Overactive Bladder Treatments
Behavioral and medical treatments
are available to help alleviate many of the adverse symptoms of overactive bladder
(OAB). After tests determine the cause of
OAB, your doctor will help you find a solution that
will minimize symptoms without many negative side effects. As with most
conditions, the goal of treatment is to find the simplest solution that is
effective. For that reason, your doctor will start by suggesting lifestyle
Training and Scheduled Voiding
Your doctor may recommend bladder
training as a first course of treatment. This method helps “teach” the bladder
to steadily hold urine. Your doctor may advise you to delay urinating for five
to 10 minutes when the urge arises. Over time, the delay can increase and help
build a tolerance to the urgency that comes with OAB. Scheduled bathroom visits
may also be helpful.
Urinating twice with a few minutes
in between may help release residual urine that can remain in the bladder and
cause OAB symptoms. This can help people who feel they don’t empty their
bladder completely during urination or who have been tested and are known to
have urine left in their bladder after they go to the bathroom. Having to go
twice every time you need to void can be disruptive to your daily routine. This
may be an effective treatment choice if you are at home.
These pelvic exercises can help manage urge in
continence in OAB by helping strengthen the muscles of the pelvic floor and
urinary sphincter. Both are important for holding urine in the bladder. You can
learn to tighten, hold, and release the muscles that control urination. Over
time, the number of repetitions and time of holding the contraction can be
Changes in diet and fluid intake
can help relieve OAB symptoms. Some include:
- maintaining a schedule of the timing and amount of daily
- limiting caffeinated
drinks and acidic beverages such
as coffee, cranberry and citrus juices, or sodas
- limiting alcohol
- eating foods
high in fiber, such as flaxseed, or taking fiber
supplements per doctor advice. This can help avoid constipation and aid the
process of proper digestion and voiding.
- maintaining a healthy body mass index
(BMI), as being overweight increases the risk of
Intermittent catheterization is a
procedure that empties the bladder completely. It can be done at home and involves
inserting a thin tube into the urethra each time you need to urinate. This
helps retrain the bladder to function properly. This treatment method is
considered more invasive and is usually used if other, simpler methods haven’t
worked. Talk to your doctor to see whether this procedure is right for you.
Anticholinergics are commonly
prescribed for people with OAB. They stop nerve impulses that are responsible
for involuntary contractions of the smooth muscle in the bladder. In people
with OAB the bladder muscle contracts, even if the bladder isn’t full, and
causes a sudden urge to urinate. Anticholinergics can be taken orally or
Tricyclic antidepressants are
sometimes prescribed for OAB because they can help relax the smooth muscle of
the bladder. Your doctor will prescribe a lower dosage for OAB than they would
One theory suggests that some women
suffer from OAB because of a drop in estrogen levels as a result of menopause.
Estrogen helps keep tissues around the bladder healthy and working properly.
There is some scientific research that suggests topical estrogen treatment may
ease the symptoms of OAB. However, research
on estrogen treatment for OAB is mixed.
Toxin Type A (Botox)
have shown that Botox injections into the bladder can reduce OAB symptoms and
can also improve bladder capacity and the ability to empty the bladder.
Research varies as to the dosage and duration of relief, but the findings are
promising for those who don’t respond to other treatments. The FDA has not
approved Botox for incontinence.
Many drug treatments have side
effects and are not safe for everyone. A doctor can determine which drug is
appropriate and safe for you.
When other measures for OAB are
unsuccessful, surgery is another treatment option. Some surgeries are
reversible but are not recommended for everyone. Women who are pregnant or who
plan to become pregnant may want to wait until after childbirth. Changes that
occur during pregnancy may counteract the surgical modification.
To help reduce urge incontinence,
an electrical device can be implanted at the base of the spine. About the size
of a small stopwatch, it produces electrical currents that can influence
bladder-control muscles by gently stimulating the sacral nerve. Before the
device is implanted, a patient will have a test run with an exterior electrical
device to see whether this treatment can help. Nerve stimulation can be costly
and have adverse side effects.
This procedure increases how much
urine the bladder can hold. It does this by adding intestine segments or by
reducing the muscle-squeezing ability of the bladder. This surgery is lengthy,
and recovery time may take several weeks. Adverse side effects can include
infection and chronic diarrhea. Intermittent catheterization may be required
for complete bladder emptying. This is widely considered to be one of the most
invasive treatments for OAB.
There are several potential
treatments for overactive bladder, including lifestyle changes, medications, simple
self-administered procedures, and complicated surgeries. The right treatment
for you is typically the least invasive and most effective option. Your doctor
will work with you to find the methods that can give you the best results with
the least inconvenience.