incontinence (SUI) and overactive bladder (OAB) with concomitant urge urinary incontinence (UUI).

Objective

The objectives of this article are to briefly review the current understandings of the pathophysiological mechanisms in SUI and OAB/UUI, and offer a set of practical, action-based recommendations and treatment strategies.

Discussion

The initial evaluation of male urinary incontinence usually occurs in general practice, and the basic work-up aims to identify reversible causes. First-line treatment is conservative management, such as lifestyle interventions, pelvic floor muscle training with or without biofeedback, and bladder retraining. Treatment options include male slings and artificial urinary sphincter surgery for men with persistent SUI, and medical therapy, intravesical botulinum toxin, sacral neuromodulation or surgery in refractory cases for those with predominant OAB/UUI.

Lower urinary tract dysfunction, such as benign prostatic hyperplasia (BPH), overactive bladder (OAB) and urinary incontinence, are common conditions that adversely affect health-related quality of life and increase the risk of institutionalisation. ¹ A Deloitte Access Economics report commissioned by the Continence Foundation of Australia found that more than 4.2 million Australians aged 15 years and older had urinary incontinence in 2010.² The prevalence of urinary incontinence increases with age and it is estimated that more than one in four men aged over 70 years have urinary incontinence.¹ The presence of poor general health, medical comorbidities, severe physical limitations, cognitive impairment, neurological conditions, recurrent urinary tract infection (UTI) and prostatic diseases have been associated with urinary incontinence.¹

Persistent, non-neurogenic urinary incontinence in adult males can be classified as stress urinary incontinence (SUI), OAB with urge urinary incontinence (UUI), mixed incontinence, overflow (paradoxical) incontinence, continuous urinary incontinence (eg fistula) and functional incontinence.^1,3 This article briefly reviews the current understandings of the pathophysiological mechanisms in SUI and OAB/UUI, and offers a set of practical, action-based recommendations and treatment strategies. All treatment options should be discussed to facilitate informed decision-making, and these options can then be individualised on the basis of patient preference, current comorbidities and specific circumstances.

Methods and evidence synthesis

A literature search was performed on the PubMed database for English-language, original and review articles published up to December 2016. Keywords included ‘male stress urinary incontinence’, ‘overactive bladder’ and ‘urge incontinence’. This article was formulated from a clinical review of contemporary literature; a detailed analysis of all relevant studies is not the goal of this article.

Pathophysiological mechanisms

Male stress urinary incontinence

The main pathophysiology behind SUI in men relates to underlying dysfunction of the urethral sphincter complex and/or change in urethral axis. This is often a complication following prostate surgery, such as radical prostatectomy or transurethral resection of prostate (TURP). Other causes of male SUI are iatrogenic sphincter injury (eg sphincterotomy in spinal patients), neurological conditions or trauma to the pelvic floor (eg pelvic trauma in motor vehicle accident). The exact incidence of SUI may vary depending on the underlying pathology, definition of SUI and source of data (eg physician versus patient report).⁴ The expected benefits of robotic prostate surgery in reducing the urinary and sexual side effects following prostatectomy have not yet been demonstrated conclusively in recent literature.⁵ Reported risk factors for post-prostatectomy SUI include the patient’s:⁵

• age
• body mass index
• pre-operative bladder function and urinary continence status
• prior radiation therapy
• pre-operative length of membranous urethra
• prior TURP
• vascular comorbidities
• stage of disease
• surgical technique employed, including nerve sparing
• surgeon’s level of experience.

While sphincter deficiency is often the main causative factor,⁴ other bladder conditions, such as detrusor overactivity, poor bladder compliance and detrusor underactivity, can often co-exist and contribute to the pathophysiology of SUI. Anastomotic stricture and scarring of the urethral tissue due to surgery and/or radiation should be considered in a patient who complains of urinary incontinence and decreased urine flow.

Male overactive bladder and urge urinary incontinence

OAB is a clinical syndrome characterised by urinary urgency, with or without urge incontinence, usually accompanied by frequency and nocturia.⁶ Proposed pathophysiological mechanisms include age-related changes in smooth muscle, leading to:

• hyper-excitability of muscarinic receptors in the detrusor smooth muscle, urothelium and neurovascular structures, and atropine resistance
• increased afferent (sensory group C fibres) nerve activity and hypersensitivity of other ion channels⁷
• denervation at the spinal and cortical levels, resulting in hyperactive voiding that is secondary to spinal micturition reflexes.

Other neurological conditions, such as Parkinson’s disease, multiple sclerosis or stroke, may cause loss of inhibitory neurons, resulting in neurogenic voiding dysfunction.⁷

The risk factors for UUI include neurological conditions, various inflammatory processes of the bladder, bladder outlet dysfunction, physiological ageing and psychosocial stressors, or the condition may be idiopathic in nature.⁸ Although it is accepted that OAB occurs more commonly in women, the true prevalence of OAB in men remains largely unknown. This is because most storage symptoms are frequently attributed to an enlarged prostate. The most common finding in patients with UUI is detrusor overactivity, which is a urodynamic observation of involuntary bladder contractions that are commonly associated with a corresponding sensation of urgency during bladder filling. Enlarged prostate and ensuing bladder outlet obstruction can result in bladder adaptations and abnormal bladder contraction (ie detrusor overactivity). It is also important to exclude other conditions that can simulate OAB-like symptoms, such as UTI, bladder stones and carcinoma in situ.^7–10 Ageing increases the prevalence of UUI and SUI, and the two can often co-exist, leading to mixed incontinence.

Practical approach to diagnosis

Basic clinical evaluation should include comprehensive history-taking, focused physical examination, urinalysis and post-void residual measurement (Table 1).^1,11–13 Evaluation of male urinary incontinence should identify the types of incontinence (eg stress, urge, mixed), with an emphasis on the timing and severity of the incontinence, and overall impact on quality of life. The presence of other urinary symptoms and past urological conditions or surgery provide useful information during the clinical assessment of the patient. Other relevant medical conditions, such as any neurological conditions, diabetes, previous pelvic injury and cognitive impairment, should also be assessed. Identifying the most bothersome symptom will often help direct management. The use of validated patient questionnaires, such as the International Consultation on Incontinence Questionnaire (ICI-Q), can often provide symptom clarification and serve as a marker for improvement. A three-day frequency–volume chart or bladder diary (eg indicating daytime and night-time frequency of micturition, episodes of incontinence, voided volumes, 24-hour urine output), is often very useful in men who report mixed incontinence.

Physical examination should include an abdominal examination to detect any abdominal or pelvic mass (eg palpable bladder), perineal examination for sensory loss, digital rectal examination for prostate size and nodules, and pelvic floor tone. A focused neurological examination is useful in screening for upper (eg multiple sclerosis, Parkinson’s disease) or lower (eg sacral nerve root lesion) motor neuron diseases. Urinalysis and microscopy are essential to exclude a UTI, while measurement of post-void residual urine offers a good estimate of voiding efficiency. A pad test (ie weighing the pad to measure the volume of urinary incontinence) can diagnose the severity of urinary incontinence and may be used to indicate treatment outcome. Blood tests for renal function are recommended if compromised renal function is suspected, and in cases of polyuria (in the absence of diuretics use), as documented by the frequency–volume chart, glycaemic index should be assessed.

Imaging studies, such as renal tract ultrasound, provide useful information in excluding the presence of upper urinary tract dilatation and co-existing bladder pathology (eg stones, tumours). Contrast studies, such as cysto-urethrography or computed tomography (CT), could assist in the identification of fistulas, strictures, bladder diverticulae or tumours. Specialised tests should be individualised with the use of cystoscopy to evaluate the presence of urethral strictures, an obstructive prostate, bladder stones or tumours.

A pressure–flow study provides valuable information on detrusor function. Urodynamic studies have a role in patients with suspected voiding difficulties or neuropathy, failed treatment, or those considering surgical treatment. Urodynamic studies provide a physiological assessment of bladder and outlet function, and demonstrate dyssynergia of bladder contraction and outlet opening, such as seen in bladder denervation.¹³ Referral to a urologist is recommended for men with a provisional diagnosis other than BPH or OAB and those with a known history of haematuria, neurological or prior genitourinary surgery, radiation or trauma (Box 1).

Role of the general practitioner

Continence assessment includes identifying the type of incontinence (ie urgency, stress-related, mixed), the severity (number and size of pads used, preferably pad weights) and the impact on activity or quality of life. In patients who have mixed incontinence, such as urgency and stress incontinence, it is important to determine which is more bothersome. In the presence of complicated lower urinary tract dysfunction, symptoms such as haematuria, recurrent UTIs, dysuria and pain will require further investigation or specialist referral to exclude malignant or infectious pathology. Medical comorbidities, especially conditions such as diabetes, ischaemic heart disease or congestive cardiac failure, neurological conditions, chronic pulmonary disease and obesity, can exacerbate OAB and SUI symptoms. Treating these conditions may not eliminate incontinence, but it may lessen the severity.

