OVERACTIVE BLADDER
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Overactive Bladder is a condition in which the muscles of the bladder contract unexpectedly causing a sudden urinary urge, frequent urges to urinate and may even experience urinary incontinence related to the urge. In fact, approximately one-third of patients will experience “wet” overactive bladder meaning that they have urinary incontinence related to urge. Two-thirds of patients have “dry” overactive bladder meaning they do not experience urge urinary incontinence. Overactive Bladder has been shown to affect many aspects of life including social, physical, sexual and psycological. Many patients are unaware of the many available option and do not seek medical attention. Currently, there are many options to improve quality of life in women with overactive bladder.
Dietary Changes
A list of foods and drinks that are removed from the diet for a few days and then reintroduced to assess if that food or drink could be aggravating bladder symptoms.
Bladder Training
Training your bladder to hold urine longer by doing pelvic floor exercises when you have an urge to urinate and allowing that urge to pass prior to urinating. The amount of time holding your urine increases incrementally over time.
Kegel Exercises
Exercises of the vaginal muscles that strengthen the pelvic floor. These exercises have been shown to improve urinary incontinence, urinary frequency/urgency as well as fecal incontinence.
Pelvic floor physical therapy
Meeting with a specialist in pelvic floor physical therapy to learn exercises and techniques that are known to improve the pelvic floor muscles. Pelvic floor physical therapy can be used to improve stress urinary incontinence, urge urinary incontinence, urinary frequency, urinary urgency and fecal incontinence.
Pelvic floor rehabilitation
The use of passive stimulation of the muscles using a device such as Emsella. This treatment can be helpful for identifying and strengthening the muscles of the pelvic floor area responsible for stress urinary incontinence, urge urinary incontinence, urinary frequency, urinary urgency and fecal incontinence.
- Emsella is an FDA approved chair that stimulates your pelvic floor muscles for you. You simply sit in the chair for 28 minutes twice weekly for three weeks and monitor as your symptoms improve over time. Sutdies have shown a decrease in pad usage and increase in quality of life out as far as 6 months after treatment.
Low Dose Vaginal Estrogen
A cream, ring or suppository can be used vaginally to improve the health of the vaginal tissue in postmenopausal women. It has been demonstrated in clinical trials that vaginal estrogen therapy can improve overactive bladder symptoms as well as dry and atrophic vaginal tissues.
Overactive Bladder Medications
Currently there are two types of medications that treat urinary urgency, frequency and urge related urinary incontinence: Anticholinergic drugs and Mirabegron. Depending on which medication is tried, it can take 2-8 weeks to see an effect.
Neuromodulation
A technology in which a stimulation is sent to the nerves responsible for controlling urinary urgency, urinary frequency, urge related urinary incontinence, fecal incontinence and urinary retention. There are currently two main forms of neuromodulation. These are Sacroneuromodulation and Tibial Nerve Stimulation.
- Sacroneuromodulation – This form of neuromodulation involves placing a small wire attached to a small battery under the skin. The wire and battery are like a pacemaker and are placed in the hip pocket area. An electrical stimulation is sent from the wire to the area of the nerves that help control bladder and bowel function. You are given a remote that communicates with the battery so you can control the stimulation, turn it off and on and try various stimulation programs. This is a popular option for because the battery is replaced every 4-6 years and not many visits are required once your programs are set.
- Tibial Nerve Stimulation – This form of neuromodulation is external. An acupuncture needle is gently inserted into the inside of the ankle. An external battery is then attached to the needle delivering a stimulation that gives a flutter sensation in the foot while the battery is connected. This energy is applied for 30 minutes. Since this option is not implanted, it requires repeat treatment weekly for twelve weeks and then monthly.
Botox
Botulinum toxin is a medication that can be injected into part of the bladder to improve urinary urgency, urinary frequency and urge urinary incontinence. The procedure is only a few minutes long and is usually done in the office using a numbing medication in the bladder. The effects can last 3-12 months, but most patients notice 4 months of efficacy. The procedure is usually repeated every 4-6 months.
The information about overactive bladder was reviewed by Dr. Maria Canter. If you have any questions, please don’t hesitate to contact us using our contact form below.