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Overactive Bladder
- Name for a group of urinary symptoms
- Sudden, uncontrolled need or urge to urinate
- The need to pass urine many times during the day and night
- Can result if the nerve signals between your bladder and brain are not working properly so that your bladder muscle contracts before it’s full
- You are more susceptible to OAB if
- You live a sedentary lifestyle and are overweight
- You do not manage chronic conditions such as diabetes
- You live with a neurologic condition ie: Multiple Sclerosis, have suffered a stroke
- You have a hypotonic (weak) pelvic floor
- Neurologic disorders/damage to the signals between your brain and bladder
- Hormone changes
- Pelvic muscle weakness/spasms
- A urinary tract infection (UTI)
- Side effects from a medication
- Urgency: A sudden, strong urge to urinate that cannot be ignored
- Urge Incontinence: The loss of bladder control
- Frequency: Having to urinate over 8 times/day
- Nocturia: Waking more than once a night to urinate
- Medical History to address
- Past and current health issues
- Over-the-counter and prescription drugs being taken
- Diet and liquid consumption
- Bladder Diary
- Over a few weeks, record
- When and how much fluid you drink
- When and how much you urinate
- How often you have that “gotta go” urgency feeling
- When and how much urine you may leak
- Over a few weeks, record
- Tests
- Urinalysis: To check for infection/blood/other abnormalities
- Bladder scan: To show how much urine is still in the bladder after you urinate
- Cystoscopy: To look at the bladder through a cystoscope to rule out other conditions
- Diet: Limit foods and drinks that irritate the bladder including caffeine, carbonated beverages, alcohol, spicy and acidic foods
- Bladder diary: To help you find patterns ie: bothersome foods, liquid consumption
- Double voiding: After you think you’ve finished emptying your bladder, try again
- Delayed voiding: Try to hold off when you have to urinate if the urgency is not severe
- Timed urination: Urinate only at set times during the day
- The goal is to prevent that urgent feeling and to regain control
- Bladder muscle relaxation exercises
- Kegels: To strengthen the pelvic floor
- Quick Flicks: Squeeze and relax your pelvic floor muscles over and over again
- Biofeedback: Computer graphs and sounds to monitor muscle movement help teach you how your pelvic muscles move and how strong they are
- Prescription drugs (Oral & Intravesical)
- Antimuscarinics & Beta-3 Adrenoceptor Agonists: Can relax the bladder and increase the amount of urine your bladder can hold and empty
- Botox: Relaxes the muscle of the bladder wall to reduce urgency and urge incontinence
- Effects can last up to 6 months
- Neuromodulation therapy: Electrical pulses are sent to nerves that share the same path for the bladder
- Help the brain and the nerves to the bladder communicate so the bladder can function properly
- Percutaneous Tibial Nerve Stimulation (PTNS): Small electrode is placed near your ankle and pulses are sent to the tibial nerve to help control the signals that aren’t working right
- 12 treatments are usually required
- Sacral Neuromodulation (SNS): Changes how the sacral nerve works (the nerve that carries signals between the spinal cord and the bladder)
- Electrical wire is implanted under the skin in the lower back
- It’s first connected to a handheld pacemaker to send pulses to the sacral nerve
- If it helps, a permanent pacemaker that can regulate the nerve rhythm is implanted
- Bladder Reconstruction/Urinary Diversion Surgery: Used only in rare and severe cases
- Augmentation Cystoplasty: Enlarges the bladder
- Urinary Diversion: Reroutes the flow of urine
