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Published: Aug. 21, 2017, 7 a.m.

Get control of urinary incontinence with tips from Internist and Women\u2019s Health Specialist, Dr. Molly Heublein, Assistant Clinical Professor of Medicine at UCSF. This is a must listen if you\u2019re still uncomfortable managing urinary incontinence. We learn nonpharmacologic strategies like pelvic floor muscle therapy, bladder training, timed voiding, foods to avoid, and run through the available medical therapies, their efficacy and side effects. Plus, a brief review of next line therapies like percutaneous tibial nerve stimulation, and botox injections for overactive bladder.

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Full show notes available at http://thecurbsiders.com/podcast

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Case: 79 yo F with at least 10 years of urinary urgency with occasional loss of small amounts of urine and rare full bladder emptying. She drinks 1 cup of coffee every morning and about 2-3 glasses of water per day. She tries to minimize liquids due to her incontinence. She has HTN and takes HCTZ. Has been on oxybutynin for 10 years and wants to try something else.

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Time Stamps

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00:00 Intro

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01:06 Listener feedback

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02:43 Announcements

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03:43 Picks of the week

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09:07 Getting to know our guest

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14:27 Case of urinary incontinence (UI)

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15:30 Epidemiology of UI

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16:34 Screening for UI

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17:30 The 3IQ Questionnaire

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18:44 Additional testing in UI

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21:23 Classifying UI

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24:00 Nonpharmacologic therapy for UI

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32:42 Effectiveness of pharmacologic versus nonpharmacologic therapy

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34:50 Case continued. Changing medications

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37:42 Mirabegron as an alternative to anticholinergics

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40:18 More options for stress UI management

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41:40 Next line therapies for urge UI, overactive bladder

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44:38 Surgery for stress urinary incontinence

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45:50 Botox therapy for urge UI, overactive bladder

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48:30 Do we need any more fancy diagnostic tests?

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50:30 Take home points

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55:05 Stuart schools us on urinary incontinence in men and timing of BPH meds

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56:40 Outro

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Tags: urinary, urine, incontinence, urge, stress, mixed, bladder, training, kegels, pelvic, floor, muscle, therapy, anticholinergic, botox, assistant, care, educ\n