Find the Right Treatment for Overactive Bladder

Managing overactive bladder (OAB) often begins with diet and other lifestyle changes. But these steps are not always enough to resolve bladder symptoms. Don't give up too quickly, though. Many treatments options can help, including behavioral techniques, medications and procedures.

When OAB causes leakage, many people turn to products such as pads and disposable undergarments. Incontinence products can help lessen the immediate impact of symptoms but are not a solution to overactive bladder. In most cases, OAB will not go away on its own and most treatments improve symptoms gradually over time. So, you'll need a long-term game plan.

There are three main treatment options:

  • Behavioral techniques. This approach involves training yourself and your body to gain control over your overactive bladder by changing your actions or habits. These methods include keeping a bladder diary, bladder training, Kegel exercises to strengthen the pelvic muscles, and biofeedback, which increases the mind's control over bodily functions and is sometimes used as part of Kegel training.

    Behavioral techniques are usually the first line of treatment for OAB. They are very effective, pose little or no risks and are inexpensive. However, behavioral techniques take practice and time. It may take weeks or months to see improvement so staying motivated is crucial for success.
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  • Medications. Anticholinergics, the primary group of drugs used for overactive bladder, relax the bladder muscles and prevent spasms. Your doctor may prescribe other kinds of drugs as well, including, for some women, hormone replacement therapy. There are also drugs that treat conditions that lead to OAB, including obesity and prostate enlargement.

    The risks associated with medications for overactive bladder vary by the drug and patient, but are generally much lower than procedures or surgeries.
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  • Procedures. These are usually reserved for severe cases of overactive bladder that do not respond to other treatments. Behavioral treatment and/or medications work for most people and surgeries and procedures carry additional risks.

    Electrical nerve stimulation is sometimes used to treat the hyperactive nerves that cause bladder symptoms. There is also surgery to reconstruct the bladder. For women, a device called a pessary may be considered. This latex ring is inserted into the vagina by a doctor to put pressure on the urethra and reduce leakage.

Check with your doctor about your options. Each one has its advantages and disadvantages, and individuals respond differently to treatments. Often a combination of treatments is prescribed.

It might take a while to find out what works best for you. In the meantime, take comfort in the fact that there are many medical treatments available for OAB.

Reviewed by: David O. Sussman, D.O., FACOS

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