Hair loss Treatment Center

PARTICIPANTS Eric S. Rovner, MD University of Pennsylvania Phil Hanno, MD Professor of Urology, University of Pennsylvania Health System Theresa Roche Patient Julia Rojas Patient

THERESA ROCHE: If I was going to be out in the park walking, I knew I had to wear a depends. And if I was going some place to the supermarket, I knew every bathroom in every supermarket. I thought it was the normal part of aging.

ANNOUNCER: In fact, most urinary incontinence is caused by an abnormal condition called overactive bladder, in which a major bladder muscle contracts too frequently causing various urinary difficulties.

PHIL HANNO, MD: Overactive bladder is a combination of symptoms that are very common in women and in men. They're urinary frequency -- patients have to go to the bathroom to empty their bladder quite often. Urgency, where they don't really have an option as to when they're going to go. They get a sudden urge to go and they'd better be there, or they may wet themselves.

ANNOUNCER: Effective treatments are available, but the first step is paying close attention to your problem.

PHIL HANNO, MD: I think patients who experience symptoms of an overactive bladder should keep a voiding diary. They should record how often they void, the time they're voiding, and what kind of volumes they're voiding, you know, how many ounces they void on an average time, that would be very helpful, and how many times they wake up at night. And then they should see their doctor and bring that information with them when they see their doctor, and that gives the doctor tremendous -- tremendously helpful clues in terms of determining what's going on and what the best treatment would be.

ANNOUNCER: Once overactive bladder is diagnosed, there are a number of treatment options available.

ERIC ROVNER, MD: Probably the best treatment for most patients to start with is a program called behavioral modification, and it's a combination of treatments, including some behavioral measures, such as voiding or urinating by the clock as opposed to by the sense of urinary urgency, changing certain aspects of their diet, losing weight, stop smoking, among other things, decreasing caffeine intake, decreasing alcohol intake.

And an integral component of the behavioral modification program is pelvic floor exercises. Pelvic floor exercises are Kegel exercises. They are intermittent contractions or voluntary contractions of the pelvic floor muscles -- the muscles around the rectum and bladder. They are very effective when done as part of a behavioral modification program.

ANNOUNCER: In addition to exercises and lifestyle changes, there are several medications that doctors can prescribe.

ERIC ROVNER, MD: These are drugs that block the activity of the nervous system on the bladder. These agents, in effect, reduce bladder overactivity. They allow the bladder to fill up to a bigger volume, allow patients to postpone urination a little bit longer, reduce nocturia -- that is, waking up at night -- reduce urinary frequency considerably.

The agents that work include Detrol, which is tolterodine; Ditropan, also known as oxybutynin, and then there's a number of lesser-known agents that are also used to some degree.

ANNOUNCER: Used in combination with behavior therapies, medical treatments can greatly improve bladder control in most patients.

ERIC ROVNER, MD: We don't cure overactive bladder, but we do rebalance the function of the lower urinary tract so that patients' quality of life can be vastly improved.

JULIA ROJAS: My life has changed tremendously in one month. I feel more confident to go out and not to have an accident. It's just been wonderful how these pills have worked on me in such a short time.

ANNOUNCER: As with any medication, drugs like Detrol and Ditropan have potential side effects that patients should be aware of.

PHIL HANNO, MD: The primary side effect is dry mouth. Some patients become constipated with these medicines. Generally, when a medication has benefits that outweigh the side effects, the patient likes to take it, and the doctor recommends it, and most of the time for overactive bladder the benefits of these medicines far outweigh the side effects.

ANNOUNCER: If patients don't benefit from medical and behavioral approaches there are surgical options doctors can turn to as well. But all too often, doctors don't even get the chance to treat overactive bladder.

ERIC ROVNER, MD: Less than half of the patients that suffer from overactive bladder actually discuss it with their health care provider. It's truly a closet condition.

ANNOUNCER: So if you're one of the many people who are suffering needlessly from overactive bladder, talk to your doctor today because regaining control means winning back your freedom.