"Only 1 in 5 men with symptoms will seek medical treatment"/ShutterStock
In movies and series, it has become synonymous with a symptom that indicates old age - the need to get up several times a night to go to the bathroom and the difficulty of holding back.
Today it is already known that the medical condition that leads to the inability to hold back, whether it is urinary control or loss of control, is not only the property of the elderly.
In fact, this is a very common phenomenon that affects about 5-7 percent of the population under the age of 40 and about 35 percent of those 40 and older.
"Overactive bladder is a syndrome characterized by an urgency to urinate, with or without urinary incontinence, a need to urinate at night and frequent urination. More than 8 times a day and at least 1 night waking are a warning sign. This means a significant impairment in the quality of life of those suffering from the phenomenon with "Social and economic effects. Urinary incontinence leads to depression, fear of going out in public and real physical harm, when those suffering from the phenomenon try to run to the bathroom and fall," says Dr. Ran Nisan, chairman of the clinical organization of the Israel Pharmacy Organization.
"The estimate among doctors is that almost 50 percent of adult women experience urinary incontinence, but only about half of them seek treatment. In women aged 60 and over, the prevalence rate exceeds 50-70 percent. Among men, the prevalence increases with age, while in men over 65 It can reach over 30 percent. Only 1 out of 5 men with symptoms will seek medical treatment. The phenomenon is more common among women and older men, but the real numbers are difficult to quantify, simply because people are ashamed to talk about the phenomenon or do not seek treatment at all."
"The most typical symptom is a sense of urgency, an urgent need to urinate suddenly and difficulty holding back"/ShutterStock
You mentioned the element of shame.
How critical is it in diagnosis?
"This is a very significant issue, because it is possible to deal with the symptoms and improve the situation. Also from studies carried out around the world, the syndrome involves a loss of independence for older people, some of whom do not always know which doctor to turn to, although a family doctor can give prescriptions for drugs or refer to treatments that will help. In cases In certain cases, the patient may be asked to see a urologist or urogenycologist (in the case of women) for an opinion."
What are the symptoms and what causes their appearance?
"The most typical symptom is a sense of urgency, an urgent need to urinate suddenly and difficulty holding back. In addition, there is an increase in the frequency, the frequency of urinating during the day and at night. The risk factors for urinary incontinence include age, obesity, multiple pregnancies and the type of birth, family history, medical conditions such as diabetes , depression, stroke, pelvic surgeries, benign enlargement of the prostate in men and more. In addition, exposure to smoking, caffeine, alcohol and artificial sweeteners also contribute to the onset of the syndrome."
How can the syndrome be distinguished from a urinary tract infection or circumstantial factors?
"When there is urinary incontinence, it is important to diagnose if it is a reversible condition resulting from a solvable disease such as a urinary tract infection or behavioral issues, heavy drinking or the use of medications and caffeine consumption. Finding the cause of urinary incontinence can be done through tests performed by the attending physician (blood, urine, and others) and questioning about medical and medication history. After ruling out the other factors, in most cases it is an irritable bladder. There is a subcategory, such as urinary incontinence as a result of effort, which characterizes women, especially after multiple births or significant obesity and then there is a weakening of the pelvic floor muscles. In these cases, there will be Urinary incontinence following coughing, laughing and climbing stairs. There is also urinary incontinence due to urgency, situations in which the bladder itself, for one reason or another, contracts involuntarily, which leads to the involuntary urinary incontinence. Sometimes these are neurological diseases, such as Parkinson's, multiple sclerosis, etc." .
How is the syndrome treated?
"Treatment varies depending on the causes of urinary incontinence. For women, it is important to work on strengthening the pelvic floor through physical therapy, and it is also important to find factors related to lifestyle and other drugs that can contribute to the condition. Regarding drug treatment aimed at helping, there are two main groups of drugs - antimuscarinic drugs and beta-drugs Adrenergics. Both are intended for urinary incontinence as a result of urgency and they act on receptors that are on the muscle lining the bladder and are supposed to reduce the contraction. The main differences between the families is the side effect profile but not effectively. It should be taken into account that the drug treatment will also help but is not expected to completely eliminate the phenomenon ".
Did the months of the war lead to an aggravation of the phenomenon?
"For some patients, the condition worsened as a result of the anxiety and depression that accompany us all these days. This affects the quality of the treatment, and increases the feeling that we suffer more from side effects to medications. In addition, war situations increase the consumption of cigarettes and caffeine. The very war and the fear of leaving the house and being in a state of anxiety , led to the suppression of this problem. Even on normal days there is a tendency not to contact doctors with complaints about this syndrome and now it has intensified."
The choice of the possible treatment is up to the decision of the therapist writing the prescription in consultation with the patient.
The information is as of February 2024.
For more information, please contact your attending physician.
Served as a public service under the auspices of Estellas Pharma International B.V. and the Pharmacists Organization in Israel without involvement in the contents
In collaboration with the pharmacy organization in Israel
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