Navigating the Care Pathway for Overactive Bladder and Incontinence

A comprehensive treatment plan for overactive bladder and incontinence is essential for improvement in bladder leaks. Learn how to navigate a care pathway for overactive bladder and incontinence, from behavioral modifications to medications or even surgery, for optimal management.

If you’ve ever received treatment for a specific health condition, chances are your doctor has consulted a care pathway as part of your treatment plan. A care pathway is a structured approach to healthcare that outlines the steps involved in managing a condition or addressing a particular health concern. It serves as a roadmap for both healthcare providers and patients, guiding them through the various stages of treatment and ensuring continuity of care.

In the case of overactive bladder (OAB) and incontinence, a well-designed care pathway is crucial to providing effective management and improving the quality of life for patients. This article explores the general concept of a care pathway and delves into the specifics of managing OAB and incontinence, highlighting the range of treatments available at different stages.

Understanding a Care Pathway

A care pathway, also known as a clinical pathway or care plan, is a multidisciplinary tool that outlines the recommended interventions and actions for managing a specific medical condition. It provides a systematic approach to care delivery, promoting consistency and standardization in treatment decisions. Care pathways are typically developed collaboratively by healthcare professionals involved in the care of patients, including doctors, nurses, physical therapists, and specialists. Most conditions that are treated by a physician have care pathways in place. Knowing a good standard of practice, and understanding what’s worked for other patients is helpful when a doctor prescribes treatment.

A care pathway that’s specific to OAB and incontinence aims to address the symptoms, underlying causes, and associated impacts on patients’ lives. Like many treatment plans, it begins with non-invasive and conservative approaches and progresses to more advanced treatments based on the patient’s response and individual needs.

Below we’ll take a closer look at the different steps along a care pathway for overactive bladder. While this path isn’t always linear (many people will likely use absorbent products throughout their treatment, as an example), it serves as a great starting point for most people.

The Initial Stage: Behavioral Modifications

The first step in the care pathway for OAB and incontinence often involves implementing behavioral modifications. This stage focuses on empowering patients to take control of their symptoms through lifestyle changes and self-management techniques. Patients may focus on one aspect of care, or implement a more holistic approach, trying several of these changes at once. Here are some common strategies employed:

  • Diet modifications. Certain foods and beverages, such as caffeine, alcohol, spicy foods, and artificial sweeteners, can exacerbate OAB symptoms. Patients may be advised to avoid or limit their intake of these substances to alleviate symptoms. 
  • Pelvic floor exercises. Also known as Kegel exercises, these target the muscles supporting the bladder and urethra. Strengthening these muscles can enhance bladder control and reduce urinary leakage.
  • Bladder retraining. This technique involves gradually increasing the time intervals between visits to the restroom. By extending the time between voids, the bladder can regain its ability to hold urine and reduce the frequency of urgency.
  • Physical therapy. In some cases, physical therapists with expertise in pelvic floor rehabilitation may be involved to guide patients through specialized exercises and techniques to strengthen pelvic floor muscles and improve bladder control.

Absorbent Products: A Versatile Treatment Option

Absorbent products play a crucial role in managing urinary incontinence throughout the care pathway for OAB. They provide a practical solution for individuals experiencing mild to severe incontinence and offer a sense of security and confidence. The use of absorbent products may be appropriate at any stage of the care pathway, depending on the severity of symptoms and the patient’s response to other treatments.

There are various types of absorbent products available, including:

  • Disposable pads. These are suitable for individuals with light to moderate urinary leakage. They are discreet, comfortable, and designed to quickly absorb and lock away urine, keeping the skin dry and minimizing odors.
  • Adult absorbent underwear with tabs. These provide more extensive coverage and are designed for individuals with moderate to heavy urinary incontinence. Tabbed briefs offer increased absorbency and leakage protection, making them suitable for overnight use or extended periods of time.
  • Reusable absorbent underwear. These are similar to regular underwear but have built-in absorbent padding. They are designed for individuals who want a more discreet option without compromising on absorbency and protection. Reusable products are designed to be washed and re-worn, making them kind on the environment and potentially more cost-effective than disposable products.
  • Incontinence briefs or pull-ups. These are similar to traditional tabbed briefs and are suitable for individuals with severe urinary incontinence or limited mobility.

