Published: July 21, 2023

Overactive Bladder Treatment Pathways: There’s a Right Choice for You

By: Katie M. Rosen, D.O.

What does overactive bladder feel like? To some, it might feel like trying to outrun a rushing ocean wave. Sometimes, the wave doesn’t catch you. But sometimes, it does.

Millions of Americans try to outrun this predicament every day.

If you are among the nearly one-third of Americans who struggle with bladder control, don’t be discouraged. A range of non-invasive treatments for overactive bladder (OAB) can help. You can even do some of these treatments yourself, at home.

Choosing your best approach starts with understanding why your bladder isn’t working the way it used to.

What is OAB, and What Are the Signs?

OAB is not a disease itself. Rather, it’s an umbrella name that describes a group of urinary symptoms.

These symptoms include the sudden, hard-to-control urge to urinate, accidental leakage (incontinence), and getting up to urinate at least twice a night.

Why Does My Bladder Overact?

When you urinate, the bladder muscle contracts to force out the contents. Afterward, it relaxes so your bladder can fill again. If something damages or weakens your bladder muscle, it can interfere with bladder control.

Research has linked high incidents of OAB to several factors. Among the leading risk issues:

  • Certain medications, alcohol, and caffeine, all of which can dull the brain’s signals to the bladder.
  • Obesity, which can put pressure on the bladder.
  • Diseases that cause nerve damage, including Parkinson’s disease, multiple sclerosis, or stroke.
  • Pregnancy and childbirth, which can weaken your pelvic floor muscles, cause nerve damage, or move the bladder and urethra.
  • Radiation therapy that irritates or inflames the bladder.
  • A urinary tract infection, which can increase the activity of the bladder muscle.

If I Have Symptoms of OAB, Can I Get Tested?

Thanks to clinical studies and other research, tests are available to detect OAB and determine the right treatment for you. Our urologists at MIU will often recommend one of or a combination of the following:

  • Urodynamics – A test measures pressure in your bladder and urine flow. Another test measures how much urine remains in your bladder after you urinate.
  • Cystoscopy – A thin, flexible scope with a tiny camera is inserted into your urethra to look for abnormalities.
  • Urinalysis – An examination of your urine sample.

Treatments for OAB Patients

We approach OAB treatment as a journey, step by step. The first step is your initial evaluation, during which we’ll provide you with a voiding diary to track what you drink and when you urinate. From there, we will advise the least costly, least invasive treatments first.

  • Lifestyle changes, including diet modification, weight management, pelvic floor exercises (Kegels), and bladder training.
  • Oral medications that relax the bladder muscle so it can hold more urine.

Next, we’ll perform a one-month follow up. A second medication might be prescribed, based on your reaction to the first. If you do not experience relief, we’ll perform a repeat evaluation, which might include a follow-up cystoscopy and or urodynamics.

If a third line of treatments is recommended, we offer multiple non-invasive pathways:

  • Sacral nerve stimulation – We implant a tiny pacemaker-like device that calms the sacral nerve, which controls bladder function. Patients can first test the therapy to see if it works.
  • Percutaneous tibial nerve stimulation or percutaneous tibial neuromodulation – We stimulate the tibial nerve, located just above your ankle, using a slim-needle electrode. These impulses travel to the sacral nerve, for better bladder control.
  • Botox – When injected directly into the bladder, Botox will partially paralyze the muscle to reduce overactivity. You’ll retain enough control to empty your bladder voluntarily.

If these approaches do not resolve your OAB, there are other options, including surgery. Our mission is to gradually get you back in control of your bladder so that in addition to relief, you gain a better awareness of your body. This will best ensure you proceed with comfort, and the confidence to eventually wave goodbye to OAB.

You can learn more about OAB here. If you have general questions about incontinence, we have a page dedicated to the condition, causes, treatments, for both women and men. We encourage you to explore ithere. Finally, click here to request an appointment with your MIU provider.

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