Overactive Bladder Treatments

The bladder is a balloon-like organ that serves as a holding tank for urine. In normal function, the bladder expands with urine, nerves send signals to the brain saying it is full, the brain sends signals back to initiate urination, and the muscles of the bladder contract, forcing the urine out. An overactive bladder is when the muscles contract involuntarily, causing a strong sudden urge to urinate, frequent urination and incontinence. There are many types of treatments available for an overactive bladder.

Causes

• The cause of an overactive bladder can be as simple as a high fluid intake. However, increased urine production could also indicate poor kidney function. Inflammation of the urinary tract can also cause the symptoms of overactive bladder. Tumors, bladder stones and an enlarged prostate can all hinder urinary function and induce an overactive bladder. An excess amount of alcohol, caffeine and even some medications can initiate the symptoms. A urinary tract infection causes symptoms very similar to an overactive bladder, so be sure to obtain an accurate diagnosis before beginning any treatment.

Behavioral Changes

• Because an overactive bladder can be caused by things like excessive intake of alcohol or caffeine, there are some simple behavioral steps that can help to reduce or eliminate the symptoms. This includes decreasing fluid intake and abstaining from alcohol and caffeine. Since the muscles of the bladder are affected, bladder training in which you delay urination instead of going every time you feel the urge, and pelvic floor exercises to strengthen these muscles can help. Maintaining a healthy weight and eating a diet high in fiber (to avoid constipation which can lead to bladder problems) are also advisable.

Medications

• There are prescription medications available that help to relax the muscles of the bladder, including Detrol, Ditropan, Vesicare, Enablex and Sanctura. These medications are taken orally and, when used in conjunction with behavioral changes, can restore normal bladder function.

Botulinum Toxin

• Botox, or Botulinum Toxin, is a protein from the bacteria that causes botulism and can be an effective treatment. Injecting small amounts into the bladder muscle paralyzes it so it cannot involuntarily contract. The Food and Drug Administration has not approved of using Botox for this purpose and care should be taken as it may cause more problems with emptying the bladder, especially in older patients.

Surgery

• For severe cases of overactive bladder there are surgical procedures to improve its ability to store urine and reduce the pressure on the bladder. The sacral nerve found near the tailbone links the spinal cord to the nerves of the bladder. Doctors have found that changing the nerve impulses of the sacral nerve has an impact on the symptoms of overactive bladder. To perform sacral nerve stimulation a wire is inserted near the sacral nerves and electrical pulses delivered, similar to a pacemaker.
  Another option is augmentation cystoplasty which is a major surgery aimed to increase bladder volume. This procedure takes pieces from your bowels and uses it to replace portions of the bladder. As with any major surgery, there are risks involved and those who choose to undertake this treatment option may have to use a catheter intermittently to aid in emptying the bladder.