Choosing the right product for you may take some trial and error. But, finding a product that fits well, is comfortable and fits your lifestyle is essential to customer satisfaction.

Medications for Overactive Bladder (OAB)

In addition to behavioral modifications and absorbent products, medications are another important component of the care pathway for OAB. Medications aim to alleviate symptoms by targeting the underlying causes of OAB, such as bladder muscle overactivity or nerve signaling abnormalities. There are different types of medications available, and their selection depends on the patient’s specific needs and medical history. Here are some commonly prescribed medications for OAB:

  • Anticholinergic medications. Anticholinergic drugs, such as oxybutynin, tolterodine, and solifenacin, are the most commonly prescribed medications for OAB. They work by blocking the action of acetylcholine, a neurotransmitter that stimulates bladder contractions. By relaxing the bladder muscles, anticholinergics can reduce urinary urgency, frequency, and incontinence episodes. These medications are available in various forms, including oral tablets, extended-release capsules, patches, and topical gels.
  • Beta-3 adrenergic agonists. Mirabegron is a medication in the class of beta-3 adrenergic agonists. It works by stimulating beta-3 receptors in the bladder, which relaxes the bladder muscle and increases the bladder’s storage capacity. Mirabegron is particularly useful for patients who cannot tolerate or do not respond well to anticholinergic medications. It is available in oral tablet form.
  • Combination medications. In some cases, healthcare providers may prescribe a combination of an anticholinergic and a beta-3 adrenergic agonist medication to optimize symptom relief. This approach targets both the nerve signals and the bladder muscle to provide enhanced control over OAB symptoms.

It is important to note that medication effectiveness can vary among individuals, and there may be side effects associated with their use. Common side effects of anticholinergic medications include dry mouth, constipation, blurred vision, and drowsiness. Beta-3 adrenergic agonists may cause increased blood pressure or a rapid heartbeat in some individuals. It is crucial for patients to discuss any concerns or side effects with their healthcare provider to ensure the best course of treatment.

Medications are often used in conjunction with other treatment approaches, such as behavioral modifications and absorbent products, to provide comprehensive management of OAB symptoms. The choice to incorporate medications into the care pathway depends on the severity of symptoms, the patient’s response to other treatments, and individual preferences.

Advanced Treatment Options

More advanced treatment options may be considered for patients who do not achieve satisfactory results with behavioral modifications and medications. These treatments target the underlying causes of OAB and incontinence and aim to provide long-lasting relief. Some notably advanced treatments include:

  • Botox injections. Botulinum toxin type A injections into the bladder muscle can effectively relax the overactive muscles, reducing the urgency and frequency of urination. The effects typically last several months before additional injections are needed.
  • Sacral neuromodulation (SNM). SNM involves the placement of a small device near the sacral nerves, which regulate bladder function. The device delivers mild electrical impulses to modulate the nerve signals, helping to control OAB symptoms. SNM is often considered for patients who have not responded to other treatments or for those with specific neurological conditions affecting bladder control.
  • Percutaneous tibial nerve stimulation (PTNS). PTNS involves the insertion of a fine needle near the tibial nerve in the ankle. Mild electrical impulses are then delivered through the needle to stimulate the nerves involved in bladder control. PTNS is a non-invasive option that is typically performed in a clinic setting over several sessions.

Surgical Interventions

In cases where conservative treatments and advanced therapies have not provided satisfactory results, surgical interventions may be considered. Surgery aims to correct anatomical abnormalities, enhance bladder function, or alleviate the symptoms of OAB and incontinence. Some common surgical procedures include:

  • Bladder augmentation. This procedure involves enlarging the bladder by using a piece of the patient’s own bowel tissue or synthetic material. By increasing the bladder’s capacity, urgency and frequency of urination can be reduced.
  • Sling procedures. Sling surgeries involve placing a supportive sling or mesh under the urethra to provide additional support and improve urinary control. This can be particularly beneficial for people with stress urinary incontinence – a condition where you leak when an increase in pressure is placed on the bladder (from laughing, coughing, sneezing, working out, etc.)
  • Urinary diversion. In certain cases, when other treatments have failed, a urinary diversion may be considered. This procedure involves rerouting urine to bypass the bladder and create a new pathway for it to be eliminated. Urinary diversions are usually reserved for severe cases or when other treatment options are not viable.

