1. Voiding disorders Presented by Rene Genadry, MD www.uihealthcare.org/urog ynecology/ UI Women’s Health Center: 319-356-2294 Iowa River Landing: 319-467-2000

2. How Does the Urinary System Work? Kidneys =make urine Ureters= transport urine into bladder Bladder= stores urine Urethra & surrounding muscles (sphincter)= constrict while bladder fills and relax when bladder contracts and expels urine Pelvic floor muscles= support bladder & urethra as a hammock attached to the bones

3. It’s a Stall World After All Do you spend an inordinate amount of time in the bathroom stall? Voiding disorders affect urine storage and release because both are controlled by the same muscle mechanisms. These disorders, including overactive bladder (OAB) can keep you from doing the things you love. 3

4. Types of incontinence Stress incontinence Urge incontinence (Overactive bladder) Mixed Incontinence (Stress and Urge) Overflow incontinence Functional Incontinence

5. Neuropathy Infection Obstruction Local tumor stones foreign body diverticulum inflammation

6. Overactive Bladder A voiding disorder is characterized by the bladder squeezing urine out at the wrong time. Symptoms of overactive bladder include: –Urinating eight or more times per day or two or more times per night –Sudden, strong urges to urinate immediately –Leaking urine after a sudden, strong urge to urinate 6

7. Contributing factors Obesity Smoking Ingestion of bladder irritants, alcohol, coffee, acid-promoting substances Pregnancy?! Menopause?! Hysterectomy?! Vaginal prolapse?!

8. Pelvic Organ Prolapse

9. OAB Treatments OAB is a treatable medical condition that you and your physician can work through. Antimuscarinics In addition to medications, everyday choices and changes to your routine can help you manage your overactive bladder. 9

10. OAB Treatments Cont’d.  Watch your fluid intake  Work to strengthen your pelvic floor muscles (PFMs)  Make dietary changes 10

11. Talk with Your Physician The most important thing to remember is that OAB does not have to run your life. Overactive bladder is a treatable medical condition that can be managed through medicine and lifestyle changes. You and your physician can discuss any more serious treatments if the lifestyle changes and medicines are not working for you. 11

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