What is an Overactive Bladder?
Overactive bladder (OAB) is a syndrome defined by these key symptoms:
- Urinary Urgency: The hallmark symptom of OAB, urinary urgency is a sudden, uncontrollable need to urinate.
- Urinary Frequency and Nocturia: Most patients with OAB experience a frequent need to urinate during the day and also during the night, which is called nocturia.
- Urge Incontinence: Many, but not all, patients with OAB develop urge incontinence. This type of incontinence occurs when the sudden urge to go to the bathroom makes you leak urine
What Causes Overactive Bladder?
When your bladder is full, nerve signals travel from the bladder to your brain, which triggers your need to urinate. As you urinate, nerves relax the muscles that normally stop urine from being released. At the same time, the muscles in your bladder contract to push urine out.
You develop OAB when the muscles involuntarily contract even though there’s little urine in your bladder. The problem occurs when nerve signals don’t work properly, or when the bladder muscles are too active.
Your risk of developing OAB is higher if you have:
- Neurologic disorder
- Hormone changes
- Enlarged prostate
- Pelvic muscle weakness
- Urinary tract infection
- Bladder stones or tumors
Taking certain medications and diseases, such as stroke and multiple sclerosis, can also result in OAB.
How Do You Treat Overactive Bladder?
Your doctor at Associated Urologists of North Carolina reviews your medical history and performs a physical exam as well as a neurological exam. Your doctor may also conduct a urinalysis and urodynamic testing to evaluate the function of your bladder.
Once your diagnosis is confirmed, your doctor develops a comprehensive treatment plan that may include:
- Lifestyle Changes: You may need to avoid foods that irritate your bladder, do exercises to strengthen the muscles or perform behavioral techniques that train your bladder.
- Prescription Medications: Your doctor may prescribe one of several antimuscarinic medications or the beta-3-adrenergic agonist drug called Myrbetriq® to help your OAB. These medications have different mechanisms of action, but as a group, they inhibit nerves, relax your bladder, increase bladder capacity, improve bladder emptying, and decrease urinary frequency and urgency.
- Botox Injections: Injections of onabotulinumtoxinA can calm the bladder muscles by stopping the nerves from triggering contractions.
- Neuromodulation Therapies: Neuromodulation therapies use mild electrical stimulation to improve OAB. Percutaneous tibial nerve stimulation (PTNS) improves bladder activity by delivering electrical stimulation to nerves at the base of your spine that is responsible for bladder function.
- InterStim® Therapy uses an implantable device to transmit electrical impulses to the sacral nerve, which also regulates the bladder. The electrical stimulation relieves OAB by normalizing nerve activity.
- Axonics® Therapy is used to stimulate the sacral nerves responsible for the overactive bladder reflex. It’s a 2-step process including a testing phase to determine if the treatment will help you and a treatment phase if you are a suitable candidate. During testing, the technician will place a tiny wire near the appropriate nerves and a small stimulator on your body. The wire causes mild pulses that are carried to the sacral nerve. These pulses should be painless and most patients experience a pulling or tingling sensation. You will keep a diary of how often you urinate, any leaking episodes, or if you experience any side effects. If the test shows that the stimulation helps your condition, you will move to step to where a small implant is inserted beneath the skin of your upper buttock where it can provide therapy for at least 15 years.
- Associated Urologists of North Carolina has been designated an Axonics Center of Excellence by Axonics, Inc. The designation recognizes the AUNC team and specifically the expertise of Dr. John Kaspar for his expertise with Axonics Therapy, the quality of his patient outcomes, and his continued commitment to improving the lives of patients suffering from debilitating bladder and bowel symptoms.
To get help for an OAB, call Associated Urologists of North Carolina today.