Treatment – Bladder disorders
Bladder Infection (Cystitis)
Treatment is by antibiotics such as amoxycillin, trimethoprim or nitrofurantoin, and by drinking plenty of fluids.
Bladder incontinence
These factors may be alleviated considerably with treatment and by taking appropriate measures such as wearing pads etc.
- Stress incontinence:
- Urinating regularly to avoid a full bladder
- Kegel (pelvic muscle) exercises
- Oestrogen tablets or cream
- Surgical procedures (to lift the bladder and tighten the bladder outlet or the insertion of an artificial sphincter in men, an operation which can be carried out in the older patient).
- Urge incontinence:
- Regular urination
- Pelvic muscle exercises
- Botox injections in the bladder
- Regular self- catheterisation
- Drugs to relax the bladder (such as Oxybutinin)
- Operation to stabilize the bladder (Clam ileo cystoplasty)
- Overflow incontinence:
- Manual pressure on abdominal wall
- Drugs to relax bladder outlet
- Surgery to treat a blockage (the prostate gland is normally surgically correctable)
- Partial retention of urine from an enlarged prostate can also be treated by intermittent self- catheterisation
- A neuropathic bladder which can have a very large (up to 6 litres) capacity can be treated by self- catheterisation
- Functional incontinence:
- Regular toileting
- Physical and psychological support (that is, enabling the person to access the toilet, to have clothes that are convenient and easy to undo/ do up and adjust, and mobility aids to help less mobile persons to reach the toilet in time).
- Persons with dementia, with a severe psychological or other mental health disorder, are likely to need to wear pads and qualify for DLA/AA care component.
- Continual Incontinence:
- Surgery to treat the fistula.
- Surgery in the form of an ileal conduit (artificial bladder, using part of the small bowel) in the case of damage from a malignancy or following radiotherapy.
Bladder stones (Bladder Calculi)
Bladder stones may be removed through an endoscope inserted into the bladder (a cystoscope), sometimes needing to be broken down into smaller fragments. This procedure is called lithopaxy.
Very large stones would need to be removed by surgical means through the bladder wall (open cystostomy). A light general anaesthetic is needed.
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Amended June 2008
