What is
overactive bladder, what medicines or remedies are available for its treatment,
are these medicines safe for all people and how much are these medicines
effective? Let’s find out what urologists say all about it. Maybe we have
answers to all of these questions that can satisfy you.
The term overactive bladder portrays a group of various
indications comprising urinary urgency, urinal frequency, urinary incontinence,
and nocturia. Urinary urgency is a condition wherein people have to hurry to
reach the toilet to pass water since it’s difficult for them to wait any
longer. When you frequently go to the toilets to pass water that exceeds 8
times daily which is above normal you have an indication called urinary
frequency. Some patients suddenly feel an urgent need to pass water that is so
immediate and forceful that they cannot reach the toilets and have to face
leakage of urine every now and then. It is called urinary incontinence. Then
there is Nocturia which means waking up to urinate in the middle of your sleep
at night.
There are medicines for the treatment of any of the above-mentioned indications and anyone who comes across them should, first of all, try medicines. Overactive bladder medicines are normally categorized into two groups. One group is called anticholinergics which include Trospium, Oxybutynin, Solifenacin, Tolterodine, and several other types of medicines. According to a most recent study, anticholinergic medicines are associated with dementia and that will be discussed at the end of this article. The other group is called Beta-3 agonists and the only medicine of this group available in the stores for urinary incontinence is called Mirabegron.
In various studies, it has been observed that people got relief from incontinence, urinary urgency, and frequent urination significantly by taking anticholinergic medicines. The volume of their urine passed each time also increased significantly. That is a sort of alternate method to know the real size of your bladder and the real volume of your urine that you can hold in the bladder. So such medicines are effective but patients with bladder incontinence often don’t take them constantly. The reason is that these medicines have a few critical adverse reactions like dry mouth, dry eyes, blurry eyesight, constipation, etc. The patients also experience a few mental changes which involve impairments of thinking, reasoning, and remembering however every patient does not experience such changes but a few of them surely can experience them. Individuals who have a history of these adverse effects are not advised to take these medicines. These medicines are also not given to patients who have any kind of urinary retention. Further, in case of having narrow-angle glaucoma, (perhaps an ophthalmologist can better explain it) you would be prohibited to take them even if these are required by you. This medicine is also not given to patients who have Gastroparesis which means slow movement of food from your stomach to your small intestine.
The statistics on anticholinergic medicines reveal that
nearly 60% of overactive bladder patients quit these medicines within a half
year and they do it due to so many reasons. Perhaps they quit these medicines
for being ineffective or having unpleasant adverse effects or they think they
can happily survive not using them or they think they should not always take
these medicines or they have no information about alternate options, therefore,
they simply discontinued taking it and didn't request any other thing. Thus,
whenever patients of urinary incontinence are advised to take anticholinergic
medicines they should continue taking them and in case of any side effect or
adverse effect follow the advice of their physician since many alternative
remedies are available which may strengthen conditions of a weak bladder
without medicines.
Beta-3 Agonist is another type of medicine and only one
medicine with the name Mirabegron is available in the market. It portrays a
normal thing that sticks to the bladder receptors which makes the bladder loosen
up and not contract. It functions by decreasing the feeling that you need to go
to the washroom. It also expands the size of the bladder to retain more urine
and does not have too many side effects. However, one of its side effects is
that patients’ BP slightly increases by nearly 10 mm Hg and that’s why they
remain under observation after seven days of starting the medicine to ensure
that their blood pressure remains within limits instead of getting excessively
elevated. There is also some nasal congestion and headaches but these are not
too severe. If you're already on some other medicine you should regulate it
while using this medicine by consulting your physician. The beta blockers
called Toprol or Metoprolol are the most well-known medicine the dosage of
which needs to be adjusted. Usually, this medicine is very well tolerated and
many patients respond to it well enough. However, medicines with trademarks at
times cost too much. Thus, although it is somewhat well-tolerated people
occasionally can't bear its cost and look for alternative medicines.
