Bladder control meds

Body: 

Hello,

I was wondering who among us has had any experience with OAB (over active bladder) medications such as Detrol. My doc wants me to try it. I have a cystocele. I told him I didn't think it would help, as my problem is basically structural. He said the drug would relax, or reduce the "tone" of, the bladder muscle, and keep it from firing randomly. He also said it could take a month for it to have its full effect.

So, I tried it for almost three weeks. Here's what happened: I still had the occasional sneak attack of urinary leakage. My POP seems to get me like that. However, it seems that my bladder became too relaxed. I often lean forward on the toilet to make sure I completely empty the bladder, a technique described in Christine's book. When on Detrol, loads more urine waited to come out until I squatted in the forward position. All I could think of was that the bladder was sagging even more. So I stopped taking the Detrol.

Can anyone help me out with what was going on there? Has anybody with a cystocele had any luck with OAB medication? It seems like every time I'm ready to report a miracle cure, something lets me know it hasn't happened yet. On the other hand, I have had some improvement using bioidentical estrogen suppositories--much healthier vulvar-vaginal tissues have resulted. And I'm still riding my horse, which I am happy to report. Thanks.

Peace,

Saddleup

Hi Saddleup

Glad you are still able to ride. This is good news indeed.

If your bladder has been 'overactive' for some time, of course you are going to feel that it is holding on to more urine for a longer time, then being more difficult to empty completely. The kink that the urethra gets when the bladder is falling back is like another sphincter, enabling the bladder to maintain its continence. Difficulty with complete emptying is 'normal' if you have cystocele. 'After' is relative to 'Before'. Neither you nor I will ever experience 'pre-POP normal' again because of our cystoceles.

I have a feeling that there is an enormous range in 'normal' and it is only when it begins to affect our everyday lives that an extreme of normal becomes 'abnormal'. It is only called 'abnormal' when a doctor says "you have abnormal bladder behaviour."

Anyway, only *you*, not your doctor, can decide whether you are better on this medication as a result of not having to organise your life around the nearest toilet, or worse because it is now more difficult to empty completely. There is always a balancing off between benefits and shortcomings of medication, sometimes one clearly outweighing the other.

I find that I have become so accustomed to finishing emptying in a position which closely approximates hovering over a seat, ready to sit on it, in order to fully empty every time, that I now regard that as 'how I pee', ie it has become 'normal', because it works every time.

As an afterthought, I wonder if overactive bladder is the bladder trying to unconsciosly empty your bladder, because it knows that you cannot do it easily without effort. Bodies are amazing in the way the lower level of the brain kicks in to compensate for higher level difficulty.

I guess you could hold the medication and wait six months to let your brain decide that you can empty fully at least once a day, preferably every time (so it can experience success more often, and learn from it), or you could let the drug do the trick it seems to do very well. You could also try dropping the dose slowly and see if you can find a point where, like Goldilocks' porridge, it is Just Right.

If my theory about your brain compensating is right, you might be able to reduce the dose really slowly until you are not taking any dose at all, doing WW posture 24/7, giving your bladder all the chances it can get to practise holding on and not spasming. If you can keep your bladder forward and resting on the front abdominal wall, it is largely out of the way of intraabdominal forces that may be trying to send it down the plughole, and preventing that pressure from making it spasm. It's just a theory, but at best it might be right. If it is wrong you are none the worse for trying.

To help you get a clearer picture of whether the drug is doing you any potential harm, or could be responsible for other unpleasant side effects that may occur as the plasma level of the drug rises, try googling it, and ask a pharmacist for some information on side effects you can expect. I have always found pharmacists much better than doctors at explaining drugs.

Once you know the worst about it, and you have worked out that there are also the benefits that you have experienced, and you know how it affects your body at different doses I am sure you will be able to decide whether, and how to use the drug.

Cheers

Louise

a very different situation, but my ds is currently taking hytrin for bladder control. in his case, a flow EMG showed results consistent with a 'tight internal urinary sphincter'. the drug is supposed to reduce the overactivity of the sphincter and help him regain normal bladder function. it takes time, they said, because the bladder has already learned to function abnormally and must be retrained. this kinda makes sense to me, as I did some bladder retraining in my day (on spinal cord units). and it does take time.

I don't know what type of medication yours is, or how it is supposed to work. but in my ds's case, we can easily measure results: he goes for repeat flowEMG studies every six weeks. its very measurable. so maybe you can ask your dr how he will know if the drug is working for you? how did the dr determine that yours was an 'overactive bladder'? is it possible to 'over relax' the bladder pharmeceutically? I really have no idea, but its a good question for the good doc.

unfortunately, for many of our troubles, there is no miracule cure. but I do believe that for the vast majority of issues, there are workable solutions. sometimes it just takes longer than we'd like to figure it all out.
but that you're back in the saddle is wonderful news : )

I tried this in the past. It's all from herbs, and I thought it worked well. I was hoping it would tighten up my bladder. I think it's more for incontinence. Here is a link to it:
http://www.interceuticals.com/interceuticals/betterwoman/index.html

Thanks, ladies, for your ideas. The Detrol made things weird. Maybe I didn't try it long enough. It didn't seem to help with the incontinence, though. I'm also drinking Bell's herbal tea for bladder health. I have not had any problem at all with urinary tract infections, for which I am grateful.