By: Umar Karaman, MD
One-third of Americans struggle with bladder control, including overactive bladder (OAB). If you’re one of them, don’t be discouraged. There are numerous treatment options which means you don’t have to live with it!
The best approach starts with knowing why your bladder isn’t functioning like it should.
What is OAB?
The term describes a group of urinary symptoms, including:
- Sudden, hard-to-control urge to urinate
- Accidental leakage (incontinence)
- Getting up to urinate two or more times a night
When you urinate, your bladder muscle contracts and forces out urine. Then it relaxes so your bladder can fill again. When that muscle weakens or becomes damaged, loss of bladder control can result. Researchers have linked OAB with:
- Alcohol, caffeine, and some medications. These dull your brain’s signals to the bladder.
- Obesity which puts pressure on your bladder
- Parkinson’s disease, multiple sclerosis, stroke
- Pregnancy and childbirth which can damage the bladder muscle
- Radiation therapy
- Urinary tract infections
How is OAB diagnosed?
These tests can confirm you have OAB and also help to determine the best treatment:
- Cystoscopy: a thin, flexible scope with camera is inserted into the urethra to examine for abnormalities
- Urinalysis: a urine sample is examined
- Urodynamics: measures pressure in your bladder and urine stream. Also determines how much urine remains in your bladder after you finish urinating.
What is the treatment pathway for OAB?
Step one is for you to keep a voiding diary to track what you drink and when you urinate. Based on the results, your urologist will recommend treatment beginning with the least costly and least invasive:
- Lifestyle changes will be recommended, including adjustments to your diet, managing your weight, pelvic floor exercises (Kegels), and bladder training.
- Medications that relax your bladder muscle so it can hold more urine.
At a one-month follow-up, your urologist may prescribe a second medication. If there is no improvement, a repeat evaluation may be needed including another cystoscopy and/or urodynamics.
The next line of treatment, if needed, may include one of the following:
- Sacral nerve stimulation: A tiny pacemaker-like devise is implanted to calm the nerve that controls the bladder. Before implantation, a test phase can determine if this is right for you.
- Percutaneous tibial nerve stimulation or Percutaneous tibial neuromodulation: Your tibial nerve is located just above your ankle. This procedure uses a slim needle electrode to stimulate the nerve for better bladder control.
- Botox: Injected into the bladder, it partially paralyzes the muscle to prevent overactivity. But you’ll still have enough control to empty your bladder.
If your urologist determines these approaches aren’t right for you, other options exist, including surgery. The goal is to get you back in control of your bladder and an improved quality of life.
Learn more about OAB here. Request an appointment with a urologist at AUI.
