Need help for a gotta-go problem? There are no perfect solutions for overactive bladder.


Lifestyle changes such as cutting back on alcoholic and caffeinated beverages may provide relief from bladder problems. (BIGSTOCK)
February 17

A product that came out this fall proposes to offer millions of women an easy solution to an embarrassing problem. The Oxytrol for Women (oxybutynin) patch is available without a prescription to treat an overactive bladder, which can cause incontinence problems and make women run to the bathroom eight or nine times a day or even more. But here’s why the experts at Consumer Reports’ Best Buy Drugs say that women should think twice before rushing out to buy it:

Drugs to treat overactive bladder don’t work very well, according to a recent CR Best Buy Drugs analysis. (This analysis didn’t include the new over-the-counter product, but it did include the prescription version of the patch, which delivers the same amount of oxybutynin.) Studies have found that only a small proportion of people get full relief of their symptoms while taking such a medication, especially for longer periods of time. But most people can expect some relief: a decrease in how often they feel a strong urge to urinate and a decline in leakage episodes.

Patches and pills to treat an overactive bladder can cause side effects that include blurred vision, constipation, dizziness, dry mouth and occasionally even mental confusion. Research finds that more than half of the people who take those drugs stop within six months.

Severe symptoms may warrant taking a drug, but for mild cases try other options first. If you and your doctor decide to try a drug, consider tolterodine (Detrol or generic), which is a pill. It’s a CR Best Buy because it has a lower risk of side effects. If cost is a consideration, talk with your doctor about prescription generic oxybutynin. It has a higher rate of side effects but can be tolerated by some people and can be found at some drugstores for as little as $4 a month. Oxybutynin is the active ingredient in the Oxytrol for Women patch, which is less likely to cause dry mouth than the pill version. But the patch may cause a rash where applied.

You might not even have an overactive bladder. Symptoms that are associated with diabetes, kidney stones, multiple sclerosis, Parkinson’s disease and urinary-tract infections can be mistaken for those caused by an overactive bladder. Other symptoms, such as urine leaking when you laugh or sneeze (such “stress incontinence” is caused by a weakness of the muscles that help keep the bladder closed), can also be confused with having an overactive bladder. And some drugs, such as those to treat high blood pressure, can cause bladder problems.

Lifestyle changes and other non-drug measures might provide enough relief. Cut back on alcoholic and caffeinated beverages, and limit fluids before bedtime. Exercises to help control bladder function can help. Your doctor may recommend Kegel exercises, which involve repeatedly tightening and strengthening the pelvic muscles that control the flow of urine. Be patient: Results can take up to six weeks.

Safety precaution: Most people with Alzheimer’s disease or other forms of dementia should generally avoid taking this class of drugs because they might increase mental confusion.

Copyright 2013. Consumers Union of United States Inc.

For further guidance, go to www.ConsumerReports.org/Health, where more detailed information, including CR’s ratings of prescription drugs, treatments, hospitals and healthy-living products, is available to subscribers.

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