Initially the general practitioners (GPs) should order urine microscopy and culture to exclude infection, haematuria and pyuria. The patient should be advised to keep a bladder diary to record the number and time of voids in a 24-hour period, volumes voided, incontinence episodes, fluid intake, degree of urgency and incontinence over a three-day period. The bladder diary allows documentation of functional bladder capacity, and checks for nocturnal polyuria (where nocturnal voided volume is >33% of the 24-hour volume) and incontinence. Post-void residual urine – often detected by bladder ultrasonography – is useful to check for incomplete emptying, which may suggest the presence of outlet obstruction or an underactive bladder (urinary retention). Simple blood tests to evaluate renal function, blood glucose level and prostate-specific antigen (PSA) may be indicated in symptomatic men.

Treatment strategies

Initial management of male urinary incontinence usually consists of basic diagnostic investigations to exclude any reversible conditions, such as a UTI (Figure 1). Conservative, non-invasive treatment options include lifestyle interventions, pelvic floor muscle training (PFMT) with or without biofeedback, and bladder retraining.⁹ Lifestyle interventions include caffeine reduction, weight loss and cessation of smoking. While more recent literature supports PFMT to treat urge and stress incontinence, its long-term efficacy remains uncertain.^14,15 Pre-operative and early postoperative (immediately after catheter removal) PFMT have been found to significantly improve and hasten the recovery of continence rate,^13–15 but there is limited evidence for preventive effects of pelvic floor rehabilitation. In some patients with co-existing urinary symptoms that are suggestive of mixed incontinence, the use of an antimuscarinic drug may be useful to eliminate potential detrusor overactivity.

Figure 1. A practical algorithm in the management of adult male stress urinary incontinence and overactive bladder/urge urinary incontinence

In patients with persistent post-prostatectomy SUI, there is no approved medical therapy,⁸ and surgical treatment is recommended after failure of conservative measures.^14,15 Published literature has found that the most significant improvement in SUI usually occurs during the first year, with minimal improvement usually seen beyond the second year postoperative.^4,16 Urethral bulking agents are generally ineffective in men and are associated with the need for multiple injections, temporary benefit and a low cure rate.^15,16 Minimally invasive male slings, such as transobturator AdVance (American Medical Systems, Minnetonka, MN, US) and Virtue (Coloplast, Minneapolis, MN, USA) slings, and adjustable slings with Argus (Promedon, Cordoba, Argentina) and ATOMS (AMI, GmbH, Feldkirch, Austria) are advocated in men with mild-to-moderate SUI without prior radiotherapy.^15,16 There is no consensus concerning each specific sling system, and the implantation of the various male slings is based on surgeon expertise and patient preference. While adjustable male slings have a theoretical advantage over non-adjustable slings – because the sling can be revised easily to provide further urethral compression in the event of persistent and/or recurrent urinary incontinence without the need for another sling or salvage artificial urinary sphincter (AUS) surgery – recent literature has found no significant difference observed in the clinical outcomes with reported similar patient satisfaction rate.¹⁷

The current AUS, AMS 800 (American Medical Systems, Minnetonka, MN, US) is considered the standard of care in men with moderate-to-severe SUI and/or SUI that is associated with radiotherapy.¹⁸ Like any surgical device, male slings and AUS have their own merits and disadvantages, and complications include erosion, mechanical failure, infection and revision rates.¹⁸ While AUS remains the standard of care in men with significant stress urinary incontinence and/or radiation-induced urinary incontinence, with excellent long-term efficacy, durability and safety records, many men prefer a male sling to an AUS because it provides an instantaneous postoperative continence. Male slings are often viewed as minimally invasive and their use allows patients to void without mechanical manipulation of a urinary device.¹⁹

The treatment of OAB/UUI aims to increase bladder capacity, decrease bladder activity and contractility, and/or decrease sensory (afferent) input. Behavioural modifications with avoidance of stimulants (eg caffeine, smoking) and pharmacological therapy with anticholinergic agents are the mainstay of treatment for UUI.^{7–9,11–13,20} At present, there is no consensus on ‘best-in-class’ antimuscarinic drugs. The drug profiles, interaction and tolerability, and dosing schedule can differ between individuals and thus, the treatment should be individualised for each patient. The common adverse effects related to cholinergic profiles, namely dry mouth, blurred vision, tachycardia, constipation, impaired cognition and urinary retention, have often resulted in poor compliance and high discontinuation rates.⁷ When using antimuscarinic agents in patients at risk of worsening cognitive function, it may be appropriate to monitor changes during initiation and continuation of treatment. Salvaging non-responders to a drug by switching to another drug has been found to be effective in some studies and so switching between drugs (ie modality, subclass) is a reasonable approach for patients in whom the initial oral agent has failed.^20,21 The beta-3 adrenoceptor agonist mirabegron represents a new class of drug and mechanism. It causes direct relaxation of detrusor muscle, inhibition of spontaneous contractile activity in the bladder and reductions in bladder afferent activity.²² While beta-3 adrenoceptor agonists are well tolerated and have no anticholinergic adverse effects (eg dry mouth), mirabegron has a potential effect on the beta receptors in the cardiovascular system, which can theoretically lead to an increase in cardiovascular events, particularly hypertension and headaches.

If patients become refractory to these initial conservative measures and/or are intolerant of the adverse effects, intravesical botulinum toxin and electrical stimulation using sacral neuromodulation are effective and considered third-line therapies in OAB.^11,20 Botulinum toxin can be injected into the detrusor muscle cystoscopically, either in an office-based setting under local anaesthesia or the operating room. The long-term benefits of botulinum toxin appear to be sustainable, with an excellent safety profile.^20,23 Sacral neuromodulation involves the insertion of an electrode into the S3 foramen, which provides nerve stimulation to the bladder and perineum.²⁴ A temporary lead can be placed to provide stimulation for a short trial period (around seven to 14 days), after which a permanent lead and generator are surgically implanted. Sacral neuromodulation does have durable treatment effects, but there are adverse effects, including pain, lead migration, infection and the need for further procedures.²⁵ Bladder reconstructive surgery with augmentation cystoplasty and detrusor myomectomy are infrequently performed these days, and urinary diversion is often reserved as the last option in severe intractable cases.²⁰

Key points

• Adult male non-neurogenic urinary incontinence is a highly prevalent condition that has a significant impact on a patient’s quality of life and healthcare resources.
• Over the past decade, there have been considerable advances made in terms of our understanding of the various pathophysiological mechanisms and management strategies in male SUI and OAB/UUI.
• Management of men with urinary incontinence requires careful evaluation, with comprehensive history-taking, focused physical examination and basic investigations to identify the underlying pathology, and should be tailored to the individual patient.
• Management involves a frank discussion about the various treatment options and the patient’s expectations, before selecting the most appropriate treatment.
• Further research efforts for the development of novel drug therapies and minimally invasive surgery are necessary to meet the increasing prevalence and patients’ expectations.

Authors

Eric Chung MBBS, FRACS (Urology), Associate Professor of Surgery and Consultant Urological Surgeron, Androrology Centre, Brisbane, Qld; University of Queensland, Department of Urology, Princess Alexandra Hospital, Brisbane, Qld. [email protected]

Darren J Katz MBBS, FRACS (Urology), Urologist and Prosthetic Surgeon, Men’s Health Melbourne; and Urology Consultant, Western Health, Vic

Christopher Love MBBS, FRACS (Urology), Urological and Prosthetic Surgeon, Men’s Health Melbourne, Melbourne and Urology South, Moorabbin, Vic; Senior Urological Surgeon, Department of Urology, Monash Medical Centre, Clayton, Vic; Bayside Urology, Melbourne, Vic

Competing interests: None.

Provenance and peer review: Commissioned, externally and internally peer reviewed.

