Overactive bladder (OAB) is a medical condition generally characterized by an excessive urge to urinate and diminished bladder control. Technically, the term is defined by an increased urge to urinate and doesn’t necessarily have to be accompanied by incontinence. As such, overactive bladder is often divided into two classifications that are independent of each other -- urgency and urge incontinence (urge UI). Urgency is an immediate need to urinate, while urge UI is triggered by involuntary contractions of the bladder even though it may not be full. In any case, both symptoms usually produce the same result: leakage.
Unfortunately, many people either ignore symptoms or mistakenly believe that there is little they can do about their situation. This is far from accurate. In fact, there are several approaches to overactive bladder treatment that range from behavioral strategies to medication. In severe cases, surgery may be the best option. However, most patients respond best to a combination of control methods.
The first overactive bladder treatment to consider is practicing repetitive Kegel exercises to improve the strength of the pelvic muscles. These exercises specifically target the urinary sphincter, the first line of defense from leaking urine even during involuntary bladder contractions. The basic technique is to contract the urinary sphincter as though holding urine for 30-45 second intervals. This can be done while standing, walking, or sitting in the car at a red light. For many people, this simple exercise can significantly eliminate symptoms of overactive bladder in as little as two months.
Bladder training is another common overactive bladder treatment. This method calls for delaying from going to the bathroom when the urge arises for increasingly longer periods of time. Of course, this isn’t always successful and may invite an embarrassing episode. For this reason, double voiding is sometimes recommended. This simply means pausing after urinating to allow the bladder a second attempt to empty completely.
Medication may be necessary to help control frequent urges, such as darifenacin (Enablex) or tolterodine (Detrol). While these drugs may help to keep the patient dry, they also tend to produce dry eyes and mouth, making the use of eye drops and drinking copious amounts of water necessary. Obviously, increased water intake can lead to more problems, so chewing gum or sucking on candy may be a better alternative to check these side effects.
Finally, surgery may be the sensible course of action for some patients. Surgical interventions include augmentation cystoplasty to expand bladder size, or electrical stimulation of the sacral nerves. The latter procedure involves the placement of a wire near the tailbone, which is regulated by a tiny battery implanted under the skin. In effect, the apparatus acts as a pacemaker for the bladder.
Obviously, the best overactive bladder treatment is the least invasive that also provides effective results. Of course, treatment isn’t a one-size-fits-all prescription. A thorough physical examination and symptom evaluation by a physician is the best way to determine the appropriate treatment according to individual need.
