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Treatment Options For Overactive Bladder


Bladder conditions, such as overactive bladder (OAB), have become such an overwhelming medical concern for people in the U.S. today, that the American Urological Association has named November “Bladder Health Month.” In an effort to raise public awareness and decrease the stigma associated with bladder issues, the AUA is hoping to improve the lives of everyone affected by these conditions.

OAB affects roughly 33 million Americans today, and despite its vast prevalence, most patients still feel embarrassed discussing it with their friends and physicians. Prevalence increases with age, and women are at a slightly higher risk than men. Studies show 27 percent of men over 40 and 30.9 percent of women over 65 are affected by overactive bladder syndrome. OAB is thought to stem from a malfunction in the bladder, as a result of miscommunication between the bladder muscles and the brain.

Although there is no known cure for the condition yet, there are numerous treatment options available. Depending on the severity of one’s symptoms, a treatment plan composed of self-care remedies, medications or more serious tactics could be the answer.

Common Symptoms of OAB

Depending on the degree of the patient’s condition, he or she may experience a wide range of symptoms. People with OAB usually feel the urge to urinate all the time, which often results in an involuntary loss of urine. This is known as urge incontinence, and is one of the most common side effects for OAB patients. Feeling the need to urinate more than eight times a day and more than twice at night are also common OAB struggles; otherwise known as frequent urination and Nocturia, respectively.

There are indirect side effects that can result from these symptoms as well. Individuals who suffer from Nocturia may also experience fatigue, bedwetting and insomnia as an outcome. Dealing with the embarrassment and inconveniences that come along with OAB can even lead to anxiety and depression in some people. Fortunately, there are numerous healthy lifestyle tips for both men and women that can help reduce these troublesome symptoms.

Bladder Training

When a person is constantly feeling the urge to urinate, he or she is forced to take frequent trips to the bathroom throughout the day. Often times, the bladder is not completely full when the person empties it, but the urge makes them think it is. Routinely emptying the bladder before it is full only makes the problem worse and will cause the patient to feel the urge with less and less volume over time. To stop this cruel cycle, OAB patients must train their bladders to hold more urine and decrease the frequency with which they visit the restroom.

The easiest way to train your bladder is by keeping a bathroom schedule / diary. Keep track of how many times per day you urinate and how many hours or minutes there are in between each time. Also, try to increase your interval time between each bathroom break. For example, if you normally feel the need to urinate every hour, try to wait an extra 15 minutes and empty your bladder every 75 minutes instead. Gradually increase this interval time every few weeks to expand the amount of urine your bladder can comfortably hold.

Kegel Exercises

Incorporating Kegel exercises into your daily routine can help strengthen bladder muscles and allow you to maintain better control of your urine outflow. These exercises are simple and begin by squeezing the muscles of your pelvic floor. If you have ever interrupted a stream of urine mid-flow, you have felt these muscles. Every day, try squeezing 20-30 times and hold each squeeze for at least three seconds.

Weight Management

Many people don’t realize that their weight can actually have a big impact on their OAB symptoms. Losing weight has shown to dramatically lower episodes of incontinence in certain obese individuals. Get your weight to a healthy BMI range by exercising frequently and eating a balanced diet. It is also a good idea to reduce your caffeine and alcohol consumption as much as possible.

Overactive Bladder Medication

Sometimes, lifestyle modifications aren’t enough, and patients need prescribed medication to manage their symptoms. Anticholinergic drugs are the largest class of drugs used to combat OAB, and there are numerous options to choose from. These medications all work by reducing the number of contractions in the bladder, which normally lead to the urge to urinate. They block the chemical that normally causes these contractions, leaving the bladder muscles more relaxed. Talk to a urologist to see if any of the following medications are right for you.

  • Tolterodine (Detrol)
  • Oxybutynin (Ditropan XL, Oxytrol)
  • Trospium (Sanctura)
  • Darifenacin (Enablex)
  • Mirabegron (Myrbetriq)
  • Fesoterodine (Toviaz)

Sacral Nerve Stimulation  

For the most severe cases of OAB, after self-care remedies and medications have not proven effective, a urologist may recommend surgery. One common and effective surgery to combat overactive bladder syndrome is Sacral Nerve Stimulation (SNS). During this procedure, the surgeon implants a small device under the skin, which helps modify nerve impulses in the bladder. This device sends small electrical impulses to the nerves just above the tailbone. These nerves contribute greatly to bladder control, and the small electric waves can reduce and even eliminate bladder control issues in patients.

SNS surgery can help patients who are experiencing overactive bladder with or without frequent leakage, and the operation is reversible. However, this surgery should not be the first thing one considers when struggling with overactive bladder. It is most suitable for patients who have already tried more conservative methods of treatment for their OAB, like self-care remedies and lifestyle changes. In fact, most doctors will require that medication, behavioral therapy or physical therapy be considered before surgery is an option.



If you’re struggling to manage your OAB symptoms, or if you would like to discuss treatment options with an experienced urologist, don’t hesitate to call us at 404-238-7186. Make an appointment at your nearest Advanced Urology today.