If you have an overactive bladder (OAB), it may feel like your condition controls your life. But it doesn’t have to. There are many ways to treat it. These include simple changes in behavior and lifestyle, medications, and alternative treatments.
Behavioral and Lifestyle Changes You Can Make
Simple changes to your daily routine can help you manage OAB symptoms:
Kegel exercises. Over time, these help strengthen your pelvic floor muscles. They also build up the muscle that controls the flow of urine from your body. When it works like it should, it helps you to hold your pee until you can get to the bathroom. When it doesn't, you have leaks. To do Kegels, pretend you’re going to pee, then squeeze the muscles you’d use to stop it. You’ll have to do them a few times a day for 6 to 8 weeks before you see a change in your OAB symptoms.
Train your bladder. This works a lot like Kegels. Hold your pee when you feel like you need to go. It’s easier if you do it while sitting down. Sit still, and squeeze your pelvic floor muscles several times in a row. When the urge to pee passes, walk slowly to the bathroom. Be patient. It may take up to 8 weeks to see results.
Watch what you eat and drink. Ask your doctor if you should limit how much you drink at certain times of the day. He might also tell you to avoid coffee, tea, sodas, alcohol, and juices. Ditto for fruits like oranges and grapefruit, and spicy foods. All of them can make your OAB symptoms worse.
Keep your weight down. Exercise and weight loss can improve urinary incontinence and OAB symptoms. It’ll ease the stress on your bladder and lead to fewer accidents.
Double void. This means you pee, wait a few minutes, and then go again. It’ll help make sure your bladder’s empty. That way, you can avoid a quick trip back to the bathroom.
Set a schedule If you can, try to space out your bathroom visits. Aim for every 2 to 4 hours. This way, you train yourself to pee at the same times every day.
Stop smoking. Cigarette smoke irritates your bladder. It can also cause a hacking cough, which could trigger leaks.
Medications You Can Take
Talk to your doctor about OAB. He can prescribe a drug that’ll help you regain your quality of life. Some control muscle spasms in your bladder by blocking nerve signals in your brain. Doctors prescribe them to both men and women. They include:
- Darifenacin (Enablex)
- Fesoterodine (Toviaz)
- Mirabegron (Myrbetriq).
- Oxybutynin (Ditropan, Ditropan XL)
- Oxybutynin gel or patch (Gelnique, Oxytrol), which you rub or place on your skin
- Solifenacin (VESIcare)
- Tolterodine (Detrol, Detrol LA)
- Trospium (Sanctura, Sanctura XR)
Women who’ve been through menopause can also use a form of the hormone estrogen that you apply inside your vagina.
Doctors also treat men with drugs that relax a muscle at the bladder neck and prostate to help with emptying. They include:
Botox injections: OnabotulinumtoxinA (Botox) blocks nerve activity in the muscles of your bladder so it relaxes. That helps it hold urine and ease OAB. You’ll get the shots in your doctor’s office. About 6% of patients who receive botox may temporarily be unable to pee. You must be able and willing to catheterize if you cannot pee after botox.
Other Treatments You Might Try
Your doctor may suggest them if other methods don’t help. You’ll get them in his office or a clinic.
Sacral nerve stimulation: The doctor uses electricity to stimulate the nerves that control your bladder. He’ll place a small device under the skin in your butt. It sends mild electric charges through a wire to a nerve in your lower back. This helps build bladder control. The procedure is commonly referred to as a bladder pacemaker. The main limitation with this treatment is the inability to obtain a spinal MRI.
Percutaneous tibial nerve stimulation: The doctor places a needle on nerves near your ankle that affect bladder control. You’ll have one session a week for 12 weeks, then maintenance treatments as needed. This procedure is done in the office.
In rare cases, augmentation cystoplasty, where intestine is used to make the bladder bigger or urinary diversion, an alternate route for bladder drainage for severe, complicated OAB patients may be considered.
Overactive bladder doesn’t have to get in the way of your daily life. With a little time, patience, and the right treatment, you can regain control -- and peace of mind.