Overactive Bladder (OAB)

Simple behavioral treatments and lifestyle changes, such as dietary adjustments, timed voiding, and bladder-holding techniques, may help you manage your overactive bladder symptoms. Other OAB treatment options include medications, injections, and nerve modulation.

Behavioral Methods

Here are five behavioral changes that can reduce the effects of an overactive bladder.

1. 1. Pelvic floor exercises. Kegel exercises strengthen the pelvic floor muscles and the urinary sphincter. Strengthening these muscles can help stop involuntary bladder contractions and urine loss.

1. 1. Weight loss. If you are overweight, weight loss may decrease your symptoms and improve stress incontinence.

1. 1. A toileting schedule. Sticking to a routine such as voiding every two to four hours, can help reduce the urge for frequent urination.

1. 1. Wearing absorbent pads or undergarments. These additions to your everyday wardrobe can protect your clothing and allow you to continue your normal activities. Absorbent clothes are available in a range of sizes and absorbency levels.

1. 1. Bladder training. If you can successfully tighten or contract your pelvic floor muscles, bladder training can help you learn to delay urination when you feel the urge.

Other treatment alternatives are available if these early efforts do not alleviate your overactive bladder symptoms.

Medications

The muscles and tissues in the urethra and vaginal area can be strengthened with vaginal estrogen therapy after menopause, which effectively lessens the symptoms of an overactive bladder.

Medications that relax the bladder can help relieve OAB symptoms and reduce urge incontinence episodes.

Anticholinergic medications help control muscle spasms in your bladder. Examples include:

• • Oxybutynin (Ditropan®)

• • Tolterodine (Detrol®)

• • Solifenacin (Vesicare®).

Beta-3 adrenergic medications cause the muscles in your bladder to relax so your bladder can hold more urine. Examples include:

• • Mirabegron (Myrbetriq®)

• • Vibegron (Gemtesa®).

Drugs for overactive bladder do not cure the condition; instead, they relieve OAB symptoms. Common side effects of most drugs include dry eyes, dry mouth, and constipation.

Bladder Injections

Onabotulinum toxin or Botox® injections into the bladder can reduce feelings of urgency and prevent urine leakage. This therapy is quite effective, even in patients who have not responded well to conventional treatments.

The beneficial effects typically last six months or longer before additional injections are required. Urinary tract infections and retention are side effects of Botox® injections.

Nerve Modulation

The symptoms of an overactive bladder can be improved by controlling the nerve impulses to your bladder. There are two main methods of nerve stimulation used to treat OAB.

1. Sacral nerve stimulation

Sacral nerve stimulation electrically stimulates the nerves that control your bladder. This treatment can help you retain bladder control by reducing urinary frequency and incontinence.

First, your doctor will implant a small device called a neurotransmitter beneath the skin around your upper buttock region. Then, the neurotransmitter sends gentle electrical impulses through a wire near your sacral nerve.

2. Percutaneous tibial nerve stimulation

Percutaneous tibial nerve stimulation (PTNS) stimulates the nerves involved in bladder control by using the tibial nerve in the leg. During treatment, a small, thin needle is inserted near the tibial nerve and connected to a battery-powered stimulator.

The tibial nerve sends impulses to the sacral nerve, which controls bladder function. The electrical pulse helps to block nerve signals that aren't working correctly and are causing unwanted bladder spasms.

Percutaneous tibial nerve stimulation is typically performed in a series of weekly appointments lasting about 30 minutes. Many individuals only require monthly visits after the initial treatments to maintain their improvements.