Patient Education and Support

Throughout the care pathway, patient education and support play a vital role in empowering people to manage their conditions effectively. Understanding your diagnosis, treatment options, and the potential outcomes and side effects associated with each intervention can go a long way in determining the success of your treatment. Your doctor should provide guidance on self-care strategies, such as maintaining a bladder diary, managing fluid intake, and practicing pelvic floor exercises. (And if they don’t, ask them about it!)

Additionally, support groups and counseling services can offer valuable emotional support, allowing others with the same condition to share their experiences, learn from others, and gain insights into coping strategies. Peer support can significantly improve patients’ overall well-being and help them navigate the challenges associated with OAB and incontinence. (Check out NAFC’s free online message boards here and connect with others living with OAB and incontinence!)

Conclusion

A well-designed care pathway is essential for effectively managing overactive bladder and incontinence. Starting with conservative approaches, such as behavioral modifications, and progressing to more advanced treatments, the care pathway aims to alleviate symptoms, improve bladder control, and enhance the quality of life for patients. By providing a systematic approach, healthcare providers can tailor treatment plans to meet the specific needs of each patient, ensuring continuity of care and optimizing outcomes. As research continues to advance, it is crucial to stay informed about new treatment options and incorporate evidence-based practices into the care pathway, enabling individuals with OAB and incontinence to lead fulfilling lives with confidence and dignity.

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¡Nos aferramos a todo el verano con esta pizza de queso feta y calabaza de verano baja en calorías! ☀️

¡Esta versión saludable de la pizza contiene proteínas, es fácil de preparar y está lista para usar durante la semana! 😍

Ingredientes:

💛 1 cucharada de piña Súper Juventud
💛 ½ taza de harina de garbanzos
💛 1 taza de agua
💛 ¼ taza de aceite de oliva
💛 1 diente de ajo
💛 ¼ cucharadita de sal

Ingredientes para pizza:

🍕 ½ taza de mozzarella rallada
🍕 ¼ de taza de queso feta desmenuzado
🍕 1 calabacín pequeño y 1 calabaza amarilla pequeña atadas con un pelador de juliana
🍕 aceitunas kalamata, cortadas por la mitad a lo largo
🍕 tomates secos
🍕 1 ramita pequeña de tomillo fresco

Instrucciones:

1. En un bol, mezcle la harina de garbanzos, el Super Youth, el agua, 2 cucharadas de aceite de oliva, el ajo y la sal. Deja reposar la mezcla a temperatura ambiente durante 1 hora.
2. Encienda el asador con una rejilla colocada a 8 pulgadas del fuego. Coloque una sartén refractaria de 10 pulgadas en el horno para precalentar.
3. Una vez que la sartén esté caliente, retírala del horno. Vierta 1 cucharada de aceite de oliva y gire la sartén para que el aceite se distribuya uniformemente. Vierta la masa de garbanzos y regrese la sartén al asador. Cocine durante 5-8 minutos, hasta que la socca esté firme y los bordes se doren y se separe de los lados de la sartén. Retire del horno, apague el asador y encienda el horno a 425 grados F.
4. Unte la cucharada restante de aceite de oliva sobre la socca. Luego cubra la socca con mozzarella y luego distribuya la calabaza en cintas encima. Espolvoree aceitunas y tomates secos encima y luego espolvoree queso feta.
5. Regrese la sartén al horno y hornee durante 8 a 10 minutos, hasta que el queso se dore y la socca esté crujiente. Retirar del horno y espolvorear tomillo fresco encima. Deje que la pizza se enfríe durante 2 o 3 minutos antes de cortarla en 4 trozos y servir.

