Treating Bladder Problems

There are medications that can control urinary urgency, for example: Ditropan®, Detrol® and Tofranil®) and other medications to relieve retention (for example, Levsinex®, Levbid® and Urispas®). Medications to control spasticity (baclofen, Botox® injections) can also be helpful.

It is important to remember that Cipro®, a medication that can be used to treat urinary tract infections, can be contraindicated in patients receiving tizanidine (Zanaflex®) for spasticity because of increasing sedation. Be sure the doctor is informed if tizanidine (Zanaflex®) is being taken.

When someone does not respond to this 'routine' type of bladder management, an evaluation by a urologist is needed.

There are a number of aids and products that help control the flow of urine
and maintain hygiene:

• Absorbent products that soak up urine, such as mini disposable pads that attach to underwear or disposable protective garments such as Depends. Some people prefer absorbent cloths that can be washed and reused.
• Catheters, thin, flexible, hollow tubes that can be inserted through the urethra (the tube through which urine leaves the body) into the bladder to drain urine. Several different types of catheters are available. Catheterization can be done intermittently, or a permanent catheter can be inserted and changed monthly by a nurse or trained family member. Indwelling catheters require monitoring and care so that complications such as infection or bladder stones are minimised.

A suprapubic catheter, which requires minor surgery, involves a tube system placed directly into the bladder through the abdomen just above the pubic bone. The insertion site must be cleansed one or more times daily, as advised by a health care professional. This kind of catheter may be more appropriate for long-term management of urinary problems as it is associated with fewer complications than a urethral catheter.

• A diverted urinary system.
• A sphincterotomy that relaxes “exit” muscles of the bladder so that the person voids continuously into an external collection device. This procedure is done only in males because an external device such as a condom catheter can be used.