General Information

What is an Overactive Bladder?

OAB occurs when the brain tells the bladder to empty even if it is not full. The primary symptom is a sudden, uncontrollable urge to urinate, which can lead to involuntary loss of urine. OAB can restrict one’s ability to perform normal daily activities.

Symptoms of Overactive Bladder:

• Urgent need to urinate immediately (urgency)
• Frequent urge to urinate (frequency)
• Involuntary loss of urine after an urge to urinate (urge incontinence)
• Frequent nighttime urination (nocturia)

Diagnosis

To diagnose OAB, your doctor will review your medical history, conduct a physical examination, and may perform additional tests such as:

• Urinalysis: To check for infections or other abnormalities.
• Bladder Diary: To track urination patterns and symptoms.
• Urodynamic Testing: To assess bladder function and pressure.
• Cystoscopy: To examine the bladder for any structural abnormalities.

Treatment

Treatment options for OAB vary based on the severity of symptoms and may include:

Lifestyle Changes:

• Dietary modifications to avoid bladder irritants (e.g., caffeine, alcohol, spicy foods).
• Bladder training to increase the intervals between urinations.
• Pelvic floor exercises to strengthen bladder control.

Medications:

• Anticholinergics or beta-3 agonists to relax the bladder muscle.

Minimally Invasive Procedures:

• InterStim: InterStim therapy is used for refractory overactive bladder and involves an implantable pulse generator that stimulates the sacral nerves. A trial period is done to test its effectiveness before permanent implantation. This is done under anesthesia in the operating room.
• Bladder Botox: Botox injections in the bladder muscle block nerve function, reducing overactivity and increasing bladder capacity. This procedure is typically done in the office and involves injecting Botox at several sites in the bladder wall.
• PTNS Therapy: PTNS is a non-drug treatment where a slim needle electrode is placed near the ankle, which sends an electrical impulse to the nerves controlling the bladder. Sessions last 30 minutes and are done weekly for 6 to 12 weeks in the office.