A Stress-Related Peptide Bombesin Centrally Induces Frequent Urination through Brain Bombesin Receptor Types 1 and 2 in the Rat

Abstract

Stress exacerbates symptoms of bladder dysfunction including overactive bladder and bladder pain syndrome, but the underlying mechanisms are unknown. Bombesin-like peptides and bombesin receptor types 1 and 2 (BB₁ and BB₂, respectively) in the brain have been implicated in the mediation/integration of stress responses. In this study, we examined effects of centrally administered bombesin on micturition, focusing on their dependence on 1) the sympathoadrenomedullary system (a representative mechanism activated by stress exposure) and 2) brain BB receptors in urethane-anesthetized (1.0–1.2 g/kg, i.p.) male rats. Intracerebroventricularly administered bombesin significantly shortened intercontraction intervals (ICI) at both doses (0.1 and 1 nmol/animal) without affecting maximal voiding pressure. Bombesin at 1 nmol induced significant increments of plasma noradrenaline and adrenaline levels, which were both abolished by acute bilateral adrenalectomy. On the other hand, adrenalectomy showed no effects on the bombesin-induced shortening of ICI. Much lower doses of bombesin (0.01 and 0.03 nmol/animal, i.c.v.) dose-dependently shortened ICI. Pretreatment with either a BB₁ receptor antagonist (BIM-23127; d-Nal-cyclo[Cys-Tyr-d-Trp-Orn-Val-Cys]-Nal-NH₂; 3 nmol/animal, i.c.v.) or a BB₂ receptor antagonist (BEA; H-d-Phe-Gln-Trp-Ala-Val-Gly-His-Leu-NHEt; 3 nmol/animal, i.c.v.), respectively, suppressed the BB (0.03 nmol/animal, i.c.v.)–induced shortening of ICI, whereas each antagonist by itself (1 and 3 nmol/animal, i.c.v.) had no significant effects on ICI. Bombesin (0.03 nmol/animal, i.c.v.) significantly reduced voided volume per micturition and bladder capacity without affecting postvoid residual volume or voiding efficiency. These results suggest that brain bombesin and BB receptors are involved in facilitation of the rat micturition reflex to induce bladder overactivity, which is independent of the sympathoadrenomedullary outflow modulation.

Footnotes

• Received November 2, 2015.
• Accepted December 30, 2015.

• This research was supported in part by the Japan Society for the Promotion of Science [Grant-in-Aid for Scientific Research (C) 26460909 (to T.S.), Grant-in-Aid for Young Scientists (B) 26861271 (to S.S.), and Grant-in-Aid for Challenging Exploratory Research 15K15583 (to M.S.)], the National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases [R01-DK088836 (to N.Y.)], the Department of Defense [Grant W81XWH-12-1-0565 (to N.Y.)], the Smoking Research Foundation in Japan, the Japan Health Foundation, and Kochi University [Discretionary Grant of the President].

• Part of this work was previously published in abstract form at the 2015 International Continence Society annual meeting; 2015 Oct 6–9; Montreal, Quebec, Canada.

• dx.doi.org/10.1124/jpet.115.230334.

• Copyright © 2016 by The American Society for Pharmacology and Experimental Therapeutics

Mental Tricks for Managing OAB

If you have overactive bladder (OAB), you know that it’s a very real physical issue. But although the problem is physical, some time-tested methods for managing it are psychological.

The mental strategies below may help control the urge to go. These techniques may also ease stress and anxiety about the possibility of having an accident.

Mental strategies are easy to learn, simple to use, and free of harmful side effects. Such strategies are often combined with other OAB treatments, such as pelvic muscle exercises and medication. Ask your doctor how these approaches fit into your personal treatment plan for OAB.

The sphincters are a ring of muscles that hold the bladder closed. During urination, the bladder squeezes and the sphincters relax, letting urine escape the bladder. Normally, the brain sends signals that control when this happens. In people with OAB, the process no longer works as smoothly as it once did. With practice, however, many people are able to retrain the brain to control the bladder again.

The National Association for Continence outlines a typical, six-week  retraining program on its website. Ask your doctor if this type of program is right for you. It involves urinating on a schedule, gradually lengthening the time between bathroom visits. If you have the urge to go between scheduled times, mental distraction or relaxation (the next two strategies) often can help you ignore the urge until it goes away.

When the urge to go strikes at an inopportune moment, try thinking about something else until the urge passes. Focus on a complex mental task that demands all your attention. For example:

• Count backward from 99 by threes

• Recite all the words to a song or poem you learned as a child

• Recall the first and last names of everyone in a large office

• Practice giving directions to your home from various locations

Focusing on relaxing thoughts is another way to take your mind off the urge to go to the bathroom. Plus, relaxation eases anxiety and stress, which may result from unexpected bathroom breaks or worries about getting to the toilet. You can use this quick and easy relaxation technique anywhere, anytime:

Take several deep breaths to calm your mind. Then picture yourself on a relaxing vacation. Use all your senses to paint a vivid scene in your mind. If you picture a beach scene, for example, you might imagine the sight of palm trees, the sound of the surf, the feel of a swaying hammock, and the taste of salt in the air.

Mindfulness works differently from distraction. Instead of ignoring an urge, you make a conscious choice to notice whatever you’re experiencing from moment to moment. You take note of sensations, thoughts and feelings, but then you move on to the next moment. This helps you see the urge to urinate as just another body sensation, which you can notice without becoming preoccupied with it.

In one small study, women who had sudden, strong urges to urinate along with urine leaks were randomly assigned to eight weeks of either mindfulness or yoga classes. Women in the mindfulness group had fewer accidents than those in the yoga group. For many, the benefits were still apparent a year later.

Like any skill, mindfulness can be honed through regular practice. Try this exercise:

Take a mindful stroll. As you walk, notice the sensation of your muscles working, your feet pressing against the ground, and your breath moving in and out. Also take note of the sights, sounds and smells around you. If other thoughts come to mind, notice them without judging them. Then let go of those thoughts as you move on to whatever the next moment brings.

By themselves, mental strategies may not solve all your bladder control problems. You might still need other treatments for OAB. But these strategies can help you feel calmer, more confident, and more in control. That in itself can be a big boost for your well-being.

• Mental strategies can help control the urge to urinate and ease stress about the possibility of an accident.

• Brain “retraining” involves urinating on a schedule, gradually lengthening the time between bathroom visits.

• Using distraction, when the urge to go strikes at an inopportune moment, you can try focusing on a complex mental task.

• The mindfulness technique involves making a conscious choice to notice what you’re experiencing from moment to moment. You take note of sensations and thoughts, then move on to the next moment.

The Startling Link between Urination and Symptoms of Adrenal Fatigue

The medical term for frequent urination is polyuria, and it is a condition that many regular people have. Some people need to urinate six or seven times a day and others have to urinate at least once every one or two hours. This can be among the symptoms of adrenal fatigue.

There are many causes of frequent urination. If it is accompanied by fever and lower abdomen discomfort, it could be a urinary tract infection. Another very common cause of frequent urination is diabetes mellitus, more commonly known as Type 2 Diabetes. The high levels of sugar in the blood cause an osmotic effect, which leads to an increase in urination. Type 1 Diabetes, or diabetes insipidus (DI), also frequently presents with polyuria. People taking water pills for congestive heart failure or high blood pressure management often also see an increase in urination. These are medical conditions that conventional medical doctors are quite knowledgeable about.

However, when frequent urination is accompanied by extreme tiredness, one must always consider adrenal fatigue. Adrenal fatigue is a complex condition that can affect almost every organ in the body. The adrenal gland is responsible for making several hormones, including the sex hormones, sympathetic hormones and cortisol. Another very important hormone manufactured in the adrenals is aldosterone, which regulates the level of sodium and water in the body. In adrenal fatigue, the levels of aldosterone may not be optimal. When the levels of aldosterone are low but still within standard laboratory ranges and standards, frequent urination can manifest as one of the symptoms of adrenal fatigue. Another very common but unrecognized cause of frequent urination, related to adrenal fatigue, is stress.

What is aldosterone?

Aldosterone is a steroid hormone made in the outer layers of the adrenal gland. The levels of aldosterone are regulated by the body’s levels of sodium potassium, as well as other hormones made in the brain. It plays a critical role in the regulation of blood pressure and sodium conservation in the body, because water follows aldosterone. The higher the body’s levels of aldosterone, the higher the body’s sodium levels and the water load; thus less is secreted. This reverse of this process also holds true.

Some patients receive prescription medications to lower their blood pressure by blocking the actions of aldosterone.

What happens when aldosterone activity is low?

Hypoaldosteronism is a medical disorder associated with low levels of aldosterone. There are many causes of this disorder, including adrenal gland failure, cancer, use of certain water pills, infection of the adrenal gland, and use of certain blood pressure medications. When low aldosterone levels occur, there is a significant loss of sodium in the urine. This can result in dehydration and a drop in blood pressure. The individual will develop extreme fatigue, lethargy and can even go into shock. These changes can be prevented by increasing one’s intake of sodium chloride, also known as table salt.

Can frequent urination be among the symptoms of adrenal fatigue and stress?

