Posted on Mar 4, 2015 1:30:00 PM by Leslie Wooldridge, GNP-BC, CUNP, BCIA-PMD

Behavioral Management: Bladder Irritants

Fluid Intake, Bladder Irritants Greatly Affect OAB Symptoms

Too much coffee!

Fluid management by limiting bladder irritants along with the amount of fluid you drink during the day and night is truly a permanent lifestyle change.That being said, patients have choices. Quality of life is always my goal when treating patients even knowing it may not result in the outcomes we expect.

Educating Patients 

As providers, we need to inform, educate and encourage our patients to do what will help them the most. This education is very powerful. We cannot be with our patients day in and day out, policing their daily activities. We often talk about compliance as a life choice. 

We list pros and cons of doing this or that. I do tell them, however, that as a conscientious provider of care I will not throw good after bad. If there are not some changes, there will not be the best outcomes. That being said, generally they can get away with a couple of cups of coffee in the morning OR a cola in the afternoon OR an alcoholic drink with dinner knowing that they will have more urgency and frequency.

It’s important that they understand this and toilet accordingly. Adding water in between their bladder irritants also fills them up and seems to help defray the extreme urgency they experience with that POT of coffee instead of two cups of coffee interspersed with two cups of water. Simple strategies result in happy patients. All or nothing doesn’t make anyone happy!

What's Normal?

Keep in mind that 6-8 total cups of fluid a day is normal for the average person. Always take into consideration those who exercise and increase their water accordingly. Half of this total intake should be water. In addition, 6-8 times voiding a day is also normal. This is also commensurate on the amount of fluid intake.

As we age it will become harder and harder to void 2-3 times a day. It is just not the norm. Depending on age, up once a night might be normal depending on what else is going on. As we age, we should be able to expect 5 uninterrupted hours of sleep. Those who drink prior to bedtime just because they are thirsty need to alter the amount. Sucking on ice cubes, one at a time, is also an effective strategy for late evening thirst. Limiting fluids at least 3 hours prior to bedtime is always optimum. Using these strategies for fluid management will most definitely enhance the outcomes of PTNS.

Urgent PC for OAB

This blog post reflects the opinions and experience of Leslie Wooldridge, a long-standing user of the Urgent PC Neuromodulation System, and was produced under a paid consulting agreement with Cogentix Medical.

Urgent PC is indicated for the treatment of Overactive Bladder and associated symptoms of urinary urgency, urinary frequency and urge incontinence. Treatment with Urgent PC is contraindicated for patients with pacemakers or implantable defibrillators, patients prone to excessive bleeding, patients with nerve damage that could impact either percutaneous tibial nerve or pelvic floor function or patients who are pregnant or planning to become pregnant during the duration of the treatment. Most patients don't experience side-effects. If side-effects occur, they are typically temporary and include mild pain and skin inflammation at or near the stimulation site. Caution: Federal law (USA) restricts this device to sale by or on the order of a physician. For complete instructions for use, storage, warnings, indications, contraindications, precautions, adverse reactions and disclaimer of warranties, please refer to the insert accompanying each product or online at Models are for illustrative purposes only. Urgent is a registered trademark of Cogentix Medical © 2015 Cogentix Medical. All rights reserved. 

Leslie Wooldridge, GNP-BC, CUNP, BCIA-PMD
Leslie Saltzstein Wooldridge, GNP-BC, CUNP, BCIA-PMD, is Director of the Adult Bladder Control Center, Mercy Health Partners, Muskegon, Michigan USA. Ms. Wooldridge received a Master of Science degree in nursing administration, critical care nursing and postgraduate certification as a Geriatric Nurse Practitioner from Marquette University, Milwaukee, Wisconsin. In 2015, she was honored with the Women’s Health Foundation Activist Award. She is also the recipient of the 2009 National Association for Continence Rodney J. Appell Continence Champion Award. Ms. Wooldridge has published in multiple refereed journals. She authored the Genitourinary chapter in The Nurse Practitioner in Long Term Care: Guidelines for Clinical Practice (2007). She has lectured throughout the United States on geriatrics, urology and clinical practice.
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