When you live with overactive bladder (OAB), your overwhelming worry becomes, "Where is the nearest bathroom?"
You never know when you'll feel the sudden urge to urinate -- the hallmark of urge incontinence. And every time you cough, sneeze, laugh, or lift your groceries, there's a good chance you'll leak urine if you have stress incontinence. The two often coexist in women.
Recent research estimates that more than 4 million people in the U.S. suffer from symptoms of interstitial cystitis (IC), a chronic bladder condition. For most of them, staying close to a bathroom is a necessity. On average, a healthy adult urinates no more than seven times a day and seldom needs to get up at night to use the bathroom. Someone with a severe case of IC, on the other hand, may urinate as frequently as 60 times in 24 hours, including multiple nighttime trips to the bathroom.
One challenge in treating OAB has been to relieve both types of incontinence -- stress and urge. "The problem is, we don't have a single treatment that takes care of both," says Linda Brubaker, MD, a professor in the department of obstetrics & gynecology and urology at Loyola University Chicago Stritch School of Medicine, and director of the division of female pelvic medicine and reconstructive surgery at Loyola University Health System. "We could give you medications that help with urge incontinence, but you might still be bothered by stress."
Or even more frustrating, you might have had surgically & non-surgical treatments to combat stress incontinence, only to find that you still urgently need to run to the bathroom three or four times a night -- and not always make it.
OAB Treatment Options
There are a number of treatments for OAB, and researchers are studying more in clinical trials.
If you have symptoms of more than one type of incontinence, it's likely that you'll need more than one treatment, Brubaker says. "And incontinence is also a chronic condition that tends to get worse as people age. This means we need a lot of options."
You may have already tried many of the most common urinary incontinence treatments -- medications, Kegel exercises, and bladder retraining. If you're still frustrated by overactive bladder or other continence problems that won't let up or go away, you might want to learn more about other OAB treatment options.
Behavioral Therapies for OAB
Some people with urinary incontinence may get relief by making simple changes to their lives and that's what experts recommend trying first.
If you have stress incontinence, for instance, in which you leak urine when you cough, sneeze, or laugh, your doctor may tell you to limit how much you drink.
If you have urge incontinence, in which you get the sudden urge to urinate and can't always make it to the bathroom in time, your doctor may tell you to avoid spicy foods, caffeine, and carbonated drinks, because they can irritate the bladder and make the problem worse.
Exercises to strengthen the pelvic floor muscles, known as Kegels, can help people with stress incontinence. Kegels can also help people with urge incontinence. Sometimes, Kegels are combined with biofeedback techniques to help you know if you are doing the exercises properly.
For urge incontinence, bladder training, sometimes called bladder retraining, can also help. This involves gradually increasing the interval time between trips to the bathroom, working up to longer and longer intervals between bathroom stops.