Yes, there are some people who experience mild to moderate stress who can develop frequent urination as one of their symptoms of adrenal fatigue. The stress may be physical or emotional. Because the control of aldosterone is partly under the influence of the brain, any type of nervous stimulus or mental stress can affect its secretion. When an individual has physical stress, there is increased release of the stress hormones, such as epinephrine, norepinephrine, glucagon and cortisol, all of which can affect urination. Short-term stress causes your body to release epinephrine. In turn, epinephrine can increase urine flow. Under chronic stress, cortisol levels will increase in early stages of adrenal fatigue (stages 1 and 2). These increased levels as one of the symptoms of adrenal fatigue cause an anti-diuretic hormone (ADH) to decrease, thereby, once again, increasing urine flow. As your adrenals continue to get stressed, cortisol levels may drop. However, as the adrenals weaken further into advanced stages (stages 3 and 4), they will also become unable to produce aldosterone at the proper levels. A decrease in aldosterone will once again result in an increase in urination as one of the symptoms of adrenal fatigue. So, in the early stages of adrenal fatigue, cortisol levels and epinephrine levels in your body may be higher, leading to frequent urination. In the later stages of adrenal fatigue, the adrenals are not able to produce aldosterone, thus resulting in increased urination as well. The end result is increased urination, loss of sodium and extreme fatigue, while dehydration can occur as adrenal fatigue advances, but for a different reason.

How does one get to the root cause of frequent urination?

Because there are so many causes of frequent urination, the medical practitioner will need to do an exhaustive work-up. Before attributing the condition to adrenal fatigue, one has to rule out other, more serious, medical conditions. It can be difficult for a healthcare provider to make a correct diagnosis linked to frequent urination, based on just the history and physical exam. Before a diagnosis can be made, your provider may ask you the following questions:

• Are you taking any medications, herbs or supplements?
• What other symptoms are you experiencing?
• Does the urination occur during the day, night or all the time?
• Are you more thirsty than usual?
• Is your urine dark, clear or bloody?
• Do you drink a lot of coffee or alcohol?
• Do you have a fever?
• Do you have abdominal discomfort when you urinate?

Depending on your answers, the provider may take the following next steps.

• Analyze your urine for bacteria, stones, glucose, acidity, levels of sodium, potassium, etc.
• Refer you to a specialist to examine your bladder to make sure it is working properly and is able to store urine.
• Order an ultrasound to make sure you have no kidney stones.
• Order hormone level tests.

Are hormonal tests sensitive for adrenal fatigue?

In general, the available tests are quite sensitive when there is a severe drop in the levels of hormones. However, if you have mild stress or adrenal weakness, the changes in hormone levels are often not readily identifiable by the standard of currently available tests. In other words, laboratory tests could be normal, leaving physicians at a loss to understand the symptoms of adrenal fatigue. That’s why a detailed health history as well as sharp clinical judgment is required to connect the dots and see if your frequent urination is indeed part of the constellation of symptoms of adrenal fatigue and stress or something else.

How does one overcome polyuria in an adrenal fatigue setting?

Increase hydration, but make sure that your electrolyte balance is maintained; this is key to avoiding medical emergencies as a result of dehydration from excessive frequent dehydration. Your sodium level needs to be maintained, as excessive fluid without adequate sodium replenishment can lead to a condition known as dilutional hyponatremia. This can be quite serious, with lethargy, and stupor as a potential end result. Excessive sodium replenishment, however, can lead to high blood pressure. Fortunately, this is seldom the problem because most sufferers of adrenal fatigue have constant low blood pressure. Raising blood pressure with proper fluid and electrolyte replenishment is usually accompanied by a renewed increase energy. Always carry a full water bottle with you. Hydrate frequently, before you notice the onset of thirst. When you are thirsty, the body is already well into subclinical dehydration.

Be careful to avoid drinks such as coffee that have a net diuretic effect. Talk to your doctor if you are on blood pressure medicine, to discuss possible adjustment.

Fortunately, polyuria as one of the symptoms of adrenal fatigue is one that can be reversed. As adrenal support improves and electrolyte balance normalizes, this phenomenon usually resolves by itself.

For a long-term solution, one must deal with the inciting underlying condition. For example, if the infection was the cause of damage to the adrenal gland, then one must use antibiotics. If stress is the cause, then one must take measures to relieve stress. The first thing you should do is find out what the stress is and try to reduce or eliminate it. There are several remedies to relieve stress and they include the following:

• Engage in some form of mild exercise. Almost any exercise – even walking – has been shown to improve the mood and lower stress, provided you can tolerate it and have no energy slump for the next 24 hours after finishing exercise. Remember that during active exercise, the feel-good sensation is often due to an adrenaline rush. If you have adrenal fatigue, you can trigger an adrenal crash after the adrenaline is burned off. Excessive exercise is not recommended.
• Engage socially with your family and friends. These individuals can provide you with support and make you feel safe. It is important to avoid toxic relationships that can trigger adrenal crashes.
• Learn to say no. There is no way you can please everyone, so stick to your limits and do not take on more than what you can handle.
• Avoid people who stress you out. If there are people who constantly irritate you, then it is time to cut them out of your life.
• Take control of your environment. This means removing anything that brings stress. For example if the TV is too loud, switch it off.
• Learn to express your feelings and don’t bottle them up.
• Practice some type of relaxing exercise, like yoga or tai chi, or try meditation or massage
• Learn to compromise and manage your time better.

Besides relieving stress on your body, it is also important that you give the adrenals the proper nutrition and attention they need to slowly recover and start producing aldosterone again.

Conclusion

If stress is the cause of your frequent urination, then lowering stress will help improve your symptoms. You need to change your lifestyle to ensure that stress is at a minimum. In most cases, stress relief can be supported by home remedies, which are generally safer than prescription medications. The next step is to make sure your adrenals are getting stronger so that they can increase their hormone production and once again bring your body back into balance. Finding an experienced clinician with this expertise is important because an improper fluid balance can have very serious negative consequences. The effects of stress relief on urination are immediate. You are also likely to notice an improvement in your energy levels and not feel as tired as often.

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90,000 Frequent urination in women

At the moment, such a problem as too frequent urination in women is very common. In the event that such urination is not accompanied by pain or any discomfort, it is not worth talking about pathology. Nevertheless, a visit to a specialist in the presence of such a problem will not be superfluous.

This ailment is diagnosed if the number of trips to the toilet in twenty-four hours exceeds ten times.You should especially be on your guard if the urge does not stop at night.

Standard

There are situations when a woman’s frequent trips to small things are justified. Similar cases can occur with too much fluid intake or when taking diuretics. A diuretic effect can be exerted not only by drugs, but also by:

• Caffeine
• Alcohol
• Herbal teas
• Various preparations for weight loss.

Factors that can affect the frequency of urination in women are:

• Stress or intense excitement
• Hypothermia of the body.

At the time of menopause, most women also have an increased urge to empty the bladder. This fact is a consequence of hormonal changes in the body and is not considered a pathology. After a certain period of time, the number of trips to the toilet will return to normal.

During pregnancy, there may also be a constant urge to urinate. A similar situation can arise if the fetus presses on the bladder (last trimester) or during hormonal changes in the body (first trimester).

Pathology

Frequent urination may appear as a result of hormonal disruption. In such a situation, specialist advice is required. Such a failure may be a signal that a serious illness is developing in the body.Such diseases include:

• Presence of kidney or bladder stones
• Bladder tumor
• Strong neurosis
• Neurogenic disorders
• Diabetes
• Strong mixing of the uterus
• Progressive myoma.

With such a problem, it will not be possible to establish a diagnosis on your own, and it is for this reason that a visit to the doctor is mandatory. For all of these diseases, immediate and rather serious treatment is required.

Cystitis

The most common cause that can provoke an increased urge to empty the bladder may be cystitis. Often, with cystitis, the patient feels painful sensations at the time of going to the toilet. In addition, the urine becomes cloudy or blood starts to appear in it. The smell from the vaginal cavity also changes, becoming more intense. Simultaneously with the increase in the frequency of urge, the portion of the excreted urine is significantly reduced. If such symptoms occur, you must immediately consult a doctor, since in the absence of timely treatment, the process is transformed into a chronic stage.Chronic cystitis cannot be treated, and the patient will suffer from periodic exacerbations of the disease throughout her life.

Self-treatment of cystitis with folk remedies will not give the desired result. This disease is accompanied by a strong inflammatory process and its treatment can be effective only in the case of taking antibacterial drugs.

90,000 Frequent urination. Frequent urination at night. What is the frequency of urination?

When is urination to be considered frequent?

An adult normally secretes 1.5-2 liters of urine.To do this, he has to visit the toilet 3-7 times a day. Urination in children is more frequent: in children of the first year of life – 12-16 times a day, at the age of one to three years – 10 times a day, from three to nine years – 6-8 times. The range of indicators is wide enough. How many times a person needs to go to the toilet depends on many factors. In particular, if you drink a lot of fluids, you should expect that the need to urinate will increase. A number of foods are diuretic; these are, for example, watermelon, melon, cranberry, lingonberry, cucumber, coffee, alcohol.Eating them is likely to increase the frequency of urination due to increased urine output.

It is abnormal to urinate more frequently with a steady fluid intake and a stable diet. As a rule, urination more than 10 times a day in an adult is already regarded as a pathology, however, for such an assessment, the discomfort experienced by a person with such a frequent visit to the toilet is also of great importance.

