By now, everyone is familiar with the gently humorous “Gotta' Go Right Now!” television commercials depicting the symptoms of overactive bladder syndrome. A middle-aged man (or woman) stuck in a traffic jam gets that look of mild panic and ends up inconveniently stopping at convenient stores all the way home from work. After stopping, he leaves the rest room relieved, but confused and concerned. This commercial exposes the disruptive symptoms of bladder conditions in a light-hearted way but overlooks a larger problem. In reality, the scenario depicted could apply to a host of other bladder problems and a much more diverse group of people. The ad also belies a simple answer for a seriously confusing condition.
Bladder dysfunction can be embarrassing, painfully disruptive, and complex. Patients are often misdiagnosed several times before getting the right help. Like the ad suggests, bladder trouble affects more than just the elderly, but bladder conditions are not isolated to older adults either. In fact, bladder conditions are a significant issue for adult women, and many men. More than one quarter of women between the ages of twenty and forty, and approximately two million annually, are stricken with bladder infections. Twenty percent of those affected will experience painful recurring infections and symptoms, of which the urge to go right now, is only one of many.
But those are just statistics. The fact is, women of all ages, and some men, are all too familiar with the common symptoms of bladder conditions and think they have little recourse. If you have recurring bladder problems, there may be more that you can do. Bladder dysfunction is serious enough to seek serious help. Here are some tips for seeking and managing treatment:
#1 See Your Doctor and Ask to See A Specialist
If you experience bladder infections, the “triad” of symptoms, or any bladder dysfunction on a chronic or recurring basis (with or without evidence of infection), ask your physician to refer you to a specialist in urology. The “triad” of symptoms includes:
Frequency (a high number of trips to the bathroom per day, often culminating in sleepless nights)
Urgency (Gotta' Go Right Now!)
Pain upon urination
Even patients who have intermittent bladder infections can do more than simply wait for the next one to occur. An urologist can identify some treatment options.
#2 Understand The Terminology
Take a little time to understand the terminology. Terminology is one of the main factors that contributes to confusion with bladder disorders. Many terms are used interchangeably by medical personnel and are not clearly explained. In addition, doctors must rely on the triad of symptoms to indicate, and sometimes differentiate, between a myriad of disorders. Bladder disorders indicated by the triad of symptoms listed above include:
Urinary Tract Infection (UTI) – Commonly referred to by the acronym U.T.I., this term refers to an infection that may be located anywhere in the urinary system including: the kidneys; ureters; bladder; or urethra. U.T.I. is used most often for the "run-of-the mill" bladder infection that lasts about a week with antibiotic treatment.
Cystitis – Cystitis literally means an inflammation of the bladder usually caused by a bacterial infection. As opposed to an U.T.I., this term is most frequently used in the medical world to refer to a condition of recurring bladder infections. You have this condition if you have more than one infection within a year.
Urethritis – Urethritis simply refers to an infection or inflammation that is isolated to the urethra. Doctors tend to use this diagnosis when patients report the triad of urinary symptoms along with generalized pain in this area of the urethra, without evidence of infection. You may have this if you have not responded to treatment for an infection. Your doctor may examine you with a scope to determine if you have inflammation in this area.
Interstitial Cystitis (IC) – IC is diagnosed primarily through the acute and chronic presence of the triad of symptoms without evidence of infection. Though more than ninety percent of patients who suffer with IC are women, many men suffer with this condition as well. If you consistently test negative for a bladder infection and still have truly acute (i.e. life altering) symptoms, you may have this condition.
Overactive Bladder Syndrome - This condition refers to a disorder that is diagnosed primarily through the acute and chronic presence of frequency and urgency (Gotta’ go right now!), and in some patients (about 40%), involuntary loss of urine. It is believed to be caused by an overactive bladder muscle.
#3 Determine Where You Fit In
Log and Monitor Symptoms
Document and quantify your problem. Trying to remember symptoms that you had two weeks ago can be difficult, but your doctor will want details. To facilitate discussion with doctors, keep logs to record the type and frequency of symptoms. You may want to rate your level of pain, count the number of times you need to use the bathroom, and determine your level of urgency. Keeping a log will: 1) help your doctor assess your situation; 2) help you articulate your unique experience; and 2) corroborate your need for specialized care.
Research
Patients will want to research bladder conditions and treatment either on the Internet or in recent books on bladder conditions. Compare your symptoms with your research and talk to your doctor about your findings.
#3 Understand Your Treatment Options
Review your treatment options carefully with your doctor. Doctors today have an arsenal of bladder treatments at their disposal including: antibiotics, anti-inflammatory medicines, bladder relaxants, anti-anxiety drugs, bladder analgesics, and diet and lifestyle changes. Doctors generally prescribe a course of common antibiotics for most conditions before trying other treatments. Some treatments unique to each condition are:
Cystitis – For recurring infections, doctors may give you stronger antibiotics and monitor your recovery more carefully. In addition, they will help you identify “trigger” events for your infections. Some doctors may give you a prescription of antibiotics that you can self administer before "trigger" events to prevent infection. Doctors will also discuss diet and herbs and other over-the-counter remedies with you.
U.T.I. – Doctors generally treat a single bout of an U.T.I. with common antibiotics and a prescription for lots of water.
Urethral Syndrome – Doctors may give you an extended round of antibiotics, anti-inflammatory medicines, and painkillers.
Interstitial Cystitis – Patients with IC must see an urologist who is knowledgeable about the condition because there is no known cause for IC, and finding the right treatment is an ongoing process. Patients are often diagnosed with all or at least one of the above conditions prior to being diagnosed with IC. For IC, doctors may prescribe Elmiron, the most widely used drug treatment, and changes in your diet and lifestyle. In-office bladder treatments to relieve symptoms are another avenue to explore with your physician. Visit the Interstitial Cystitis Network online for more information on this condition.
#4 Track Your Progress
Keep track. Patients should record treatment and prescription results and bring this list to appointments to facilitate efficient doctor visits. This can be compared or combined with your symptom-tracking log. If the treatments are unsuccessful, bring some ideas to your physician. Physicians will generally be more open to helping you with alternative therapy after you complete the doctor’s preferred regimen of treatment.
#5 Speak Up
Talk with family and friends and network with other people who suffer with these conditions. You can most likely find a support group in your area. It is important to stay educated and to be your own advocate. There is help out there, right now.