Bladder Control Does Matter

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1 Bladder Control Does Matter Y0028_2726_0 File&Use

2 If you suffer from urinary incontinence, you re not alone Don t be afraid to raise your hand if you ve been struggling with the embarrassment and discomfort of a bladdercontrol problem for some time. Maybe you hoped it would go away, but it hasn t. Maybe it s even getting worse. The reality is that almost 13 million people in the United States experience urine leakage. Women are about twice as likely as men to have this problem. More than 4 out of 10 women have an overactive bladder after menopause and bladder control problems tend to increase with age. Men can also have bladder issues especially those with prostate problems. Facts show that fewer than 50% of women tell their doctor about their symptoms and therefore don t get help. However, about 80% of women who do seek help find that their symptoms do improve. Some simple treatment options include lifestyle changes that you can make specific to your diet and exercise. Doctors call these behavioral therapies and they are safe, easy, effective and inexpensive. Sometimes they are the only treatment you may need. Your doctor can suggest the treatment that s most appropriate for you. What types of incontinence are there? Stress Incontinence When urine leaks because of pressure put on the bladder from everyday activities like laughing, sneezing, lifting and exercise. Overactive Bladder This urinary frequency or urgency happens when abnormal nerves send signals to the bladder at the wrong time, causing the muscles to squeeze without warning. Urge Incontinence When you have a sudden need to urinate and can t hold the urine long enough to get to the bathroom in time. It can happen during sleep and can be triggered by hearing running water. It is also a problem for people who have diabetes, Alzheimer s disease, Parkinson s disease and multiple sclerosis, and those who have had a stroke. Overflow Incontinence The unexpected leakage of small amounts of urine because the bladder has not emptied correctly and is full (rare in women). Functional Incontinence Your control of your bladder is normal but you can t get to the restroom in time. This may be caused by physical disabilities, medical conditions such as arthritis, or even external obstacles. Mixed Incontinence Most women with incontinence have this type, which is a combination of stress incontinence and urge incontinence.

3 Treatment options There are many options for treating the multiple forms of incontinence. They range from drugs to behavioral therapy, and depend on the type of incontinence you have, the severity of your problem and the underlying cause. Medical treatment options may be a solution depending on your personal situation and health history: y Biofeedback helps you to regain bladder control through sensors that make you aware of your body signs. y Medications your doctor could prescribe a drug to help keep the bladder less full during urination, or tighten the muscles that help reduce leakage. y Injections a substance can be injected by your doctor that thickens the area around the urethra to help close the bladder opening (often prescribed for stress incontinence). y Special devices. y Surgery.

4 Behavioral therapies can improve bladder control with minimal side effects but take some time and patience before seeing results. z Bladder training delaying urination after you get the urge to go. This can be achieved through pelvic muscle exercises also known as Kegel exercises that train and strengthen the muscles that you use to stop urinating. Questions to ask yourself If you answer yes to any of the questions below, you may be suffering from urinary incontinence or a bladder control problem. o Do you have sudden urges to urinate that are difficult to control? o Do you urinate very frequently? For example, more than 8 times in a 24-hour period? o Do you get up twice or more during the night to go to the bathroom? o Have you made changes to your life because of a frequent need to urinate and/or concern that you won t get to a bathroom in time? z Timed voiding scheduled bathroom trips that can start as early as every hour and gradually extend to set, periodic visits. z Avoiding certain foods and drinks: y Caffeine and alcohol are bladder irritants and increase urine production causing a more frequent and urgent need to urinate. y Acidic fruits such as oranges, lemons and limes. y Spicy foods, sugar and chocolate can all irritate your bladder and contribute to your urinary leakage problem. y Coffee, tea and soda. z Lifestyle changes: y Maintaining a healthy weight being overweight can cause stress incontinence. y Quitting smoking smokers are more likely to develop bladder control problems and develop a chronic cough which can place stress on the bladder. y Exercising physical activity can reduce bladder control problems. y Managing your medications some drugs like those used for high blood pressure, hearing medications, muscle relaxants, sedatives and antidepressants can contribute to bladder control problems. o Do you ever experience leakage when laughing, coughing, lifting heavy objects or performing other activities?

5 Talk to your doctor to get help Only your doctor can diagnose the type of incontinence you have and suggest the treatment that s most appropriate for you. Your doctor will explore your past and present medical history, including diseases, surgeries, diet and medicine. The best thing to do for your appointment is to be prepared. You can help your doctor understand your symptoms by completing this checklist and taking it with you to your next appointment. Checklist 1. Write down any symptoms you re experiencing, including those you may think are related to urinary incontinence. 2. Note any major stresses or recent life changes. 3. Bring a list of all your medications, including vitamins or supplements. continued on back

6 Be prepared with answers for these questions from your doctor: (Note time of day, if possible and if any of the symptoms has gotten worse) When did you first experience symptoms? Do you have these symptoms all the time, or occasionally? What, if anything, improves and secondly worsens your symptoms? How often do you need to urinate? When do you leak urine? Do you smoke, drink alcohol or drink caffeinated beverages such as coffee or soda? How many of each beverage on average do you drink daily? How often do you eat spicy, acidic or sugary foods? Ask your doctor these questions: What s the most likely cause of my symptoms? Is this a temporary problem, or will I always have it? What treatments do you recommend? I have other health conditions including How can I manage these conditions together? Are there any changes to my diet you would suggest? What may happen what your doctor may ask of you: y Keeping a diary your doctor may ask you to keep a bladder diary for several days that records how much you drink, when you urinate, the amount of urine you produce, whether you had an urge to urinate and the number of incontinence episodes. y Urinalysis to look for infection, traces of blood or other signs of medical illness. y A blood test to check for various chemicals or substances that can cause incontinence. y Other specialized tests such as a pelvic ultrasound, stress test, and/or x-ray of your bladder.

7 Don t let urinary incontinence keep you from enjoying life If you aren t taking part in activities with family and friends due to a fear of involuntary leakage and/or public embarrassment, it s definitely time to seek help. Talk to your doctor and learn more about urinary incontinence and thousands of additional health topics at MyExcellusMedicare.com For more information you can also talk to one of our Nurses* 24/7 by phone at (TTY) There is no cost to you for this important advice. You can also sign up for monthly e-newsletters with health topics and other information at MyExcellusMedicare.com/ .

8 165 Court Street Rochester, NY A nonprofit independent licensee of the Blue Cross Blue Shield Association This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, may change on January 1 of each year. Excellus BlueCross BlueShieid contracts with the Federal Government and is an HMO plan and PPO plan with a Medicare contract. Enrollment in Excellus BlueCross BlueShield depends on contract renewal. B-3946 / MEDM EUI