DEAR DR. DONOHUE: For the past five years I have had a major problem with bladder control. I wore urinary pads 24 hours a day, seven days a week. Then I read an article on the InterStim. I searched and finally found a doctor who was familiar with it. After examining me, he decided I had nerve damage and was a candidate for the procedure. I am ecstatic about the results. Please let others know about it. – L.H.

ANSWER: Treatment for regaining urinary bladder control depends on the cause of control loss.

Urge incontinence is a feeling of having a full bladder at all times. That feeling triggers a response in the bladder wall. It contracts, and a woman must make a beeline for the bathroom to prevent an accidental loss of urine.

Stress incontinence is urine leakage when a woman coughs, laughs or strains to lift a heavy object. Due to childbearing and aging, the pelvic support tissues for the bladder have weakened, and bladder control is lost.

There are other causes, such as nerve damage, and there are instances when many factors have a hand in urinary incontinence.

For urge incontinence, bladder retraining is often useful. A woman keeps a record of how often she visits the bathroom. Then she holds off the trip to the bathroom for 15 minutes past the usual interval for passing urine. She then slowly increases the interval between her visits until she has reached the stage where they can be delayed for three or four hours. Ditropan and Detrol can sometimes quiet bladder spasms in people with urge incontinence.

Kegel exercises are particularly designed for women with weak pelvic bladder supports. A woman contracts the muscles that stop the flow of urine. Once she knows which muscles to contract, she performs a series of 10 contractions upon wakening, a series at lunchtime and then another before retiring.

The InterStim device is helpful for women who have defective nerve input to the bladder. Through a wire, it activates the sacral nerve — the nerve whose impulses keep the bladder closed. This device is not for every woman with incontinence. I don’t want to raise false hopes.

I have addressed this answer to women. I don’t mean to neglect men. They have the same problems and often the same treatments.

DEAR DR. DONOHUE: I read what you had to say about colon polyps and how long it takes for them to evolve into colon cancer. Here is my question: If a person had a colon polyp removed, how long does it take for another polyp to appear? – I.B.

ANSWER: I can’t give you a definite answer. It can take a year, two years, five years, or you might never have a recurrence of a polyp. The doctor who discovered the first polyp will outline a surveillance program to detect any new polyps.

You can increase the odds of not having another polyp by carefully watching the amount of saturated fat in your diet. Cut down on your consumption of meat and sugar. Take folic acid — a B vitamin — either in a multivitamin pill or in a pill containing only that vitamin. If you prefer to go the natural route for vitamins, eat lots of green, leafy vegetables. They are a good source of folic acid. Don’t smoke. Smoking promotes polyp growth, something that does not get the attention it should. Calcium cheap and plentiful, appears to prevent polyps and colon cancer.

Ask your doctor about taking a daily aspirin. A low-dose aspirin tablet — 81 mg — is another way to keep the colon free of polyps.

DEAR DR. DONOHUE: I have been a regular blood donor for more than 30 years. This past year I have had to take blood pressure medicine for a mild elevation of pressure. When I went to donate blood, I was turned away. Why? My blood pressure is under good control. – C.P.

ANSWER: Your controlled blood pressure is not the reason for the reluctance to take your blood this year. It is more likely that your medicine is the reason. Medicines stay in your blood. Your blood pressure medicine might be a problem for the recipient of your blood.

Your willingness to donate blood deserves recognition. If everyone were as generous, there would never be a shortage of blood in blood banks.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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