Frequent urination is abnormal if one of the following symptoms is observed:

• Constant urge to urinate;
• the amount of urine when urinating is insignificant.Normally, an adult should excrete about 200-300 ml of urine at a time;
• Burning or pain is felt during urination;
• urination interferes with the normal rhythm of life (work, travel, sleep).

Frequent urination at night (nocturia), polyuria and urinary incontinence

Distinguish between increased urination at night and during the day. Frequent urination during the daytime is called pollakiuria. Particular attention is paid to frequent urination at night.Normally, a person usually goes to the toilet no more than once a night. With an increase in urination at night, the development of many diseases begins. If most of the urine is excreted at night, this condition is called nocturia .

Increased urination may be due to more urine being excreted. If the total amount of urine exceeds 1.8 liters, then this condition is called polyuria . Persistent polyuria is caused by serious diseases, and temporary polyuria is also often pathological.

Frequent urination is also associated with a problem such as urinary incontinence . Urinary incontinence occurs when a person is no longer able to suppress the sudden urge to urinate. Usually, urinary incontinence develops against the background of frequent urination.

Causes of frequent urination

In addition to the food factor (drinking plenty of fluids, specific diet), the physiological causes of frequent urination include stress and hypothermia.Frequent urination is also observed in pregnant women, especially in the first and third trimesters. Certain medications can also lead to more frequent urination.

In such cases, frequent urination is observed, as a rule, in the daytime and is temporary. As soon as the factor that caused it ceases to act, the frequency of urination is normalized.

Frequent urination caused by diseases of the genitourinary system has a pathological nature.Moreover, in most cases, the cause of frequent urination is irritation of the urethra and bladder neck, which are abundantly innervated. The irritation can be caused by infection or mechanical (in the case of urolithiasis or tumor). Normally, the nervous system should receive a signal from receptors in the bladder neck region only in one case – if the bladder is full. But as a result of pathological irritation, the signal is given prematurely, and the urge to urinate arises.

Frequent urination causes the following diseases of the genitourinary system :

Also, frequent urination is observed with diseases such as:

• diabetes. With diabetes, the patient is thirsty, drinks more than the norm, which leads to increased urination;
• cardiovascular failure.

When is increased urination a reason to see a doctor?

If the frequency of urination has become an irritating factor for you or there is reason to suspect that the frequency of urination is of a pathological nature (caused by a disease), you should consult a urologist.The first signal is often the urge to urinate at night. If you become more likely to get up to use the toilet at night, do not postpone your visit to the doctor. Remember: the earlier the treatment of the disease is started, the easier it is to treat it.

Treatment of frequent urination in Moscow

If you complain of frequent urination, you should consult a urologist.

The family doctor’s urologists have extensive experience in treating diseases of the genitourinary system. Based on modern diagnostics, urologists of the “Family Doctor” will establish the cause of frequent urination and prescribe an effective treatment.

Pediatric urologists of JSC “Family Doctor” will help in case of frequent urination in children.

And the bubble is “nervous”! Who is at risk of “urinary” neurosis | Healthy life | Health

However, the treatment of this disease is also under the jurisdiction of specialist neurologists.

Our experts – urologist, Ph.D. Kuzma Milenin and neurologist, psychotherapist Igor Mikhalev.

Problem Node

This disease is characterized by a variety of symptoms: urinary incontinence and urinary retention.

There are many reasons for this disorder. One of the most common are neuroses. Apparently, therefore, the disease is still known under another bright name – bladder neurosis. Doctors note that the disorder is associated with a fear of urinary incontinence. Against this background, the fear of leaving home for a long time develops. Moreover, to be in a situation in which it is impossible to use the toilet. Most of the patients with this neurosis are women and the elderly.

It is believed that neuroses are the result of autonomic dysfunction.It is thanks to the sympathetic and parasympathetic parts of the autonomic nervous system that a person controls the direction of his natural needs. When this system fails, control can be lost. The result is abnormal urinary retention, which in fact occurs more often, urinary incontinence.

Nevertheless, the overwhelming majority of doctors are optimistic about the treatment of “urinary” neuroses: such psychogenic disorders are considered reversible. The issue is resolved thanks to the work of psychotherapists, as well as the use of antidepressants and tranquilizers under the supervision of a doctor.

Injuries and tumors of the spinal cord, in which the intersection of a large number of sympathetic and parasympathetic nerves, coming from the bladder, rectum, blood vessels, genitals, are much more formidable causes of the development of bladder neurosis. However, problems with urination are possible with alcohol abuse, even with banal sciatica. This pathology of the nervous system also occurs in multiple sclerosis.

Therefore, doctors of various specialties involved in the treatment of neurogenic bladder emphasize: in such disorders, a competent initial examination by a neurologist is very important.The tactics of treatment may directly depend on the conclusions of this specialist.

In a given rhythm

In about 30% of cases, a neurogenic bladder is accompanied by the development of secondary inflammatory-dystrophic changes in the urinary system – vesicoureteral reflux, chronic cystitis, pyelonephritis. All this can lead to arterial hypertension, nephrosclerosis and chronic renal failure. As a result, a person runs the risk of becoming disabled.

Often, spinal injuries, especially in the lumbar spine, lead not only to urinary disorders, but are also accompanied by constipation or fecal incontinence. This knot of problems can be resolved only through the efforts of specialists in different specialties – a neurologist, urologist or neuro-urologist.

Treatment of neurogenic bladder depends on the cause of the disease. First of all, doctors are engaged in the treatment of the primary disease that caused urinary disorders, and in parallel with the prevention of genitourinary infections with courses of antibiotics and uroseptics, as well as with the help of regular drainage of the bladder with catheters.

In some situations, specialists develop a patient’s reflex to urinate with the help of special “trainings”, stimulating this process with pharmaceuticals, nerve impulses, and a catheter. Or they simply advise the patient to learn how to empty the bladder at a strictly defined time.

Sometimes, to increase intra-abdominal pressure, the patient is advised to wear a lumbosacral corset. Reflexology becomes a good help. As a result, the bladder “gets used” to emptying and begins to work in a given rhythm.Given the prevalence of this disorder and its social connotation (there are many middle-aged and elderly women among the patients), unscrupulous entrepreneurs from medicine and all sorts of “healers” who offer various “traditional” or “innovative” methods of treatment are increasingly being integrated into the solution of this problem. The cost of services goes off scale, while efficiency tends to zero.
Experts warn: neurogenic bladder is not a disease in which amateur performance is allowed.One of the components of success in the treatment of this ailment is regular follow-up by a urologist, neurologist, and nephrologist.

90,000 Vegeto-vascular dystonia: symptoms, etiology

When a mismatch creeps into the work of the parasympathetic and sympathetic branches, a person develops a complex of painful manifestations. This instability of the vegetative system is called vegetative-vascular dystonia. In medical publications, it is also called neurocircular, vasomotor dystonia, or autonomic dysfunction.

The person does not control the activity of the autonomic nervous system. Its sympathetic department speeds up the work of internal organs, the parasympathetic department coordinates the immune response, is responsible for the recovery processes in the body. It returns the sympathetic branch activated by stress or physical exertion to its original state.

Typology VSD

There is no general classification of the disease. Based on certain signs, vegetative-vascular dystonia is divided into several groups:

• mild – there are no vegetative crises, the symptoms cause insignificant discomfort;

• moderate – crises periodically occur, a person becomes disabled during an exacerbation of the disease;

• severe – exacerbations and crises occur frequently.

According to the combination of symptoms, they are divided into 5 types:

• hypertensive – with tachycardia, headache, short-term increase in blood pressure, panic attacks;

• hypotonic – with an episodic or constant decrease in blood pressure, dizziness, loss of strength, body aches, headache;

• cardiac – with a slow, uneven or rapid pulse, shortness of breath, chest pain;

• vagotonic – with increased salivation, chest tightness, breathing problems;

• mixed – with alternation or a combination of different symptoms.

By the nature of the flow, they are divided into 4 groups:

• latent – occurs when exposed to a stress factor, the rest of the time the disease does not manifest itself;

• paroxysmal – in the form of seizures;

• permanent – permanent;

• mixed – there can be an alternation of permanent and paroxysmal forms.

Depending on the prevalence, 3 types are distinguished:

• local – with local lesion;

• systemic – with the involvement of one body system in the process;

• generalized – involving several systems.

Most often, the VSD is asymptomatic.Under the influence of overload, stress factors or unfavorable conditions, the mismatch between the sympathetic and parasympathetic systems increases, which leads to an exacerbation and manifestation of a crisis. Often, a crisis is the total result of the accumulated components, which explains its large-scale and versatile symptoms.

