Overactive Bladder? You Don’t Have to Live with It.

By: Tia Schellato, D.O., FACOS

What’s it like to experience the symptoms of overactive bladder? If having to urinate while in the movie theater causes more stress than the drama on the screen, you likely know.

And that theater audience includes many other people like you. Overactive bladder (OAB), which can cause urinary incontinence, affects nearly 33 million people. An estimated 30% of men and 40% of women endure the condition.

We use the term “endure” purposefully. Many men and women simply live with the condition and don’t ask their doctors about OAB. They might feel embarrassed, inadequate, or unsure a treatment could help.

Here’s how you should feel: It’s not your fault.

OAB Is a Medical Condition. It Can Be Treated

OAB is not a disease; it’s the name for a group of urinary symptoms that occur because of illness or changes in your body that can’t be prevented. These conditions include:

• Bladder obstruction, such as bladder stones or an enlarged prostate
• Diabetes
• Kidney disease
• Neurological disorders including Parkinson’s disease, multiple sclerosis, or stroke
• Nerve damage
• Childbirth, which can weaken the pelvic muscles
• Menopausal-related drop in estrogen, which weakens tissue

Untreated, OAB can disrupt your sleep, social life, and even your sex life, which can take an emotional toll. That can be prevented.

Symptoms of OAB

The most common symptoms of OAB include a sudden and hard-to-control urge to urinate, leakage, having to urinate sooner than every two hours, and waking up more than twice a night to urinate.

If you regularly experience any of the above symptoms, your doctor can perform a number of tests to confirm whether it’s OAB. You can help by keeping a “bladder diary” before your visit so you can confidently answer questions about how long you’ve experienced symptoms, how often you leak, and what activities trigger leakage.

The better you can describe the symptoms, the sooner the bathroom drama can be over.

Training Your Bladder

Based on your diagnosis, your doctor will likely suggest “training” approaches first, such as:

• Behavioral changes –Cutting back on caffeine, alcohol, and artificial sweeteners, and not drinking before bedtime.
• Timed voiding – With this bladder-training exercise, the patient limits urination to scheduled times of the day.
• Biofeedback – The doctor places sensors around the pelvic area that send information to a monitor, displaying how the muscles respond when squeezed. The patient can then repeat the exercise (Kegels) at home.

Medications And Surgical Options

• Oral medications – Muscle-relaxing drugs (anticholinergics and beta-agonists) are the most common drug therapies for OAB.
• Botox – Because the medicine in Botox relaxes muscles, it can stop the bladder wall from contracting too often when injected. It is recommended for those who do not respond to oral medications.
• Tibial nerve stimulation or implantable device – The doctor inserts a slim needle under the skin of your ankle, near the nerve that affects the bladder. An outside device then sends electrical pulses through the needle. Patients undergo once-weekly sessions for 12 weeks. There is also a new device that can be implanted in the ankle area.
• Sacral Nerve Therapy (Interstim or Axonics) – Here, a tiny pacemaker-like device is implanted near the tailbone and delivers small pulses to the sacrum nerves, which control the bladder and surrounding muscles.

You can learn more about the symptoms and treatments if you visit MidLantic Urology’s website on OAB.