Esta receta de ensalada de papa es un BÁSICO del verano ☀️

Perfecta para cualquier ocasión, repleta de ingredientes saludables y deliciosa: esta es una receta que querrás conservar para siempre. 🧡

Ingredientes:

🥔 3 libras de papas rojas, lavadas y cortadas en trozos pequeños
🥔 6 huevos
🥔 6 trozos de tocino cocido, partido en trozos (opcional)
🥔 1 pepino largo, picado
🥔 1 taza de cebolla verde picada

Ingredientes del aderezo:

🥔 1 taza de mayonesa
🥔 2 cucharadas de mostaza dijon
🥔 1 cucharada de vinagre de manzana
🥔 1 cucharadita de sal marina
🥔 ½ cucharadita de pimentón
🥔 ½ cucharadita de pimienta negra molida
🥔 1 cucharada de piña Súper Juventud

Pasos

1. Llene ¾ de una olla grande con agua y hierva.

2. Agrega las patatas y los huevos a la olla.

3. Baje el fuego a medio y hierva las patatas y los huevos durante unos 15 minutos, o hasta que las patatas estén blandas.

4. Mientras se cocinan las papas y los huevos, agregue el pepino, la cebolla y el tocino en un tazón mediano.

5. Haga el aderezo en un recipiente aparte mezclando todos los ingredientes hasta que quede suave.

6. Una vez cocidos, retira las patatas y los huevos de la olla y colócalos en un recipiente con agua fría.

7. Enjuagar las patatas

8. Retire los huevos del agua fría, pélelos y píquelos, luego agréguelos a la ensaladera.

9. Secar las patatas y añadir a la ensaladera.

10. Vierta el aderezo sobre la ensalada y mezcle todos los ingredientes hasta que todo quede cubierto con el aderezo.

¡Adelántese a las deliciosas recetas de otoño de moda con esta receta de calabaza rellena de quinua y col rizada de otoño (y los beneficios son infinitos)! 😍

Ingredientes:

💛 1 calabaza espagueti
💛 1 cucharada de aceite de oliva
💛 Sal + pimienta
💛 ⅔ taza de quinua, seca
💛 1 ⅓ taza de agua (para cocinar la quinua)
💛 4 hojas grandes de col rizada, cortadas en trozos pequeños
💛 ½ taza de queso de cabra
💛 ⅓ taza de semillas de granada

Vinagreta De Vino Tinto

Vendaje:

❤️ ¼ taza de aceite de oliva
❤️ 2,5 cucharadas de vinagre de vino tinto
❤️ ¼ cucharadita de miel
❤️ ½ cucharadita de mostaza dijon
❤️ ½ cucharadita de orégano seco
❤️ ½ cucharadita de ajo en polvo
❤️ 1 cucharada de Súper Juventud
❤️ Sal + pimienta al gusto

Instrucciones

1. Precaliente el horno a 400 grados y forre una bandeja para hornear con papel pergamino.
2. Cortar la calabaza por la mitad a lo largo y quitarle las semillas con una cuchara.
3. Coloque la calabaza boca arriba en la bandeja para hornear. Unte el interior con un poco de aceite de oliva, sal y pimienta, luego colóquelo en el horno durante 20-25 minutos.
4. Mientras tanto, coloca la quinua seca en una olla grande con agua. Llevar a ebullición, luego reducir el fuego, tapar y dejar cocinar a fuego lento durante unos 15 minutos.
5. Mientras todo se cocina, prepara el aderezo batiendo todos los ingredientes del aderezo en un bol. Dejar de lado.
6. Cuando la quinua esté cocida y aún caliente, agregue la col rizada y mezcle con el aderezo. Revuelva y cubra la olla durante unos minutos para que la col rizada se ablande.
7. Retire la calabaza del horno y vierta la mezcla de quinua y col rizada en las mitades de calabaza.
8. Cubra con queso de cabra y luego vuelva a colocar la calabaza en el horno durante otros 7 a 10 minutos.
9. Saque la calabaza del horno nuevamente y cubra con granada. ¡Disfrutar!

¡Mejora tu próxima comida con esta deliciosa pero sencilla receta de calabaza asada que sorprenderá a tu paladar! ✨

¡Esta receta es el acompañamiento saludable perfecto para cualquier cena familiar, o impresiona a tus compañeros de trabajo y amigos en tu próxima comida compartida! 🍽️

Ingredientes:

🧡 1 – Calabaza
🧡 2 cucharadas – Aceite de Oliva
🧡 1 cucharada – Salvia Fresca (picada)
🧡 1 ½ cucharaditas – Tomillo fresco (picado)
🧡 ½ cucharadita – Sal
🧡 ¼ de cucharadita – Pimienta Negra

Alioli de ajo:

💛 ⅓ taza – Yogur griego
💛 1 cucharada – Colágeno Súper Juvenil
💛 1 cucharadita – Ajo en polvo
💛 1 cucharadita – Jugo de limón
Agregue todos los ingredientes a un tazón pequeño y bata para combinar.

