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Incontinence & Overactive Bladder Health Center

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Hope for Overactive Bladder Problems

A range of OAB treatments, from pills to Botox, can help you reclaim your life.

Medications for Overactive Bladder

If lifestyle adjustments aren't enough, doctors can choose from several prescription medications to treat OAB.

The drugs commonly prescribed work by relaxing the muscles and preventing the bladder spasm. Among the commonly prescribed are:

  • Detrol LA (tolterodine)
  • Enablex (darifenacin)
  • Sanctura (trospium)
  • Vesicare (solifenacin)
  • Ditropan XL (oxybutynin)

"They work very well in the majority of cases," Bozeman says. About 75% of OAB patients get improvement on the medications. "I have plenty of patients who are on medication and haven't had an accident since."

But like most drugs these overactive bladder treatments can have side effects, including dry mouth and constipation, and that can make you drink more water, in turn increasing urine output.

Experimental Remedies for OAB

Botulinum or Botox can help, says Chancellor, who has been studying the approach. He has worked with a number of pharmaceutical companies as a consultant and to help develop the Botox treatment.

"It's off-label," he tells patients, meaning it is not approved specifically for OAB by the FDA, but that his studies and those by others have found it effective.

When injected into the bladder muscle wall, Botox can help with bladder symptoms for six months or so. "About two-thirds to three-quarters of patients find it helpful," says Chancellor, who regularly uses Botox for bladder problems.

In a study presented at the American Urological Association meeting in 2007, Swiss researchers reported success in using Botox in 180 women and men with overactive bladder. Within two weeks, 87% had significant improvement in symptoms, the Swiss reported. Urgency disappeared in 75% and incontinence in 84%.

Another option is electrical stimulation to stimulate the sacral nerves that help control the bladder and its sphincter muscles.  This treatment is not well studied but is considered safe. In one study reported in the British Medical Journal in 2000, nearly half of people using electrical stimulation reported improvement.

Researchers don’t fully understand how electrical stimulation works to treat OAB. The mild electrical current may make the muscles contract, producing an effect similar to Kegel exercises. The electrical current may also encourage the growth of nerve cells that cause the muscles to contract.

Typical treatment would involve electrical stimulation for 15 minutes, twice a day, over 12 weeks. Some doctors will send you home with special equipment so you can do the therapy yourself; others may require appointments at the doctor’s office.

OAB: Reclaiming Your Life

Dunn, the Pittsburgh calligrapher, has reclaimed her old quality of life. She shops at the mall and goes about her workday with much less worry these days.

"I can have a regular day as a normal human being. I can make it to the bathroom."

Reviewed on April 07, 2009

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