Urge Incontinence -

[Atir123]

Hi to everyone! I started having the problem with urinary incontinence about 4 years ago when I was 30. At first it was not that bad and I did not really worry or think about it. The last 2 years it got worse. It is not that much the frequency as the urgency that is my problem. The urge comes suddenly and is very strong. I have few minutes to find a toilet or otherwise I just can not hold it. At night usually I go just once and not every night but right after I wake up and I get out of bed the urgency is extremely strong.  
  I went to see a urologist. Urinalysis was negative for blood, nitrites and leukocytes. Hematology and coagulation test were fine too. After the digital rectal exam, the doctor thought that my prostate is slightly boggy and slightly tender but contain no nodules. So his assessment was low grade prostatitis. Prescribed Levaquin 500mg. No improvement at all.
  After that he prescribed Oxybutynin, which did not help so I had to go through cystoscopy. Nothing wrong was found. The doctor said that I just have an overactive bladder.
  I started to search the web for possible reasons for my problem. I found that this problem can be related to neurological injuries (such as spinal cord injury or stroke), neurological diseases (such as multiple sclerosis)- which I do not think apply to me or the reason can be just idiopathic- and I can not accept that neither.
  Now when this problem is my major concern I recalled that my ex-wife also has this exact problem too but for some reason this was never discussed. And I know that this urgency started right at the time when I was living with her. Unfortunately we do not keep contact so it is not possible for me to talk to her about this. I am not even sure if this has anything to do with it. Urinalysis and the cystoscopy would find any possible UTI and they did not. Plus I do not have any pain or burning.
I will appreciate any comment or advice. Thank you!

[Dalubaba]

I am 79,  I take 0.75 Mg. of Alprozolam  at night for sleep since last 18 yrears.
I get up usually 2 or 3 times for urination. Few days back on consecutie two days I had to go to bathroom for 10 to 12 times in the night.
I got lower abdomen sonography the report is as under.
Kidneys are normal in size.( approximately 8.5 cm.) with smooth regular contour. Renal cortical echogenecity is within normal limits. And cortical differentiation is adequate.No pelvicaliceial dilatation is seen.
Ureters are undialated.
Urinary bladder is normal in size. And contour with mild trebeculated walls echofree lumen.
There is no significan past void residue.
Prostate measures 4.0x2.7x3.0cm with normal echo structure.
URINES ANALYSIS IS NORMAL.
I was asked to take valium or increase the dose of Alprozolam.
I am doing kegel exercises off and on. Pleas suggest appropriate pelvic floor exercises.
There is no urinary emergency. Now I am trying to delay urination for some time. You may suggest if some drug is indicated. Because of frequent urination, my sleep is disturbed. Does self prostate massage helps in this condition? Pleas reply and oblige. Thands.

[Dr Santos]

Some of the causes of Overactive Bladder are: Urinary tract infection, side effects of medications( those with caffeine and diuretics), neurological diseases, tumors or abnormalities in the bladder, inflammation of the prostate or prostate cancer , nerve damage caused by trauma, or bladder outlet obstruction due to previous surgery for incontinence.

Take care and regards.

[Atir123]

Thank you very much for you answer. I certainly hope that the bladder training and pelvic floor exercises can give any results.
  Unfortunately, it is still unclear to me and my doctors how all of a sudden after 30 and so years of normal urinary history I would need to train my bladder and pelvic muscles.

[Dr Santos]

How are you? It is good that your test results are fine. Over active bladder (OAB) treatment has many approaches, from medication, to behavioral changes, to a combination of both. Two natural treatment that is 50 % effective are bladder training and pelvic floor exercises. There are also no side effects noted unlike in medications prescribed.  If the symptoms persists  and bothers you, it would be good to consult your doctor for proper evaluation and  treatment that suits your medical history.

I hope this helps. Take care and keep us posted.