Bladder Spasms (cont.)
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Treatment of Bladder Spasms
How your doctor treats your bladder spasms depends on what exactly is causing your painful symptoms. But in general, therapy may involve one or more of the following treatments. A combination of treatments often works best.
Change in diet. This may help prevent bladder pain if certain foods and beverages are the culprit behind your spasms. Avoid spicy, acidic, or citrusy foods, as well as alcohol and caffeine. Keeping a food diary, which tracks your meals and your symptoms, can be helpful.
Timed voiding. This involves timed trips to the bathroom to urinate, usually every 1.5 to 2 hours. Timed voiding is especially helpful for children. As the bladder spasms get better and fewer wetting accidents occur, you can extend the time between trips to the bathroom.
Pelvic floor exercises ("Kegels"). Kegels and other forms of physical therapy help strengthen and relax the bladder and other muscles that help the body hold in urine. Kegels, combined with biofeedback, are a good way to help reduce bladder spasms in children. To tighten your pelvic muscles, squeeze your muscles in the same way as if you were trying to stop the flow of urine or prevent yourself from passing gas. Kegel exercises take practice, and tightening the wrong muscles can put more pressure on your bladder. Ask your doctor for specific instructions.
Medicines to relax the bladder. The most commonly prescribed drugs to relax the bladder and prevent spasms are called anticholinergics. They include oxybutynin chloride, tolterodine and others. A common side effect is dry mouth.
An antidepressant called imipramine hydrochloride (Tofranil) also helps relax the bladder and reduces bladder spasms.
TENS. Electrical stimulation through the skin (transcutaneous electrical nerve stimulation, or TENS) sends mild electrical pulses to the bladder through patches applied to the skin. It's believed the electric signals help you feel better by increasing blood flow and releasing hormones that block pain. TENS is often used to relieve muscle or back pain. In the case of bladder spasms, doctors think the increased blood flow makes the bladder muscle stronger, which reduces spasms and leakage.
Electrical stimulation implant (Inter-Stim). This is placed under the skin to deliver gentle electrical pulses to the bladder at regularly timed intervals. Your doctor may recommend this therapy if you have severe bladder spasms and urge incontinence that does not get better with other treatments.
Pain medicines and sedatives. These may be given to patients who have catheter-related bladder spasms after surgery. But they don't always take away all the discomfort. Some research suggests that a prescription anti-inflammatory medicine called ketorolac may help relieve or prevent catheter- or surgery-related bladder spasms in children.
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