Dear Dr. Roach: I am a 75-year-old man who has recently found myself unable to hold back urinating much of the time. I cannot get to the bathroom soon enough or can’t unzip my pants fast enough.
I know there are supposed to be exercises for this, and I have tried them from time to time with mixed results. I think I am too far gone for them now.
Interestingly, I never pee in the bed, even though the need to go wakes me up every hour or every hour and a half. I was on a Flomax derivative for quite a while to control the size of my prostate, but was taken off of it by my cardiologist due to shortness of breath, which is now gone.
Every once in a while, I take one anyway, but I don’t think this would be any help toward solving the problem. Is there anything I can do?
M.C.
Urinary urgency (the sense of needing to go right away) is common in older men, usually due to the prostate, but sometimes due to an overactive bladder. Infection needs to be ruled out first, then a drug like tamsulosin (Flomax) is often tried. If this isn’t well-tolerated, there are other similar drugs, or a different class of drugs, to shrink the prostate, such as finasteride (Proscar).
However, before going too far down the route of medications, I will refer my patients to a urologist, who has the ability to test whether it’s the prostate or the bladder that’s the real problem.
Pelvic floor exercises are effective for both men and women with overactive bladder symptoms, but you need to find out what’s causing the problem (infection, prostate or bladder) first.
Dear Dr. Roach: A column on urinary tract infections did not mention cranberry juice.
I used to have this painful problem, but not anymore. What cured me was replacing my daily orange juice with cranberry juice. I hope this can help others with this problem.
J.R.
Some studies have shown a benefit in reduction of urinary tract infections by drinking cranberry juice or by taking cranberry capsules.
Cranberries contain a substance that blocks bacteria from sticking to the wall of the bladder. However, systemic reviews of all the available studies have concluded that there isn’t strong enough evidence to recommend cranberry juice for prevention of infections.
Even so, I have had patients like you who have had relief. The only downside is that most cranberry juices have a fair amount of sugar; otherwise, cranberry juice is safe.
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