New Treatments for Overactive Bladder
Behavioral Therapies for OAB continued...
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.
Medications for OAB
Several different medications have been approved to relieve the symptoms of urinary frequency and urgency. They include oxybutynin (Ditropan, Oxytrol, Gelnique), tolterodine (Detrol), solifenacin (Vesicare), fesoterodine fumarate (Toviaz), trospium (Sanctura), and darifenacin (Enablex). Oxytrol is available in a pill by prescription and in the form of the skin patch over the counter for women.
These drugs help prevent the uncontrollable muscle contractions that can lead to overactive bladder and leaking. However, they can cause side effects, including dry mouth, blurred vision, constipation, and urinary retention. Extended-release versions of these drugs may help reduce side effects.
Percutaneous Tibial Nerve Stimulation
If your overactive bladder hasn't improved with lifestyle changes and medicines and you don't want to have surgery, percutaneous tibial nerve stimulation (PTNS) is an option. During this technique, the doctor inserts a fine-needle electrode into the nerve just above your ankle. A mild electrical impulse is passed along the needle to nerves of the spine that control bladder function.
"It's a fairly simple procedure, done in the office," says Ross Rames, MD, associate professor of urology at the Medical University of South Carolina. Rames works with the university's Bladder and Pelvic Health Center. "Often, we'll see improvement within the first couple of weeks after the patient starts PTNS treatments." With PTNS, you'll need a series of 12 treatments, scheduled about a week apart. You may need more than one treatment to keep seeing results.