If it is more of an urgency problem that got to go, got to go now those again can be treated with behavior modification, dietary modification to avoid those bladder irritants. Physical therapy again to help to bring the strengthening around the muscles and the pelvis and help to provide a greater inhibitory force and often medications can be used as well. There also are, again, some procedures that can be done to improve those symptoms that those are usually reserved for the patients that fail those earlier conservative therapies.
Very often women that had these over active bladder episodes will almost worsen the symptoms themselves because they get this programming in their brain where I got to go, so I started rushing to the bathroom and I basically began raising my bladder on a regular basis and they sort of condition themselves and they feel that urge, their first movement is you know fly, run to the bathroom and try to find it and hope that there is nobody in the way you know my gosh, oh my gosh. Whereas really if they sat there and contracted their pelvic muscles and used that inhibitory force to fight that urge, they could then go to the bathroom on their own terms. So very frequently it does take this behavior modification where we do timed voiding and avoidance exercises to help to retrain their bladder to respond voluntarily. When people are born they are all incontinent. It's a learned activity to maintain bladder control, and many women need to relearn that control when they’ve gone through an episode where they have kind of lost some of that function.
