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Overactive Bladder

                                          

Overactive bladder (OAB) is a condition characterized by a sudden need to urinate, usually with daytime and nighttime frequency.

OAB occurs when the bladder muscle (detrusor) squeezes or contracts more often than normal and often at inappropriate times. Instead of staying at rest as urine fills the bladder, the bladder muscle contracts while the bladder is filling with urine.

Treatments

Behavioral Therapies

Behavioral regimens have been shown to reduce urinary urgency and frequency. These regimens range from simple maneuvers such as timed voiding and fluid management to biofeedback (education of how to contract the pelvic floor muscles with the aid of gentle electrostimulation). Pelvic muscle exercises (Kegel exercises) are beneficial in controlling urinary urges and can be done alone or in combination with drug therapy. Also, patients may help their voiding problem by changing certain aspects of their diets (e.g., decreasing caffeine or alcohol intake), losing weight, and stopping smoking.

Drugs

Medications can help relax the bladder muscle or prevent a bladder contraction. The two main classes of medications to help with and OAB are Anticholenergies and Beta 3 Agonists. Botulinum Toxin (Botox) may also be injected into the bladder wall to control the overactive bladder muscle (this is mainly used in patients with neurological, unstable bladder conditions).

Sacral Nerve Stimulation

A small neurostimulator is implanted to help regulate unstable bladder contractions or help empty the bladder. This method of treatment is often used in patients that are not benefited by the medications or are unable to tolerate their side effects. This is an outpatient procedure with a short recovery time.