On the subject of an association between anticholinergic
medicines and dementia, the two latest studies were released comparatively not
long ago. It was released in the British Medical Journal, and by analyzing a
very large research database already available, they discovered in that
database nearly 40 thousand individuals more than 65 years of age have dementia.
These individuals were placed in one group. Individuals of the same age and
other significant medical conditions but without dementia were also traced from
the same large database and placed in the second group. People in the group having
dementia were coupled with people having similar ages and medical conditions in
the other group not having dementia and the two groups were then compared. The
main focus of this study was explicitly on medicines these people were taking
from four to twenty years earlier than their dementia was identified. The
confounding factors were also tried to be controlled. Confounding factors means
the things which may be interconnected with dementia and may likewise be seen
ordinarily in individuals using anticholinergic medicines. The age of the
people, their smoking habits, their medicines being used, and different factors
which may be causing dementia were also considered. It was found that the
danger to get dementia was explicitly connected with the medicines for bladder
incontinence in case these medicines were taken four to twenty years earlier
than their dementia was identified. This study faced much criticism. The main
criticism was that they are retrospectively analyzing a past database, and
secondly, we couldn’t say whether the confounding factors could be managed
since we have no idea about the basic reason for dementia. Further, we cannot
regulate if the prescribed medicine were used or anticholinergics that were
accessible without a prescription were used. May be that certain individuals
were attributed to the “dementia-free” category but they could be taking these
medicines.
The criticism of the above-mentioned database resulted in one more hypothesis namely “a few things, say urinary incontinence might be almost the same amongst the people who had been taking anticholinergic medicine and those who had dementia in both groups separately which implies that the basic reason, for instance, urinary incontinence, maybe going before their dementia.” This is so because urinary incontinence in a few cases like multiple sclerosis is the first-ever indication of neurological issues. Thus there is a possibility of its being the initial sign of dementia. In case you see some urinary incontinence this may be the first indication that you will be seeing however nothing can be said with certainty. It’s difficult to assess which one of the two symptoms is responsible to cause the other however what we can say with surety is that an association between the two is there. Does it mean to stop taking medicines for overactive bladder that are helpful to further elevate your level of well-being? Well, the decision in this respect is yours however in case your level of well-being is unsatisfactory these medicines may be quite helpful. (@ chhanno blogspot com 24102021).
Quite
like the above study another study was released by American Medical
Association. In this study, the data of sixty-thousand individuals having
dementia were analyzed. The quantity of standard dose of anticholinergic
medicine that is required per day was taken into account in this analysis to
establish an association between the medicine and dementia. Now we can’t say
with surety whether it’s the basis of dementia however what we can say with
surety is that an association between the two is there. Anyhow, it was observed
that taking a standard dose of this medicine per day continuously for 3 years
or proportionate thereof is closely linked to dementia. Only the individuals
above the age of 65 were taken in this study and the data of a maximum of the
past eleven years till their dementia was identified during which they had been
taking anticholinergic medicines was analyzed.
Although these are perfect and all-around good studies however in the end we have no idea about the actual reason for dementia so far. It’s difficult to decide whether in the two groups anticholinergic medicines explicitly or a collective confounding component is responsible for dementia. The net result is that please use it carefully as an association between the two is there. For instance suppose a change in mental attitudes like carelessness or poor memory is noticed by you whether in yourself or a close relative on anticholinergic medicine then you must influence to stop that medicine forthwith, of course in consultation with your physician. Whenever you visit the physician you should talk to him about the effectiveness of your medicines since some medicines including anticholinergics which were prescribed for urinary incontinence yet you no longer remember their actual reason as well as these may not be so beneficial for you if continued. Therefore, you have to reassess your medicines each time you see your physician. Finally, you must be informed about the fact that more options are available for the treatment of bladder incontinence for example Botox injections, bladder pacemakers, or acupuncture. All these are nontraditional remedies and may function to improve overactive bladder.
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(Updated on 08-01-2023)
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