Diane K. Newman, RNC, MSN, FAA

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The area of pelvic health in women is a growing area of concern for  health care providers as well as women with disorders that involve the  pelvic area (bladder, pelvic floor muscle, rectum and uterus.) Chronic  pelvic pain and vulvodynia, two frustrating pelvic disorders seen in  young adult women, is not well understood. Research on these two  conditions, which are often linked under the umbrella of “chronic pain  syndromes”, is scarce, especially as it relates to successful  treatments. Women with these complaints tend to visit specialists who  provide non-surgical treatments for incontinence and other pelvic  disorders because they seem appropriate. This article will provide an  overview of the clinical picture of both conditions, describe specific  evaluation techniques, and outline practical treatment options that can  be provided.

Articles

The area of pelvic health in women is a growing area of concern for health care providers as well as women with disorders that involve the pelvic area (bladder, pelvic floor muscle, rectum and uterus.) Chronic pelvic pain and vulvodynia, two frustrating pelvic disorders seen in young adult women, is not well understood.

Pelvic Health in Women: Understanding Chronic Pelvic Pain & Vulvodynia

‘Overactive bladder’ (OAB) may include increased  frequency of urination, urinary urgency, and urge-related incontinence  symptoms that occur either alone or in combination. Urge-related  incontinence is defined as urine leakage that happens shortly after or  in concert with the urge sensation to void. Urge UI is caused by  involuntary bladder contractions that occur as your bladder fills. With  urge UI, a person may be aware of the urge sensation but will be unable  to stop leakage until getting to the toilet. Urine loss is usually in  large amounts that soak underwear and even outer clothing. 
         
         An additional symptom seen very often in the elderly is  nocturia, awakening at night to void, which will often disrupt sleep.  This bothersome medical condition affects men and women of all ages,  although it’s incidence increases significantly with age. Many people  find it difficult to discuss this problem with their doctor or nurse. 
         
         Some medical conditions, especially strokes, impair inhibition  of bladder contractions (detrusor hyperreflexia.) Other local factors  such as urinary tract infection or bladder tumors can cause bladder  irritation leading to         OAB.          
         
         The prevalence of overactive bladder is poorly understood. In  the past, many experts believed that such voiding dysfunction symptoms  as urgency and frequency were harmless and did not cause significant  problems for individuals. New research shows that the triad of symptoms -  urinary frequency, urgency and urge incontinence, alone or in  combination - can have a significant impact on someone’s quality of  life. 
         
         Many people with OAB adjust their habits and lifestyle to  accommodate the management of symptoms and may adopt such coping  mechanisms as restricting fluids and urinating to a timed schedule or at  the first sensation of urgency. Car trips and vacations are limited.  Shopping, visiting public places, entertaining or socializing are  curtailed and in some cases stopped. Finding accessible public toilets, a  behavior referred to as ‘toilet mapping’, becomes a source of major  anxiety. Initially, increasing the frequency of bladder emptying may  reduce the number of incontinent episodes. 
         
         Typical symptoms of OAB include: A strong and sudden desire to  void that cannot be controlled – urgency. The need to empty the bladder  frequently, usually more often than eight times a day - frequency.  Urinary leakage if the urge sensation cannot be suppressed. Leakage  occurs usually on the way to the bathroom or during change of position  like getting up out of a chair – urge incontinence. Getting up several  times at night because of the need to urinate – nocturia. 
         
         Considered abnormal at any age, overactive bladder is a highly  prevalent condition that affects both genders but is more common in  women. Many people never report symptoms of OAB due to their perceptions  that treatment is not available or effective or that the symptoms are  normal consequences of aging or childbirth. Effective treatment includes  the combination of new drug management with behavioral interventions.

1. Milsom, I, Stewart, W, Thuroff, JW (2000) The Prevalence of Overactive Bladder. The American Journal of Managed Care, 6(11), Sup:S565-S573. 

2. Wein AJ, Rovner ES. (2000) The overactive bladder: an overview for primary care health providers. Int J Fertil Womens Med 1999; 44: 56-66.

‘Overactive bladder’ (OAB) may include increased frequency of urination, urinary urgency, and urge-related incontinence symptoms that occur either alone or in combination.

Author | Diane K. Newman, RNC, MSN, FAA

Articles

Pelvic Health in Women: Understanding Chronic Pelvic Pain & Vulvodynia

What is an Overactive Bladder?