Photo Credit: by Saltdeanbeach, flickr.com
Overactive bladder, or OAB, can occur when your brain and your bladder miscommunicate—they tell you that you have to go even when your bladder isn’t full. It can also be caused by the muscles in your bladder involuntarily contracting, prematurely creating the urge to urinate. So, if you are running (sometimes urgently) to the bathroom more than eight times a day or are getting up to go more than twice a night and your urination patterns are interfering with your life, you just might have overactive bladder.
Overactive bladder causes you to have to go all the time, right now, or else. And if you don’t get to the restroom in time—or sneeze too many times or laugh just a little too hard—what happens next can be embarrassing. But you should know that there are many treatment options available, including a few surprising ones you probably haven’t heard of. And who knows, they just might change your life.
If you are suffering from overactive bladder, know that you are not alone. While as many as 33 million Americans—30% of men and 40% of women— are living with overactive bladder symptoms, there are likely many more who are too embarrassed to ask for help, have written it off as a normal part of aging, or think that there is nothing you can do about it.
Even though your chances of having overactive bladder increase as you age, it is not a normal part of aging. It can be brought on by any number of causes:
• Enlarged prostate
• Diabetes
• Cognitive decline
• Certain medications
• Urinary tract infections
• Neurological disorders
• Weak pelvic muscles
• Menopause
And, believe it or not, there are certain foods that can bring on OAB symptoms. You may find that eliminating these foods may be helpful in managing your overactive bladder.
Surprising Ways to Calm Your Bladder
While there is no cure for overactive bladder, treatment options abound including a few unexpected ones, like Botox, electrical stimulation, and acupuncture. Medication is also an effective alternative that can be used on its own or in combination with other therapies.
Botox
Botox, down there? We know, it sounds weird, but stay with us. We know that Botox relaxes muscles, hence all the smooth foreheads. So, if OAB is caused by contractions of your bladder muscle, it makes sense.
One study found that nine out of ten patients’ instances of daily urinary incontinence fell by 50% and 44-52% of patients’ incontinence ended altogether. Another study focused on the long-term effectiveness of receiving one to six Botox injections over a three-year timeframe. Daily instances of incontinence dropped consistently and a third of the patients saw lasting results from one injection in over a year.
“The bottom-line gist is that we found that Botox has a good, long-lasting, safe and consistent effect over time among patients who do initially respond to it and choose to continue treatment,” said Dr. Victor Nitti, vice chair of the department of urology at NYU Langone Medical Center in New York City.
Your doctor will administer the injection right in their office. The Botox will be injected into your bladder muscle, then after you wait for about a half an hour to make sure there are no problems with the injection, you’re outta there. One injection can last for up to eight months and you can continue the treatments indefinitely.
If you’re not quite ready to inject Botox into your bladder, we get it. There are a couple other routes you can go.
Electrical Stimulation
If you’ve tried everything to quiet down your overactive bladder, but nothing is working, maybe it’s time to consider electrical stimulation. Don’t worry, if this method sounds a little shocking—pardon the pun—there’s no need for alarm. It’s very safe. And there are two options to consider: sacral nerve stimulation and percutaneous tibial nerve stimulation.
Your sacral nerve is responsible for sending signals that tell you when you need to urinate. And sometimes those signals are just plain wrong and send you sprinting to the bathroom. Sacral nerve stimulation is designed to interfere with those signals and reduce bladder control problems.
Sacral nerve stimulation is done in two steps.
First, your doctor will do a test run to see if sacral nerve stimulation will work for you. A thin wire will be inserted near your sacral nerve in your lower back. This wire sends stimulation to your nerves and is connected to an external battery-powered device that you will wear for a couple of weeks. During this time, you will record your symptoms to see if there is an improvement in urgency, frequency, or incontinence.
If the evaluation period is successful in alleviating your symptoms by at least 50%, you will return for the second step where you will be placed under general anesthesia and a pacemaker-like device will be permanently implanted.
Thanks to new FDA-approved technology, you and your doctor can control your sacral nerve stimulation therapy via an app. Your doctor will use the app to program the device and you can use it to discreetly manage your own therapy.
You should know that sacral nerve stimulation is not a forever fix. Up to 2/3 of the people who have the surgery will need another one within five years to repair the device or replace the battery.
A non-surgical option, percutaneous tibial nerve stimulation involves your doctor putting a thin needle near your tibial nerve on your ankle. Electrical impulses are sent from an external stimulator through the needle to the nerves that control your bladder.
This relatively painless treatment is done in your doctor’s office, every week for about 12 weeks to gradually change your bladder activity. Once your symptoms have improved, you may need occasional treatments thereafter.
While the jury is still out on whether one of these electrical stimulation procedures is more effective than the other, studies have found that both of these procedures are more effective than medication or pelvic floor muscle training, such as Kegel exercises, in relieving OAB symptoms.
Acupuncture
Acupuncture is a centuries-old practice known for relieving pain, but to soothe overactive bladder? Turns out, it works for some people.
If you’re not familiar with acupuncture, it is the use of fine needles applied into specific areas of your body to open the flow of your body’s energy or “chi,” which releases endorphins and promotes healing.
When used as a treatment for OAB, the needles are strategically placed on areas affecting your kidneys and bladder to reinforce recovery of bladder function.
Acupuncture, a minimally invasive treatment for OAB symptoms, has been shown to reduce urgency and improve quality of life with no side effects or complications. Additionally, acupuncture is a great option for those who are not able to endure OAB medications.
Medications for overactive bladder
Sometimes a combination of treatments works best and your doctor may prescribe medication in tandem with other therapies or even with other medications.
Myrbetriq works by relaxing the bladder and reducing the urge and frequency of urination. A recent study has shown that it is an effective, well-tolerated treatment in patients age 65 or older resulting in fewer episodes of incontinence and urges to urinate. Vesicare is another effective OAB medication that treats incontinence, frequency, and urgency issues. While each drug, on its own, provides benefits, clinical trials have shown that a combination of Myrbetriq and Vesicare provides even greater improvement in OAB symptoms.
If you have overactive bladder, know that there are millions of other people dealing with the frequent urges and incontinence that come with it. While these symptoms can be upsetting and cause disruption to your daily life, it doesn’t have to be that way. OAB is nothing to be ashamed of and there are many treatment options available including Botox, electrical stimulation, acupuncture, and medications. Now is the time. Talk to your doctor and be honest about your symptoms so you can take back control of your bladder—and your life.
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