Instrucciones:

1. Precaliente el horno a 425 grados F.

2. Pele y quite las semillas de la calabaza; media longitud

3. Córtelo transversalmente en rodajas de ¾ de pulgada y luego mezcle con aceite de oliva, salvia, tomillo, sal y pimienta.

4. Colóquelo en una bandeja para hornear y hornee a 425 grados durante 20 minutos.

5. ¡Sirve con alioli de ajo y disfruta!

¿Busca una nueva forma creativa, sabrosa y nutritiva de incorporar una variedad de verduras a su dieta? 🥗

¡Esta saludable ensalada de pasta los contiene, es fácil de preparar y está lista para usar durante la semana! 😍

Ingredientes:

💛 3 tazas de pasta fusilli
💛 1 ½ tazas de garbanzos cocidos, escurridos y enjuagados
💛 2 tazas de tomates cherry cortados por la mitad
💛 1 taza de pepinos persas, cortados en mitades finas
💛 2 tazas de rúcula
💛 1 taza de albahaca
💛 ½ taza de perejil picado
💛 ½ taza de menta picada
💛 ¼ taza de piñones tostados
💛 1 taza de queso feta desmenuzado

Vendaje:

💗 ¼ de taza de aceite de oliva virgen extra
💗 1 cucharada de Súper Juventud
💗 3 cucharadas de jugo de limón
💗 1 cucharadita de mostaza dijon
💗 3 dientes de ajo picados
💗 1 cucharadita de condimento italiano seco
💗 ¼ cucharadita de hojuelas de pimiento rojo
💗 ¾ cucharadita de sal marina

Instrucciones:

1. Ponga a hervir agua en una olla grande y cocine la pasta según las instrucciones del paquete.
2. Mientras tanto, mezcle todos los ingredientes del aderezo en un tazón pequeño.
3. Escurrir la pasta y mezclar con un poco de aceite de oliva, luego dejar enfriar a temperatura ambiente.
4. Agregue la pasta cocida a un tazón grande, mezcle los garbanzos, los tomates, los pepinos, la rúcula, el perejil, la menta, la albahaca, el queso feta y los piñones.
5. Vierta el aderezo y revuelva para cubrir
6. Sazone al gusto con aceite de oliva adicional, sal, pimienta, limón o las especias preferidas.

¡Comencemos este fin de semana con cinco recetas de cócteles refrescantes y deliciosas que comparten un ingrediente secreto (Detox✨) que realmente tiene muchos beneficios! 💖
Por qué te ENCANTARÁ Detox:

🌿 Totalmente natural
🌟 13 superalimentos que estimulan el metabolismo
🚫 Sin laxantes
🍑 Refrescante sabor a melocotón
🌾 Sin gluten

¡Saborea el verano y disfruta del clima cálido junto con estas deliciosas y nutritivas paletas de yogur helado con frutos rojos! ☀️

Justo el regalo para mantenerte fresco durante toda la temporada ✨ repleto de proteína de colágeno magra para mantener tu cabello, piel y uñas tan radiantes como siempre. 💗

Ingredientes:

☀️ 2 ¾ tazas de yogur griego con miel y sin grasa
☀️ 1 cucharada de Súper Juventud
☀️ 1 taza de bayas mixtas congeladas
☀️ ¼ taza de agua
☀️ 2 cucharadas de azúcar
☀️ moldes de paletas deseados
☀️ palitos de helado

Instrucciones:

1. Coloque el yogur, Super Youth, las bayas, el agua y el azúcar en un procesador de alimentos; pulsa hasta que las bayas estén finamente picadas.
2. Vierta la mezcla de bayas en los moldes para paletas que desee, inserte los palitos para paletas y luego congele hasta que estén firmes.