Discover the many ways to improve OAB.
Patients with OAB feel a sudden urge to urinate, which can be followed by leaking. Some people leak on the way to the bathroom or while they are trying to pull their underwear down. Sometimes the entire bladder empties causing an embarrassing accident and expensive pads are often worn to prevent wet clothing. Many of those suffering from OAB will feel the urge to go even though their bladder is not full.
The bladder holds urine and expands to hold fluid like a water balloon. The muscles around the urethra tighten to hold in urine while the bladder muscle relaxes. When you urinate, the brain signals the urethra and pelvic floor muscles to relax. The bladder muscle squeezes which pushes urine out of the body. Normal frequency of urination is under 8 voids per day and 1 per night. In people with OAB, the bladder muscle is overactive and squeezes too often. These bladder spasms cause urgency, frequency and uncontrolled leakage even when the bladder is not full.
It can feel embarrassing to have uncontrollable bladder leakage but OAB effects 40% of adults. You are not alone. It is important to find an OAB provider who can guide you to improvement. During your first visit a thorough voiding history will be obtained. A pelvic exam will often be performed to help identify other conditions that influence the bladder, such as prolapse or leakage with straining.
Additional tests might include:
Treatments range from behavioral changes and physical therapy to procedural and surgical options:
Pelvic Floor Physical Therapy
Typically, medications regardless of class are not a successful long term management strategy for OAB due to to poor compliance, side effects, high cost and/or ineffectiveness (refer to lists below). Medication samples are great to try when available to see if OAB symptoms improve while using the drug. In some patients medications might be a reasonable option if tolerated, affordable and efficacious. Most patients will be candidates for OAB therapies beyond medications.
Beta Agonist Drawbacks:
The electroceutical coin (eCoin) is being studied for urge urinary incontinence. The eCoin OAB device is a nickel-sized, pacemaker-like device implanted into the lower leg to stimulate the tibial nerve.