Treatment Of Overactive Bladder (OAB) & Urge Incontinence
For the millions of people with overactive bladder (OAB), the following symptoms are significant causes of concern:
- Frequent trips to the bathroom (frequency)
- Strong uncomfortable urges to void that cannot be ignored (urgency)
- The inability to prevent or stop voiding after an urge occurs (urge incontinence)
- Awakening at night multiple times to void (nocturia)
OAB interferes with work, daily routines, intimacy and sexual function; causes embarrassment, and can diminish self-esteem and quality of life. After a thorough evaluation is performed and a diagnosis is made, many treatment options are available.
Dietary changes may also help with symptoms of overactive bladder. Avoiding caffeinated beverages such as soda, coffee, and tea may help. Caffeine is a known bladder irritant and may increase your need to void more frequently.
Pelvic Floor Muscle Exercises
Pelvic floor muscle exercises, also known as Kegels, can help improve incontinence and prevent it from worsening. They can help you suppress the urge to urinate. The exercises strengthen and tone the muscles that support the pelvic organs. These muscles contract and relax under your command to control the opening and closing of the bladder. When these muscles are weak, urine leakage may occur. To achieve the best results, imagine yourself as an athlete in training. You need to build strength AND endurance of your muscles. This requires commitment and regular exercise. Correct technique also is very important.
For more information on how to perform Kegels, see our Patient Information page.
Medications can help relax the bladder and provide relief from OAB symptoms. They can be used alone or in combination with other treatments. Since they are prescription drugs, they must be used under the supervision of a healthcare provider. Medications do not cure incontinence but can help reduce or eliminate problems of bladder control. Certain medications called anticholinergics or antimuscarinics can block the chemicals that act on the bladder nerves and decrease bladder contractions. Many of these drugs are safe for long-term use. If you have glaucoma, you should check with your ophthalmologist.
Botox injections are also very popular for overactive bladder now. Botox is very effective at relieving frequency, urgency and urge incontinence. There are a few side effects possible with Botox treatments but the results are generally excellent, and it is a minimally invasive brief procedure that can be performed under local anesthesia in the office. Dr. Byers is one of the most experienced physicians in Orange County with the use of Botox for OAB
Learn more about Botox for overactive bladder
There are two kinds of neuromodulation (nerve stimulation) that are effective for overactive bladder. The first to be developed was the InterStim® sacral nerve stimulator, and more recently a peripheral nerve stimulator has been developed. Both are very effective and safe. We are proud to be a leading center offering urgent PC for OAB.
Watch this brief video for more information about neuromodulation for overactive bladder.
PTNS (Percutaneous Tibial Nerve Stimulation)
PTNS has gained popularity as a simple, safe, effective treatment for frequent urination, excessive nighttime urination, urgency and urge incontinence. It is a 30-minute procedure performed in the office at weekly intervals for 12 weeks, followed by monthly maintenance treatments. Several clinical trials show results comparable to those of medications. We are proud to be a leading center for PTNS in the area.
Sacral Nerve Stimulation
InterStim® therapy is an established treatment option for people with urge incontinence caused by overactive bladder who do not respond to behavioral treatments or medications. The InterStim® device is an implanted neurostimulation system that sends mild electrical pulses to the sacral nerve, a nerve near the tailbone, that influences bladder control muscles. Stimulation of this nerve may relieve the symptoms related to urge incontinence as well as frequency, urgency and fecal incontinence.
The effectiveness of the therapy is tested with a temporary external InterStim® device inserted through a small needle in a simple office procedure. For a period of 3 to 7 days, the patient records his or her voiding patterns. The record is compared to recorded voiding patterns without stimulation. The comparison demonstrates whether the device effectively reduces symptoms. If the test is successful, the patient may choose to have the device implanted. Adjustments may be needed, especially in newly implanted devices. Battery changes are generally needed every 3-5 years.