Effective Method for Men with an Overactive Bladder

Diane K. Newman | February 13, 2020

I see many young and older men with complaints of overactive symptoms of urgency and frequency. The older men may have benign prostatic hyperplasia (BPH) and the younger men seem to have no underlying pathology. Whatever the cause, these are distressing symptoms that affect the quality of life for all of these men. Drug therapy is usually recommended at first with behavioral therapy added usually as an afterthought. But based on a recently published research in JAMA by Burgio and colleagues, clinicians should consider a more effective stepped approach to combination overactive bladder (OAB) therapy by first recommending behavioral therapy.1


diane k newman

Diane K. Newman, DNP, ANP-BC, FAAN is an Adjunct Professor of Urology in Surgery, Perelman School of Medicine, University of Pennsylvania and Co-Director of the Penn Center for Continence and Pelvic Health. She is the author of several books. The most recent is as lead editor of the 1st edition of the SUNA Core Curriculum for Urologic Nursing and of Clinical Application of Urologic Catheters, Devices and Products.

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Everyday Urology - Oncology Insights
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By Diane Newman, DNP, ANP-BC, FAAN
Everyday Urology-Oncology Insights: Volume 1, Issue 4

The Core Curriculum is a first-of-its-kind textbook that can be used by nurses to study for specialty certification as a urology registered nurse, and is a source of material to support urology nursing instruction in academic programs. It has applicability to nurses in acute care, long term care, home care and rehab settings as all encounter patients with urologic problems.
Library Resources
Evidence based monographs by experts to define and guide clinical practice
Intermittent Catheters
Written by Diane K. Newman, DNP, ANP-BC, FAAN
March 4, 2020
Intermittent catheterization (IC) can be indicated as treatment for voiding problems due to disturbances or injuries to the nervous system, non-neurogenic bladder dysfunction, or intravesical obstruction with incomplete bladder emptying.

Intermittent catheterization should be performed in the presence of a residual urine volume and symptoms or complications arising from this residual volume of urine.
Written by Diane K. Newman, DNP, ANP-BC, FAAN
March 4, 2020
Intermittent catheterization (IC) is the preferred procedure for people with incomplete bladder emptying not satisfactorily managed by other methods. Complications and adverse events can arise in both men and women but are seen especially in male patients performing intermittent self-catheterization long-term. Urethral/scrotal events can include bleeding, urethritis, stricture, the creation of a false passage, and epididymitis. Bladder-related events can cause UTIs, bleeding, and stones. The most frequent complication of IC is urinary tract infection (UTI).
Written by Diane K. Newman, DNP, ANP-BC, FAAN
March 3, 2020
The number of catheter types and designs has increased with the advancement of new technology. This has added complexity to the catheterization process for both the nurse and the patient. Catheter types are now gender specific, acknowledging the anatomical differences in urethral length between men and women. Standard male catheter length is 16” (~40cm), whereas female catheters range in length from 6-12”.  Pediatric lengths are 6-10”.  Many women find that shorter catheters do not shift and are easier to grasp and insert.
Written by Diane K. Newman, DNP, ANP-BC, FAAN
November 29, 2019
Intermittent catheterization (IC) is the insertion and removal of a catheter several times a day to empty the bladder. This type of catheterization is used to drain urine from a bladder that is not emptying adequately or from a surgically created channel that connects the bladder with the abdominal surface (such as Mitrofanoff continent urinary diversion). Intermittent catheterization is widely advocated as an effective bladder management strategy for patients with incomplete bladder emptying due to idiopathic or neurogenic detrusor (bladder) dysfunction (NDO).
Written by Diane K. Newman, DNP, ANP-BC, FAAN
February 5, 2020
Medicare Changes Reimbursement Policy to End Re-use of Intermittent Catheters.  This change allows for up to 6 catheter changes a day in hopes to stop re-use of FDA labeled "single-use" catheters. The old policy made individuals sterilize and clean their catheters any way they knew how which lets a very high-risk opportunity to have the individual get infected with catheter-associated bacteria to arise.  No longer will catheter users suffer from severely painful UTIs.
Written by Diane K. Newman, DNP, ANP-BC, FAAN
February 1, 2013
Patients may be concerned about the discomfort associated with intermittent catheterization, the need to maintain privacy, the fear of performing the catheterization, and the inability to find a clean and appropriate toilet when traveling outside their home. Clinicians need to consider these patient concerns in their teaching and recommend possible strategies.
Indwelling Catheters
Written by Diane K. Newman, DNP, ANP-BC, FAAN
January 15, 2013
The 2009 Centers for Disease Control and Prevention (CDC) guidelines for the prevention of catheter-associated urinary tract infections (UTIs) recommends catheter use only for appropriate indications.
Written by Diane K. Newman, DNP, ANP-BC, FAAN
January 15, 2013
Catheter related problems due to an indwelling urinary catheter (IUC) have existed as long as urinary catheters have been utilized.
Written by Diane K. Newman, DNP, ANP-BC, FAAN
January 15, 2013
In this resource article, Diane Newman, DNP, ANP-BC, FAAN provides best practices for the management of indwelling urinary catheters starting with documenting in the patient’s medical record all procedures involving the catheter or drainage system.
Written by Diane K. Newman, DNP, ANP-BC, FAAN
January 15, 2013
In this resource article, Diane K. Newman, DNP, ANP-BC, FAAN provides techniques and procedures for use of indwelling catheters including appropriate urinary catheter use, examples of appropriate indications for indwelling urethral catheter use and more. 
Written by Diane K. Newman, DNP, ANP-BC, FAAN
January 15, 2013
Catheters are semi-rigid but flexible tubes. They drain the bladder but block the urethra.