Etiology

The main cause of the syndrome is a hereditary predisposition. In addition, there are pathogenetic factors that cause a functional disorder of the autonomic nervous system:

• in children, the disease can be provoked by intrauterine fetal hypoxia, birth trauma, stresses that the mother experienced in the first months of pregnancy;

• in adolescents, VSD is formed under the influence of endocrine disorders, physical inactivity, chronic diseases, emotional stress, conflict situations;

• in adults, overweight, hormonal changes, trauma to the brain or spinal cord, severe single stress, being in a state of prolonged nervous tension, osteochondrosis of the cervical spine, mental and physical fatigue, regular lack of sleep, infectious diseases of the respiratory system and the brain, intake bronchodilators, oral contraceptives and a number of other negative stimuli.

The female half of the population is 3 times more likely to suffer from vegetative-vascular dystonia due to hormonal changes in the body during pregnancy, immediately before childbirth and at the stage of extinction of the function of the reproductive system.

Symptoms of the disease

In infants, an exacerbation of VSD is accompanied by frequent regurgitation, impaired appetite, and excessive accumulation of gases in the intestines. Children of the older groups complain of shortness of breath, headaches, and digestive disorders.They more often show a tendency to conflict behavior, whims, colds.

Comparison of common symptoms of VSD helps diagnose the disease in adults and children. Their list includes:

• increased fatigue;

• violation of appetite and functions of the digestive system;

• frequent urination;

• shortness of breath, lack of air;

• tachycardia, arrhythmia;

• pain in the region of the heart;

• increased sweating;

• numbness or coldness in the limbs, chills.

The disorder is often accompanied by an aggravated reaction to changes in weather factors, anxiety and anxiety, and sleep that does not bring adequate rest.

The vegetative system regulates the work of all systems of the body, therefore, the disease can manifest itself as a disruption in the functioning of the respiratory, cardiovascular, digestive systems, a malfunction of thermoregulatory, dysdynamic, neuropsychiatric and sexual processes.

To make a correct diagnosis, the therapist needs to get the results of echography, electrocardiography, and other hardware studies, to get acquainted with the results of the examination by a neurologist, ENT, endocrinologist, ophthalmologist.

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VSD therapy

Complex therapy of the disease includes identifying the cause of the VSD and eliminating negative symptoms. At the initial stages, it is recommended to limit ourselves to:

• the introduction of an adequate mode of work and rest, physical and psychological stress, normalization of nutrition;

• to reduce emotional stress by taking drugs based on hawthorn, valerian, St. John’s wort;

• to activate mental activity by taking remedies based on lemongrass, zamanihi;

• to improve well-being with physiotherapy measures:

• general and acupressure massage;

• physiotherapy exercises;

• electrosleep;

• water procedures.

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A significant role of drug therapy is assigned in the treatment of moderate and severe forms of the disease. Attention is focused on the therapy of concomitant pathologies, normalization of thyroid function. During crises, B vitamins, sedatives, antidepressants, drugs for the regulation of cardiac activity are prescribed.

What complications lead to VSD

The crisis is the most common complication of the disease.A severe malfunction occurs in the function of the autonomic system, which leads to a strong sudden attack.

According to the type of violation, crises are divided into 3 groups:

1. Vagoinsular. A person has a feeling of suffocation, fever, sweating increases, the number of heart contractions decreases, blood pressure drops, and often the stool becomes liquid.

2. Sympathoadrenal. The patient’s limbs grow cold and numb, the skin turns pale, the body temperature and blood pressure rise, and the heartbeat increases.Unexplained anxiety and panic attack are added to severe chills.

3. Mixed. In such crises, the set of symptoms is a mixture of the first and second groups.

If the disease is ignored for a long time, VSD can lead to a decrease in immunity, provoke the development of type 2 diabetes mellitus, heart attack, stroke, cardiomyopathy, persistent arterial hypertension that is difficult to correct.

Prevention and its meaning

A good full sleep, a healthy lifestyle, a proper diet help prevent and defeat VSD, even for people with a hereditary disposition to the disease. With an exacerbation, the main role is assigned to rational therapy; in other cases, it is necessary to increase the adaptive abilities of the body by organizing an optimized working day, observing sleep and wakefulness, physical activity and proper nutrition.

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90,000 Frequent urination: possible causes | MedEx clinic (CJSC, Kutuzovsky prospect)

Frequent urination: possible causes

Frequent urination is not always an alarming symptom.It can be physiological and pathological. Increased urge to urinate can be caused by heavy fluid intake, physical activity, or pregnancy. However, they are typical for a number of diseases.

MedEx Personal Medicine Clinic invites you to make an appointment with a Kurologist. At your service – a wide range of diagnostic and therapeutic procedures. Doctors work by appointment, so appointments are skipped.

Causes and Symptoms

The normal frequency of urination varies from person to person.On average, it is 4 to 10 times during the day, once – at night. If it has increased, first you need to make sure that the changes are not physiological in nature: in this case, they will go away on their own.

Physiological causes of frequent urination include:

• Hormonal changes. Some hormones fluctuate throughout the menstrual cycle and also change during menopause.
• Excessive fluid intake.If you drink a lot – because of the heat, intense physical activity or a special diet, frequent urination is inevitable.
• Pregnancy. Frequent urination during pregnancy is due to the fact that the uterus presses on the bladder, stimulating the frequent urge to empty it.
• High blood pressure, stress, hypothermia. This leads to the fact that more blood enters the kidneys and the volume of urine produced increases.
• Pathological causes of frequent urination are caused by various diseases.In this case, the symptom does not go away on its own, but requires a visit to a doctor.
• General pathological causes include:
• Inflammatory kidney disease. They are accompanied by a pulling back pain, clouding of urine, and an increase in the general body temperature.
• Urolithiasis. Formation of calculi with localization in the kidneys and bladder. Urination becomes painful, and impurities in the urine may appear.
• Cystitis.Inflammatory process in the bladder with pain and cuts during urination, as well as increased urge to urge.
• Urethritis. Inflammation of the urethra is accompanied by general malaise, frequent urination without pain, and a slight increase in body temperature.
• Diabetes mellitus. The volume of produced urine increases due to damage to the walls of blood vessels and impaired filtration capacity of the kidneys. The risk of inflammatory diseases of the genitourinary system also increases.
• Other diseases.These include glomerulonephritis, tuberculosis of the bladder and genitals, and an overactive bladder. It is also possible an increase in urination due to mental disorders.

In addition, there are specific pathological causes of frequent urination, specific only to women or only to men.

Frequent urination in women is often associated with weakness of the pelvic floor muscles, uterine myoma, endometriosis. Also, the symptom is characteristic of many inflammatory and tumor processes of the female reproductive system.

Frequent urination in men can be caused by prostate adenoma, prostate cancer, prostatitis, bladder neck sclerosis. Possible symptoms include a burning sensation in the urethra, pain in the groin and lower back, a feeling of not completely emptying the bladder. In a number of diseases, frequent urination is replaced by urinary retention.

Important! The information is for reference only. If you find one or more of the symptoms in yourself, make an appointment with your doctor.

Diagnostics

Determining the causes of frequent urination begins with a thorough history. The doctor finds out how much the frequency of daytime and nighttime urges has increased, whether there are signs of urinary incontinence, pain or other symptoms.

To clarify the diagnosis, functional and laboratory tests are carried out:

• Ultrasound;
• CT;
• MRI;
• urogenital screening;
• blood test for PSA hormone;
• blood test for glucose levels;
• general urine analysis;
• urine analysis according to Nechiporenko;
• urine culture.

Research is needed to determine the root cause of frequent urge to urinate, to identify the causative agent of the infection, to assess the severity of the inflammatory process, if any.

Treatment methods

The doctor determines how to treat the underlying disease, taking into account its nature and location. As a rule, an integrated approach is used. The patient is prescribed drugs that normalize the act of urination, and also eliminate the root cause of the pathological symptom.

Inflammatory diseases are treated with a course of antibiotics. With diabetes mellitus, it is necessary to control glucose levels with drugs and a special diet. Gynecological diseases and prostate adenoma may require surgery.

A healthy diet with limited fluid intake is recommended throughout the course of treatment and during the recovery period. It is necessary to exclude spicy and salty foods, do not drink water before bedtime. As an auxiliary therapy, on the recommendation of a doctor, decoctions of medicinal herbs and plants can be used.

Expert opinion of the doctor

To prevent problems with urination, you should visit your urologist at least once a year, and if you have alarming symptoms, make an unscheduled appointment. The risk of developing diseases of the genitourinary system is reduced if you observe intimate hygiene, protect yourself during intercourse, and lead a healthy lifestyle.

Sign up for the diagnosis and treatment of frequent urination in Moscow

MedEx invites you to make an appointment with a urologist by phone or through your personal account on the website.During the recording, you can clarify the rules for preparing for the survey and other issues. The results of diagnostic procedures and laboratory tests are issued in digital form: this simplifies their use and analysis when it is necessary to involve related specialists.

