Overactive Bladder

What is an overactive bladder?

Some common symptoms of an overactive bladder (OAB)

• I use the bathroom more than eight times during the day.
• I get up more than twice during the night to use the bathroom.
• It bothers me how much I have to go.
• I often have a sudden need to go with little or no warning.
• I have wet myself because I can’t get to the bathroom in time.

Symptoms

Overactive bladder is used to describe a collection of symptoms. A patient may have one or more of these symptoms:

• A sudden, intense urge to urinate (urinary urgency), sometimes followed by the loss of urine (urge incontinence)
• Urinating more than eight times daily or twice at night (urinary frequency)

Cause

Overactive bladder is generally caused by bladder muscles that are overly sensitive or overactive. This over-activity is caused by damage to nervous system or to the nerves and muscles associated with bladder. The cause of the nerve damage is often unidentified and you should discuss your symptoms with your doctor. Overactive bladder symptoms of urinary urgency, urinary frequency or urge incontinence may be present in people with interstitial cystitis or post-radical prostatectomy.

Prevalence

It is estimated that over 16% of the adult population have one or more of these symptoms. Both men and women can have OAB.

How is overactive bladder treated?

A variety of treatments are available, including behavior modification, pelvic muscle strengthening, medications and neuromodulation.

Behavioral modifications

Scheduled voiding
The patient is prompted to use the bathroom every 2–4 hours.

Bladder training
Involves scheduled voiding in which the length of time between bathroom visits is gradually increased.

Pelvic muscle rehabilitation
Pelvic floor exercises, commonly referred to as Kegel exercises, are often recommended. Depending on the severity of a patient’s symptoms, Kegel exercises may be combined with pelvic muscle stimulation, which is mild electrical stimulation to help automate the process of performing Kegel exercises. Stimulation is generally applied using a home-use device.

Biofeedback
A process using visual or auditory signals to assist targeting the right muscle during exercise.

Drug therapy
Anticholinergics, antimuscarinics or β3 agonists may be prescribed. Hormone therapy, such as estrogen creams, may also be effective in helping to improve pelvic floor muscle function.

Neuromodulation
Bladder function is regulated by a group of nerves at the base of the spine called the sacral nerve plexus. By stimulating these nerves through gentle electrical impulses (neuromodulation), your bladder activity can be changed. This can be done through an office-based procedure or by surgically implanting a device in your buttock.

Contact us today to learn more about your treatment options.