Overactive bladder (OAB) is a bladder condition affecting about 15% of women across all ages. It can be costly, embarrassing and result in avoiding social activities for fear of leakage. Age increases the risk for OAB, as do some bladder conditions such as infections, bladder stones, or abnormal growths. For some women, the cause can be unknown.
Women with OAB will feel a sudden urge to urinate, sometimes followed by leaking. Some women leak on the way to the bathroom, or while they are pulling down their clothes. Sometimes the whole bladder empties. It is also common to feel the frequent urge to go even though your bladder isn’t full.
Made of muscle, the bladder walls hold urine. As urine flows into the bladder, the walls expand to make room for more fluid, like a water balloon. The muscles that surround your urethra, the tube you urinate from, tighten to hold in urine while the bladder muscle relaxes. When you urinate, your brain signals the urethra and pelvic floor muscles to relax. The bladder muscle squeezes, pushing the urine out of the body. Typically, women urinate four to seven times per day and one time at night.
In women with OAB, the bladder muscle is overactive and squeezes too often. These bladder spasms make it feel like you need to urinate often and quickly, even if there isn’t much urine in your bladder.
So, how do we treat OAB? There are individual treatments or combination therapies that may be best for you. We always recommend dietary changes to start with. There are certain types of drinks that can provoke bladder spasms and cause irritation. For example, coffee, tea, sodas and other beverages with caffeine worsen symptoms. Artificial sweeteners, fruit juices, and alcohol can also bother your bladder.
We can also consider bladder training. OAB causes you to make frequent bathroom visits, however this can make your symptoms worse because your bladder will learn to hold less urine. Bladder re-training involved using your pelvic floor muscles and “mind over bladder” techniques to gradually increase the time between bathroom visits. Our office makes referrals to pelvic floor physical therapists in the Memphis area that can help with this training.
Medications can be used to treat OAB that can help your bladder to hold more urine for longer periods of time. They also reduce urine leakage. Potential side effects include dry mouth and constipation. There are different options available and we can see which is the best fit for you.
Another option to treatment is Botox. Botox is a drug made from a toxin produced by bacteria, which is called botulinum toxin. It is used medically to treat certain muscular conditions and cosmetically to remove wrinkles by temporarily paralyzing muscles. You may have heard of Botox as the cosmetic treatment for wrinkles in the skin of the face. Another use of Botox can be applied for patients with urgency urinary frequency. As opposed to lasting only 3 months in the face, it can last up to a year in your bladder.
Involuntary contraction of the muscle of the bladder wall, called the detrusor muscle, can lead to symptoms including urinary urgency, frequency, and incontinence. Botox relaxes the bladder muscles so that your bladder can hold more urine. This will give you more time to make it to the toilet without leaking. The U.S Food and Drug Administration has approved the use of Botox for the treatment of overactive bladder and we are happy to offer this option for our patients.
Remember, OAB can be controlled and you can get your life back!