Sources

1. Ilyina I.Yu., Dobrokhotova Yu.E. Features of urination in gynecological patients // MS. 2014. No. 19.

2. Apolikhina I.A., Chochueva A.S., Saidova A.S., Gorbunova E.A. Modern possibilities of drug treatment of overactive bladder in women // MS. 2017. No. 2.

3. Protoshak V.V., Tsygan V.N., Shestaev A. Yu., Rassvetaev A.V., Kharitonov N.N., Matic A.I., Gulko A.M., Kulai D.G. on the pathophysiology of nocturia // ECU. 2013. No. 3.

90,000 how to cure urinary incontinence in women

how to cure urinary incontinence in women

How to cure involuntary urination in women

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What is how to cure urinary incontinence in women?

The doctor diagnosed cystitis, prescribed inexpensive and natural Diforol.I bought and now do not wake up at night from the feeling of incomplete urinary emptying. I began to sleep more calmly, not to run to the toilet.

The effect of using how to cure involuntary urination in women

The drug Diforol can be used both for treatment at any stage of the course of the disease, and for prophylaxis. It is enough to adhere to a small instruction: Take 1 teaspoon of the drug per day. Drink with a glass of water. During the day, maintain a normal level of hydration (1.5-2 liters of water per day).

Expert opinion

Diforol is a new generation genitourinary system regulator, developed according to a unique formula. Voted the best and most popular for 2020. According to urologists, once and for all relieves of frequent, uncontrolled urination with urethritis, cystitis, going to the toilet every 0.5 hours.

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In order to place an order on how to cure involuntary urination in women, you must leave your contact information on the site.The operator will contact you within 15 minutes. Will clarify all the details with you and we will send your order. In 3-10 days you will receive the parcel and pay for it upon receipt.

Customer Reviews:

Dasha

Diforol not only relieves unpleasant manifestations of the disease, but eliminates the cause of increased urination. After completion of therapy, the likelihood of recurrence of pathologies is minimal. Subject to receiving the original product.

Anna

My bladder was never particularly strong, but the situation was especially aggravated during the PMS period, about a week, I could not sleep until the morning, literally dribbled a drop every 5 minutes. Diforol completely solved my problem! The result is not quick, it is important to drink the course, in my case it was 1.5 months. The form of administration is convenient, only 1 tsp. funds per day, but still I advise you to set a reminder on the phone, it is advisable to take it at the same time and not skip it, so that the effect is better.

Diforol is not only an effective, but also completely safe drug, which explains a large number of positive reviews. Buyers note: the natural remedy works 100% of the time. And it doesn’t matter what exactly caused the increased urination and soreness in the lower abdomen. The drug Diforol has a powerful antibacterial and anti-inflammatory effect, so the exact diagnosis does not matter. Where to buy how to cure urinary incontinence in women? Diforol is a new generation genitourinary system regulator, developed according to a unique formula.Voted the best and most popular for 2020. According to urologists, once and for all relieves of frequent, uncontrolled urination with urethritis, cystitis, going to the toilet every 0.5 hours.

Involuntary urination in women – causes, symptoms, treatment. Urinary incontinence in women is a phenomenon that is encountered at any age. It causes physical and psychological discomfort, complicates the usual life activities. A similar phenomenon requires a doctor. Why does urinary incontinence occur in women: causes and symptoms, diagnosis and treatment…. Experts call enuresis a violation of urination, which is accompanied by the inability to regulate the emptying of the bladder. Treatment of urinary incontinence in women: surgery, medication, exercise. … More than half of women experience urinary incontinence at least once. … Normally, the urge to urinate appears after accumulation in the bladder. Urinary incontinence in women is a violation of urination, accompanied by the inability to arbitrarily regulate the emptying of the bladder. Depending on the form, it manifests itself as uncontrolled leakage of urine with tension or at rest, sudden and n.In the event of involuntary urination, a narrow-profile specialist is needed – a urologist. … These are the main home treatments for urinary incontinence in women. You need to see a doctor and determine the cause of the pathology, with the consent of the urologist, start drinking certain herbs, do it. First you need to visit a urologist. He will be able to identify the causes and type of incontinence (stress or urgent). > The gynecologist can not always choose the right treatment for urinary incontinence in women Types of urinary incontinence: – Stress type of incontinence – urine is released when laughing, coughing ,.Causes of uncontrolled urination in women after 40, 50, 60 years. The main types of incontinence and factors. One in three women over the age of 60 will have some degree of involuntary urinary leakage during their lifetime. Risk factors: Gender: pregnancy, childbirth. Urinary incontinence in women – diagnosis and treatment of urinary incontinence There are treatments for stress urinary incontinence. In a study conducted in the United States, out of 2,000 women over the age of 65, 36% of those surveyed had urge to urinate.According to D.Yu. Pushkar (1996). Symptoms, diagnosis and treatment of urinary incontinence in women at the Federal Research Center for Medical and Biological Medicine in Moscow. … Urgent incontinence – the release of a certain amount of urine with a very strong urge to urinate, which a person cannot resist; Combined NM is given. Urinary incontinence in women at a young age usually occurs after a complicated labor. … Because of this, the tone of the urethra worsens, which leads to involuntary leakage of urine at the slightest exertion, for example, at.In 60% of women, frequent urination or urinary incontinence occurs during menopause. At this time, the level of estrogens in the body decreases, and in the tissues of the bladder and the sphincter there are receptors that respond to their number. Lack of estrogen leads to atrophic changes in organs.

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The drug Diforol can be used both for treatment at any stage of the course of the disease, and for prophylaxis. It is enough to adhere to a small instruction: Take 1 teaspoon of the drug per day.Drink with a glass of water. During the day, maintain a normal level of hydration (1.5-2 liters of water per day).

how to cure involuntary urination in women

The doctor diagnosed cystitis, prescribed inexpensive and natural Diforol. I bought and now do not wake up at night from the feeling of incomplete urinary emptying. I began to sleep more calmly, not to run to the toilet.

Treatment of frequent urge to urinate in women with drugs. … If the reason for the frequent urge to urinate in a woman is established at the first symptoms, then the treatment does not take much time.Tablets for the treatment of frequent urination will be great help to cope with the problem. … The psyche of women is more stable than that of men. Prolonged exertion, stress, depression – this is what rarely pulls women into a state of illness. Stress has become a problem in the 21st century, therefore it affects. How to Treat Frequent Urination in Women? The effect of treatment will depend on the accuracy of the diagnosis. It is used for the treatment of diseases of the kidneys and urinary tract as the causative factors of frequent urination.Types of drugs recommended for women to treat incontinence. … Frequent urination in men should be treated as quickly as possible, otherwise the disease. Tablets for frequent urination in men will be highly effective if prescribed correctly. So you have to go first. Drugs used by men. Tablets for the treatment of women. … Consider why frequent urination appears in women without pain and others. Therapy for urinary frequency during lactation is similar to that for pregnant women.The problem of frequent urination in nursing. Frequent urination in women is common. It may be related to. The reasons for frequent urination in women without pain can be very different, and therefore there is no need to compare your case with that of a friend. Treatment of frequent urination in women with folk remedies. … The urge to urinate has become more frequent, and you have not consumed a large amount of water, diuretics – this may be a symptom of a disorder in the functioning of the genitourinary system.A number of diseases and. Frequent urination is a reason to consult a gynecologist or urologist. … Frequent urination, accompanied by soreness in women after sexual intercourse. Asthma: phenotyping and treatment with modern methods, depending on the phenotype 11.11. Adenovirus infections – adenovirus. Most often, such violations occur in women during menopause and. It is recommended to use it with frequent urge to urinate, as it is. The drug is prescribed for the treatment of urinary incontinence in children, adults and the elderly.Average dose for an adult.

Sedatives for cats: reviews of veterinarians, a review of preparations

Stress is a difficult condition for the body. Sometimes it is very difficult to cope with it. And if a person can suspect he has a pathological condition and turn to a specialist, then for cats this task is impossible.

The only thing she can do is to signal with her behavior that she is feeling bad and uncomfortable.It is important not to overlook the symptoms of stress in your cat, as it can cause serious health problems.

When a cat may need sedatives

There are many factors that contribute to a stressed cat.

These include:

• Moving to a new place of residence.
• Visiting exhibitions, places with a large crowd of people.
• Visit to the veterinary clinic, carrying out procedures.
• Walking
• The appearance of a child or a new family member in the home.
• Change of owner.
• Travel by car, flight.
• Street noise during holiday events.
• The onset of puberty.
• Surgical intervention – castration or sterilization.
• Illness.
• Lack of attention from the owner.

Cat stress symptoms

Stress is a pathological condition of the body caused by some irritating factor.With timely diagnosis and proper treatment, it can be dealt with in a short time.

Stress is of two types – acute and chronic.

Acute stress is triggered by an unexpected event. In the body, the level of cortisol, the stress hormone, rises sharply. This is manifested by a sharp change in the behavior of the pet.

