Remember when being accident-prone meant you had a knack for tripping on uneven sidewalks? If you’re among the more than 33 million U.S. men and women living with overactive bladder (OAB) today, then accident-prone has taken on a potentially more awkward meaning.
OAB, a common condition characterized by the sudden and frequent urge to urinate, affects an estimated 40% of women and 30% of men. Yet many of them never seek a doctor’s help. Instead, they try to cope with OAB symptoms because they’re embarrassed, aren’t aware of available treatments, or just don’t know how to bring the issue up.
But we do know how to bring it up. OAB and incontinence are so common, in fact, that our urologists talk about it every day.
Why Your Bladder Becomes ‘Overactive’
OAB is a condition in which the bladder squeezes out urine at the wrong time; typically before it is full. While this issue becomes more common with age, OAB also can be brought on by illness or changes to your urinary system. Among them:
- Obstructions including bladder stones, tumors, constipation, or (in men) an enlarged prostate
- Hormonal changes from menopause (in women)
- Chronic, recurrent UTIs
- Pelvic floor dysfunction
- Diabetes
- Misfires by the nerves that control bladder muscles
- Neurological disorders including Parkinson’s disease, multiple sclerosis, or stroke
Getting Ahead of OAB: Your Treatment Options
The most common symptoms of OAB include needing to urinate more than every two hours, urine leaks (incontinence), and waking up more than twice a night to urinate. If you experience these symptoms, your doctor can help, starting with a physical exam and urinalysis to screen for OAB. Other possible tests include going to the bathroom to determine how much your bladder empties or to assess the strength of your urine stream.
If your symptoms require it, your doctor might also perform one of the following tests:
Cystoscopy – Examining the inside of the urinary tract using a slender, camera-equipped scope.
Urodynamics – Gauging bladder pressure using two scopes, in the urethra and the rectum.
Your Step-By-Step Therapy Options
Depending on the diagnosis, your doctor will likely advise non-invasive therapies first, such as:
- Liquid and diet restrictions –Reducing caffeine, alcohol, and artificial sweeteners (bladder irritants); keeping a healthy weight; and avoiding liquids two to three hours before sleeping.
- Kegels – Performing pelvic-strengthening exercises daily and at regular intervals.
- Bladder training – Holding off on going to the bathroom for as long as you can, then gradually extending the waits.
- Pelvic floor physical therapy – Performing physical therapy exercises to strengthen and tighten the pelvic muscles.
- Biofeedback – While sitting in a comfortable chair (fully clothed), two sensors are used to measure the activity of the muscles that control bladder functions. This technique is used to help train patients on how to properly perform pelvic floor therapy.
- EMSELLA Chair – Patients sit in a comfortable chair-like device (fully clothed) that uses high-intensity focused electromagnetic energy to strengthen the pelvic floor muscles.
If you do not respond to the above therapies, the doctor might suggest the following.
Medications
- Oral prescriptions – Muscle-relaxing drugs can ease involuntary bladder contractions.
- Botox – When injected into the bladder, Botox has proven effective in relaxing the bladder. Often, Botox is advised in cases where the patient does not respond to oral medications.
- Estrogen replacement therapy (for menopausal women) – Reintroducing hormones to strengthen genital tissue.
Nerve Stimulation
- Sacralneuromodulation – Think of this approach as the “pacemaker for the bladder.” The doctor implants a thin wire equipped with an electrode under the skin by the sacral nerve, which controls the bladder. The electrode delivers pulses to the nerve.
- Tibial nerve stimulation – Here, electric pulses stimulate the sacral nerve via the tibial nerve, near your ankle. Rather than an implant, the electrode is delivered through a needle, usually over 12 weekly sessions.
You Can Make Accidents a Memory
Your first step to skipping urgent bathroom runs can start now. Keep a “bladder diary” to record your symptoms, how often they occur, and the activities that cause leakage. Then share it with your AUI doctor. Together, we will find a solution.
Don’t spend another night with OAB on your mind. Explore our OAB treatments and a video that explains our surgical options.
