OAB Treatment
Bladder Training with Timed Voiding
This treatment is used for urge and overflow incontinence. The patient keeps a voiding diary of all episodes of urination and leaking, and the physician analyzes the chart and identifies the pattern of urination. The patient uses this timetable to plan when to empty the bladder to avoid accidental leakage. In bladder training, biofeedback and Kegel exercise help the patient resist the sensation of urgency, postpone urination, and urinate according to the timetable.
Bladder Training
The most common OAB treatment that doesn't involve medication is bladder training. This helps change the way you use the bathroom. Instead of going whenever you feel the urge, you urinate at set times of the day, called scheduled voiding. You learn to control the urge to go by waiting – for a few minutes at first, then gradually increasing to an hour or more between bathroom visits.
Pelvic Floor Exercises
You can use a type of exercise called "Kegels" to strengthen the pelvic floor muscles that control urination. When doing Kegels, you tighten, hold, and then relax the muscles that you use to start and stop the flow of urination. A special form of training called biofeedback can help you locate the right muscles to squeeze. It helps to start with just a few Kegel exercises at a time, and gradually work your way up to three sets of 10. Another method for strengthening pelvic floor muscles is electrical stimulation, which sends a small electrical pulse to the area via electrodes placed in the vagina or rectum. While this sounds unpleasant, there is no pain associated with this therapy.
Weighted Cones
Another technique that can strengthen the pelvis and bladder muscles is the use of weighted cones. The tampon-shaped cone is inserted into the vagina and held there by contracting your pelvic muscles. As your muscles strengthen, the weight of the cone is gradually increased. This helps improve your ability to hold urine until you get to a bathroom. While pelvic exercises often help, the mainstay of OAB treatment is the use of medications called anticholinergics.
Drugs for Overactive Bladder
With OAB an inappropriate signal from our nervous system causing the muscles in the bladder wall to contract and release urine at the wrong time. Medications called anticholinergics can combat this problem by blocking the nerve signals and reducing bladder muscle contractions. They relax the smooth muscle of the bladder, reducing detrusor muscle contraction and subsequent urgency, frequency and urge incontinence (wetting accidents).
Surgical Treatments for OAB
In some cases we will implant a small device similar to a pace maker under the skin. This therapy, called interstim, can often control symptoms when more conservative measures such as pelvic floor exercises and medications have failed or were not tolerated. The device is implanted in the back through a minimally invasive procedure. A wire from the device runs alongside the sacral nerve and delivers an electric signal to the nerve. This signal helps to control the bladder muscles and decrease the number of abnormal contractions.
Other, less common, surgical procedures for OAB include increasing the storage capacity of the bladder (hydrodistention), limiting nerve impulses to the control muscles (denervation) or diverting the flow of urine.
Elimination and Challenge Diet
Bladder control problems that are not the result of neurological damage, poor muscle tone, or hormone deficiencies may result from irritability within the bladder or urethral tissues caused by chronic inflammation and/or food sensitivities. An elimination and challenge diet can help determine a food sensitivity.
Until you get your overactive bladder under control, wearing absorbent pads can help hide any leakage that occurs.
Some other helpful tips for preventing urge incontinence include going to the bathroom on a regular basis, especially before physical activity, avoiding drinking caffeine or a lot of fluids before activities not drinking any fluids right before you go to bed, and avoiding lifting heavy objects.