Get control of urinary incontinence with tips from Internist and Women’s Health Specialist, Dr. Molly Heublein, Assistant Clinical Professor of Medicine at UCSF. This is a must listen if you’re still uncomfortable managing urinary incontinence. We learn nonpharmacologic strategies like pelvic floor muscle therapy, bladder training, timed voiding, foods to avoid, and run through the available medical therapies, their efficacy and side effects. Plus, a brief review of next line therapies like percutaneous tibial nerve stimulation, and botox injections for overactive bladder.
Full show notes available at http://thecurbsiders.com/podcast
Case: 79 yo F with at least 10 years of urinary urgency with occasional loss of small amounts of urine and rare full bladder emptying. She drinks 1 cup of coffee every morning and about 2-3 glasses of water per day. She tries to minimize liquids due to her incontinence. She has HTN and takes HCTZ. Has been on oxybutynin for 10 years and wants to try something else.
01:06 Listener feedback
03:43 Picks of the week
09:07 Getting to know our guest
14:27 Case of urinary incontinence (UI)
15:30 Epidemiology of UI
16:34 Screening for UI
17:30 The 3IQ Questionnaire
18:44 Additional testing in UI
21:23 Classifying UI
24:00 Nonpharmacologic therapy for UI
32:42 Effectiveness of pharmacologic versus nonpharmacologic therapy
34:50 Case continued. Changing medications
37:42 Mirabegron as an alternative to anticholinergics
40:18 More options for stress UI management
41:40 Next line therapies for urge UI, overactive bladder
44:38 Surgery for stress urinary incontinence
45:50 Botox therapy for urge UI, overactive bladder
48:30 Do we need any more fancy diagnostic tests?
50:30 Take home points
55:05 Stuart schools us on urinary incontinence in men and timing of BPH meds
Tags: urinary, urine, incontinence, urge, stress, mixed, bladder, training, kegels, pelvic, floor, muscle, therapy, anticholinergic, botox, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student