Its signs:

• restless behavior;
• aggression;
• profuse salivation;
• rapid heart rate and respiration;
• frequent meows;
• Involuntary urination and / or defecation;
• grin;
• reared wool;
• back arching;

90,011 dilated pupils;

• ears pressed to the head.

Chronic stress is caused by a systematic effect on the psyche of a cat of any factor. This changes the behavior and habits of the animal.

Its symptoms:

• tendency to hide in secluded places, mostly dark;
• loss of appetite, or, conversely, an increase;
• intermittent vomiting;
• Frequent licking;
• constipation or diarrhea;
• lethargy, apathy, unwillingness to participate in games;
• prolonged sleep;
• active combing of the skin, up to the appearance of blood;
• inadequate response to noise;
• urination in places not intended for this.

Experts distinguish three phases of stress in cats:

1. Anxiety. Sometimes the owners simply do not notice it.

It is characterized by:

• Appetite disturbance;
• decrease in body temperature;
• rapid breathing;
• desire to actively lick oneself;
• urinary incontinence;
• diarrhea.

2.Resistance. As the annoying factor disappears, the pet’s condition returns to normal.

3. Exhaustion. It occurs if the stimulus continues to affect the psyche, and it does not cope with the load.

Depletion is indicated by:

• lethargy, apathy;
• loss of appetite;
• tissue and organ dystrophy.

This condition is dangerous and can lead to serious consequences.

Consequences of stress

Failure to provide timely assistance can lead to serious consequences. The protective functions of the body are especially affected – the pet’s immunity is significantly reduced. In severe cases, stress is fatal.

Diagnostics and treatment

If your cat is suspected of being stressed, you should see your veterinarian. This is very important, since some dangerous diseases have similar symptoms.

If stress is associated with a medical condition, the veterinarian will diagnose it and prescribe the necessary therapy.

In the case when the animal is physically healthy, it is possible to suspect that the cat has a pathological condition caused by some irritating factor.

It is better to turn to a specialist who studies animal behavior and deals with its correction – a zoopsychologist. This is a relatively new direction in veterinary medicine, which has successfully proven itself.

The task of a zoopsychologist is to study how a pet’s life works and to correct its environment. Further, the specialist, if necessary, prescribes sedatives. It is important that the zoopsychologist works not only with the animal itself, but also with the owner. This is necessary in order for the doctor to see the complete picture of what is happening.

Depending on the situation, the cat can be assigned:

• aroma and phytotherapy;
• tactile communication with the owner – special massage;
• intake of vitamin and mineral complexes;
• sedatives.

Cat sedatives

Relevant if other methods of psychological assistance do not work. In this case, the specialist may recommend the cat a means with a sedative – calming effect.

Important! All drugs must be selected and taken only under the supervision of a veterinarian!

Calming agents have a cumulative effect and should be used systematically to achieve the desired result.

Produced as:

1. Tablets. Used orally, can be mixed with feed.

2. Solutions and drops for oral administration. They can also be mixed with food or given to the cat using a syringe with a dispenser.

3. Collars. Contains essential oils that help relieve nervous tension. The collar should be worn at all times for the period specified in the instructions.

4.Sprays. The substance is sprayed in the area where the cat feels uneasy.

5. Drops on the withers.

6. Suspensions.

7. Liquids. The bottle is placed in a diffuser, which is inserted into an outlet. Evaporation of the active substance occurs, which has a beneficial effect on the condition of the pet.

The duration of action of a particular agent is indicated in the instructions for use.

The opinion of the veterinary expert

Cat Sedation Overview

Ceva

Country of origin: France

Release form:

• collar;
• spray;
• diffuser solutions.

Ceva Feliway bottle + diffuser

Volume: 48 ml

Composition: analogue of the pheromone of the facial glands of the Feliway cat.

Application: remove the cap from the bottle, fix the diffuser and screw tight. Do not choose sockets located behind furniture, decor items, doors.

Ceva Feliway Friends Pheromones for cats

Volume: 48 ml

Composition: pheromone Feliway Friends, which has a calming effect only on cats, as in nature it is secreted by a mother-cat in the mammary glands.

Application: open the bottle and insert into the diffuser. Do not use replaceable units of other brands!

Relaxivet

Country of origin: Russia.

Release forms:

• drops for oral administration;
• liquid in the diffuser;
• spray;
• collar;
• drops on the withers;
• suspension;
• tablets.

Important! Relaxivet products are safe for pets, non-addictive.

Relaxivet Sedation collar for cats and dogs

Length: 40cm

Ingredients: essential oils of chamomile, lavender.

Application: fasten the collar so that it does not squeeze the neck and does not cause discomfort.

Duration of use: up to 1 month of continuous wear.

It takes effect a few minutes after putting it on.

Relaxivet Spot-on withers drops for cats and dogs

Number of pipettes per pack: 4.

Ingredients: essential oils (catnip and rosemary), extracts of herbs – motherwort and skullcap.

The composition was developed jointly with the German company Neoterica.

Application: Apply to dry, intact skin of the withers.

The action begins in 30 minutes.

Relaxivet sedative suspension

Volume: 25 ml.

Composition:

• L-tryptophan: Natural antidepressant.
• L-theanine: antioxidant, relaxant.
• Inositol: vitamin B8.

The effect is noticeable after the first application

Duration of action: up to 12-24 hours.

Course duration: up to 3 months.

Application: orally using a syringe with a dispenser. If the stress is short-term, the drug is given again an hour after the factor that provoked it.

Dosage: 1 ml per 2 kg of body weight.

No Stress

Manufacturer: Beaphar (Netherlands).

Release form: diffuser with replaceable block. Replacement blocks are sold separately.

Volume: 30 ml.

Principle of action: has a beneficial effect on the nervous system, soothes it.

Ingredients: valerian essential oil.

Duration of action: 4 weeks of continuous use.

Action area: 50 sq.m.

Application: insert the diffuser into a socket (220 volts).

Cat Comfort

Manufacturer: Beaphar (Netherlands).

Release form: diffuser with replaceable block. Replacement blocks are sold separately.

Volume: 30 ml

Composition:

• analogue of the facial pheromone of cats F3 – 2%;
• hydrocarbons;
• flavors.

etc.

Principle of action: the pheromone, which is part of the product, helps to correct the problematic behavior of the cat caused by:

• by visiting a veterinarian, groomer, exhibition;
• transportation or relocation;
• the arrival of a new pet or family member.

etc.

Area of ​​operation: 70 sq.m.

Application: Place the replacement unit in the diffuser. Plug into a socket (220 volts).

Duration of use: 30 days (with continuous use).

FITEX

Manufacturer: AVZ, Russia.

Release form: drops for cats and dogs.

Volume: 10 ml

Ingredients: valerian root, motherwort extract, common hops, Baikal skullcap.

Application: orally, on the root of the tongue or in the cheek pouch. Can be mixed with food. It is taken 1 hour before meals.

Dosage: 3-5 drops, 3 times a day.

Course duration: 15-30 days.

Stop Stress

Manufacturer: Apicenna, Russia.

Release forms:

• tablets;
• feed additive.

Stop-Stress 2-in-1 Cat Arousal and Behavior Reduction Pills

Package quantity: 15.

Ingredients: aminophenylbutyric acid (phenibut), herbal extracts (hops, Baikal skullcap, peony, motherwort), excipients.

Application: orally, on the root of the tongue.It is permissible to mix with feed.

Dosage: selected individually.

Course duration: 15-20 days. It can be extended up to 4 weeks if necessary.

Contraindications:

• allergy to one of the components of the preparation;
• diseases of the genitourinary system;
• diabetes mellitus;
• neoplasms;
• bearing offspring and lactation.

Stop-Stress Plus for cats feed additive

Volume: 30 ml

Composition:

• L-theanine;
• tryptophan;
• glycine;
• excipients.

Application: inside, on the tip of the tongue or in the cheek pouch. It is permissible to mix with a small amount of feed.

Dosage: 1 drop per 1 kg of body weight.The daily rate is divided into 2 doses.

Duration of admission: up to 3 months.

GimCat

Country of origin: Germany.

Release form: paste.

Volume: 50 g

Ingredients: St. John’s wort, L-tryptophan, beta-glucan, meat and meat products, oils, fats, eggs and egg products, fish and fish products, algae.

Usage: Give the cat from a tube or mix with food (water).

Dosage: 6 cm of paste per day (1 cm = 0.5 g).

Express Soakoin

Manufacturer: Astrafarm, Russia.

Release form: tablets.

Package quantity: 2 or 6.

Application: inside. It has a meaty flavor.

Ingredients: trazodone succinate.

Dosage: set by your veterinarian.

Duration of action: up to 8 hours.

Contraindications:

• sensitivity to drug components;
• diseases of the kidneys and liver, cardiovascular system;
• seizures of epilepsy;
• pregnancy and lactation;
• age

Summary

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