FAQ

The text below is intended for informational purposes only, has not been reviewed by the US Food and Drug Administration and is not meant to replace the advice of your physician.

Q. I am a 46 year old woman and I have been leaking for 10 years. I saw a doctor who told me surgery would not help me but medicines and exercises would. I have a friend who had surgery and now she is dry. Why do only some people get better with surgery?

A. It is likely you have a type of incontinence known as “urge incontinence” and not “stress incontinence”. A person with urge incontinence will have the urge to urinate but is unable to make it to the bathroom on time. The bladder begins to squeeze down before the appropriate time and leakage occurs. This is part of having an overactive bladder. Surgery is not done for this condition, although in drastic cases which do not respond to more conservative measures, a type of new pacemaker device implanted near the spinal nerves may be of benefit. Your friend probably had stress incontinence which can generally be improved or cured with surgery. Keep in mind that many people have both stress and urge incontinence, a situation known as mixed incontinence.

Q. Can a person have off and on incontinence? It seems like I can be fine on some days but other days are terrible.

A. This is not an uncommon thing. If you have stress incontinence, it may be days when you have a cough or are doing heavy lifting that pose a problem. If you have urge incontinence and an overactive bladder, drinking certain beverages or eating certain foods some days may trigger your problems.

Q. I was told I have an overactive bladder but the medicines I tried dried out my mouth and eyes so bad I couldn’t stand it. I tried different ones in the smallest pill they had. What else can I do besides suffer?

A. Unfortunately, just about all of the prescription bladder medicines have a tendency towards causing dryness. The newer ones are better than what older ones in this regard, but they still cause problems in some cases. There are other things you can do to help yourself. Biofeedback and electrical stimulation may improve things, along with a bladder retraining program. Dietary changes can also play a role.

Certain herbs have been used for thousands of years to treat symptoms we now recognize as being due to an overactive bladder. Alpinia oxyphylla and Schisandra chinensis are key ingredients in a formula which has been used for generations, and which continues to be used to this day, to treat the problem of frequent urination. Cornus officinalis is another herb which has long been used to treat "excessive and frequent urination".

Exciting new scientific research has suggested that Nitric Oxide has significant effects upon the bladder muscle as well. We clearly are only beginning to understand the critical role Nitric Oxide plays in the urinary tract. Evidence points to a decrease in Nitric Oxide as playing a role in bladder overactivity. It would appear that we will be hearing a lot more about Nitric Oxide and the bladder as scientists continue to unlock the mysteries of this fascinating molecule.



Q. I never had a bladder infection until last year. Now I have had 5 of them and I don’t know why. I’ve been to a doctor who x-rayed me and looked in my bladder and said everything was fine. Is it something I am doing to cause them?

A. Certain things, such as a new sexual partner or the new onset of incontinence, can trigger bladder infections. Often times no new events have occured and it is unclear why someone will suddenly start having infections repeatedly when nothing is wrong with their anatomy. Drinking plenty of fluids, emptying your bladder on a regular basis and good hygiene all play a role in preventing infection. Cranberry has been shown in many studies to decrease the adherence of certain bacteria to the bladder wall and decrease the rate of recurrent bladder infections. Other herbs such as Echinacea provide a more general stimulus to the body’s immune system.

Q. I have had a lot of bladder infections in the last two years and now I am on an antibiotic pill every day. I have had to switch pills because of a yeast infection and I don’t like taking so much antibiotics. Can I become resistant to them and will they hurt something after a while?

A. Using a low dosage of an antibiotic once a day for a long time is often done to prevent recurrent infections but it has definite drawbacks. You don’t become resistant to them but the bacteria can. Also in women they definitely have a tendency to lead to vaginal yeast infections. There can be serious medical side effects from the medicines but in general that is a rare occurrence.

Many studies have been done on Cranberry showing that it helps to prevent certain bacteria from “latching on” to the wall of the bladder, so that they get flushed out with the normal urine flow. Studies have shown conclusively that Cranberry can cut down on the number of bladder infections a person has. It is extremely difficult to drink enough cranberry juice every single day to accomplish this, and so a dietary supplement is an excellent idea. Consider herbs to support the immune system and assist in flushing out the urinary tract as well.

Q. I have bladder infections all the time but my doctors keep telling me that I don’t have any infection when they check my urine. Do some people have urine that doesn’t let the infection show?

A. A person may have symptoms exactly like a bladder infection, with frequent urination, an urgent need to go and even burning with urination but not actually have an infection at that time. In some cases the body may have already cleared out the bacteria and all that is left is an inflamed bladder. In other cases there may have never been an infection, but rather a flare up of bladder symptoms.

It is not understood why some people are prone to this. It may be the foods they eat, stress and/or a variety of other factors we will understand better in the future.

There are substances found in nature that can be beneficial in this scenario. Petroselini herba has been in use for thousands of years, dating back to ancient Roman times. It is currently in use and on the German Commission E list for flushing out the urinary tract. The British Herbal compendium actually approves its use for painful urination.

Goldenrod is an herb which has many useful properties including action as an anti-inflammatory. It is in use for irritations of the urinary tract and may in fact directly soothe tissues which are inflamed.

Though most enzymes are not well absorbed when taken by mouth, Bromelain is an exception. It has recognized anti-inflammatory properties and is approved by the German Commission E for conditions of swelling. Bromelain has been used to reduce pain and has also shown to help, when used with antibiotics, to more effectively clear a bladder infection when it is present.



Q. Are all bladder infections caused by bacteria?

A. The vast majority are, but infection with viruses can occur. Parasites can live in the bladder, but that would be rare in a developed country.

Q. What is the normal time between trips to the bathroom to urinate?

A. That is going to depend on many things, with the most important one being how much fluid intake is going on. All else being equal, the more one drinks the more one will produce urine and need to go to the bathroom. In general, urinating about every 2 to 3 hours or 8 times in a day would be normal. Waking up to 2 times during the night to urinate is also considered to be within normal limits.