The challenge is to produce a catheter that matches as closely as possible to the normal physiological and mechanical characteristics of the voiding system.
Written by Diane K. Newman, DNP, ANP-BC, FAAN
January 15, 2013
Each year, urinary catheters are inserted in more than 5 million patients in acute care hospitals and long-term care (LTC) facilities. Historically, indwelling urinary catheters (IUC) have been used in the chronically, medically compromised older adults.
Written by Diane K. Newman, DNP, ANP-BC, FAAN
January 15, 2013
A catheter is inserted for continuous drainage of the bladder for two common bladder dysfunction : urinary incontinence (UI) and urinary retention. Indwelling urinary catheters are either inserted transurethrally or suprapubically.
Written by Diane K. Newman, DNP, ANP-BC, FAAN
January 25, 2013
Indwelling urinary catheters (IUCs) are semi-rigid, flexible tubes. They drain the bladder but block the urethra. IUCshave double lumens, or separate channels, running down it lengthwise.
Pelvic Health
Written by Roger R. Dmochowski, MD, MMHC, FACS and Benjamin M. Brucker, MD
April 16, 2019
Michael, a 61-one-year old executive accountant, presents for annual PSA monitoring and digital rectal examination. He reports that alpha-blocker therapy using tamsulosin has improved his benign prostatic hypertrophy, but that he still wakes frequently at night to void.
Conference Coverage
Recent data from conferences worldwide
Presented by Jeffrey P. Weiss, MD
Miami, FL (UroToday.com) Dr. Jeffrey Weiss provided an update of the management of nocturia. Patients are oftentimes asked to fill out a 24-hour voiding diary but compliance in completing them is sometimes very difficult to obtain.
Presented by Harris Emilio Foster, MD
Miami, FL (UroToday.com) Dr. Foster leads the audience through the AUA BPH Guidelines briefly emphasizing the new changes /updates that will be seen in the new updated BPH guidelines.
Presented by Alison P Downey, MD
Philadelphia, PA (UroToday.com) Dr. Chapple from Royal Hallamshire Hospital, Sheffield, and his colleagues presented their experience and outcome of surgical intervention in the management of bladder pain syndrome in a tertiary center.
Presented by Mikel Gray, Ph.D., RN
Philadelphia, PA (UroToday.com) Mikel Gray, Ph.D., RN provided an overview of urodynamic procedures, which were defined as a set of tests created to estimate storage and evacuation of urine from the lower urinary tract (LUT).
Presented by Shannon Novosad, MD, MPH
Philadelphia, PA (UroToday.com) Shannon Novosad, MD, medical officer at the Centers for Disease Control and Prevention (CDC) has opened Educational Course on Clinical Directions in Continence care by providing an overview