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Overactive Bladder Treatment Options

Treatment Options for OAB

Your treatment plan is uniquely tailored to you and your specific needs

After initial evaluation and diagnosis, your treatment plan may include:

  • Conservative Treatments
  • Medications
  • Re-Evaluation & Diagnostic Testing
  • Advanced Treatments
  • Clinical Trials

Medications

Your urologist may prescribe a specific OAB medication. Not all medications work the same for all patients. These medications may reduce frequency and incontinence allowing for fewer bathroom trips and less leakage. Your Wellness Team will work to determine which medication is best suited for you. If one medication does not reduce or relieve your symptoms, your urologist may prescribe a different medication or recommend further evaluation.

Call your OAB team:

· If you experience bothersome side effects from medications such as dry mouth, changes in blood pressure, constipation, dry eyes, and/or blurry vision

· If you are unable to urinate – STOP all OAB medications and call the office immediately

Re-Evaluation

Should you fail conservative treatments and one or more medications, your urologist will re-evaluate your treatment plan. A re-evaluation may include diagnostic testing and more advanced treatment options.

Diagnostic Testing

Your urologist may order further tests to determine your next course of treatment such as:

Urodynamics: A procedure that assess how the bladder and urethra are performing their job of storing and releasing urine
Cystoscopy: A common office-based urological procedure that allows your urologist to look inside your bladder and urethra
Ultrasound: A diagnostic medical imaging technique used to visualize muscles, tendons, and many internal organs

Advanced Treatments

If you have not seen improvement using conservative treatments and/or medication, your urologist may prescribe a more advanced treatment:

1. Botox® — Botox is a prescription medicine that is injected into the bladder muscle and used

  • To treat OAB symptoms such as a strong need to urinate or leaking, urgency, and frequency
  • To treat incontinence with OAB due to neurologic conditions
  • It is typically effective for 6-9 months

2. Neuromodulation (Interstim® Therapy)
Evaluation and Treatment – a staged procedure will be performed to determine if bladder dysfunction is due to a nerve or muscle issue. Based on the results of the evaluation, your urologist may suggest surgically implanting a small device to stimulate your sacral nerves with milk electrical pulses. The sacral nerves help to control your bladder and bowels

  • Battery life is 5-15 years

3. Percutaneous Tibial Nerve Stimulation (PTNS) – delivers a gentle electrical pulse to the tibial nerve via an acupuncture-like needle placed in the skin near the ankle that is attached to a neurostimulator

  • Administered during weekly 30-minute sessions for 12 weeks and thereafter as prescribed by your urologist

Resources:

https://www.medtronic.com/us-en/patients/treatments-therapies/bladder-control/about/your-journey.html
https://www.botoxforoab.com/botox-and-oab/

Clinical Trials

We have a robust research department. You may be a candidate for a clinical trial that would help your OAB, and may be contacted by one of our coordinators.

Our OAB Program is designed with you in mind – Urinary Incontinence, overactive bladder symptoms, and pelvic health issues may affect your quality of life. Our Wellness Team and fellowship trained physicians offer comprehensive evaluation, surgical and non-surgical treatment options, and will help you choose the best treatment option.

Treatment Options for Bladder Control

There are many ways to manage bladder control problems. Remember, if conservative treatments don’t deliver the results you need, you have more options.

Lifestyle Changes

Conservative treatments can help some people but may not work very well (or at all) for others. All of these are relatively simple behavioral changes that you may already be doing.

  • Diet and exercise: Changes may include decreasing your caffeine intake and getting more exercise.
  • Bladder retraining: Also called biofeedback, this involves delaying going to the bathroom and sticking to a strict schedule.
  • Pelvic floor strengthening: This can be accomplished through Kegel exercises, which involve repeatedly contracting and relaxing the muscles of the pelvic floor.

Oral Medications

When lifestyle changes fail to deliver the results you want, oral medications are the next step. These medications can help control symptoms but may cause other issues.

You have to remember to take these medications every day. Some side effects can be unpleasant, such as dry mouth, blurry vision, constipation, and hypertension. Other side effects are more serious. In fact, data suggests that one class of drugs for OAB (anticholinergics) may increase risk of dementia in elderly people. Even more important, these medications don’t always work. In one survey, 72% of people said they stopped taking their medication after just six months.

Advanced Therapies

If conservative treatments don’t deliver the results you want, you have more options.

Medtronic Bladder Control Therapy Delivered by The InterStim™ System

  • Try it during an evaluation
  • Proven long-term relief

Implanting an InterStim™ system has risks similar to any surgical procedure, including swelling, bruising, bleeding, and infection. Talk with your doctor about ways to minimize these risks. Complications can occur with the evaluation, including movement of the wire, technical problems with the device, and some temporary pain. Your doctor or nurse will provide you with the information regarding how to operate the test device and inform you of other precautions related to the evaluation and activity restrictions.