Treatment Options for OAB
OAB is a condition that can be difficult to live with. Urgency causes some to avoid situations where a sudden urge to go could be embarrassing or stressful. Fortunately, there are several treatment options that you and your health care provider can discuss after an OAB diagnosis is made, and the outlook for those suffering from OAB is often good. These treatments range from natural, behavioral remedies to, for those with relentless symptoms, surgery.
There are several non-drug treatments that your health care provider may recommend for helping with symptoms of OAB. These treatments carry no side effects and can make living with OAB significantly easier for many, making them a common starting point for treatment.
- Bladder training – This is the most common treatment for OAB. Bladder training involves setting a schedule for emptying your bladder. You and your health care provider can decide on a schedule that works for you, maybe every two to four hours. After some time you will learn to control urgency by waiting for your scheduled trip to the toilet. Bladder training can also include “double voiding”, which is emptying the bladder twice. After urinating, you may a few moments and attempt to go again, which can be helpful for those who have trouble fully emptying the first time.
- Pelvic floor exercises – Although it may take up to six to eight weeks to notice a relief in symptoms, pelvic floor exercises, called Kegels, can alleviate involuntary contractions of the bladder. Your health care provider will help you locate the right muscles to tighten and ensure you are doing Kegels correctly.
- Weight loss – Being overweight can exacerbate symptoms, so ensuring you are at a healthy weight can be helpful for managing symptoms of OAB.
- Pads – For many, wearing absorbent pads can alleviate the stress of embarrassing leakage, allowing those who live with OAB to lead normal lives.
- Limiting fluids – Limiting caffeinated beverages and all fluids before bed are two examples of ways that watching your fluid intake could help with OAB.
There are several medications on the market which can relax the bladder and help alleviate symptoms of OAB, including urge incontinence. These medications include:
- Darifenacin (Enablex)
- Fesoterodine (Toviaz)
- Tolterodine (Detrol, Detrol LA)
- Oxybutynin (Ditropan XL)
- Oxybutynin as a skin patch (Oxytrol)
- Oxybutynin gel (Gelnique, Gelnique 3%)
- Trospium (Sanctura)
- Solifenacin (Vesicare)
- Mirabegron (Myrbetriq)
- Oxytrol for women
Oxytrol for women is the only medication available without a prescription. Always talk to your health care provider before beginning any medical regimens. Overall, most people do well on these medications, however, there are some possible side effects. Side effects may include dry mouth, dry eyes, and constipation.
For those who do not see an improvement in symptoms with behavioral and medicinal approaches, an injection of Botox into the bladder may be a viable option. These injections, used in small doses, partially paralyze the bladder muscles, helping lessen contractions. This is often reserved for severe cases of OAB, as about half of those who undergo the procedure have side effects. One side effect is urinary retention, which can result in the need to catheterize yourself.
If the cause of your OAB is a misfiring of nerve signals, regulating those impulses can improve symptoms. This is done through a procedure in which a wire is placed near the nerves which carry signals to the bladder, near the tailbone. A small device is then used to deliver electrical impulses to the bladder. This process is similar to having a pacemaker for your heart.
If all else fails, there are surgical options that can help those who suffer from OAB. Surgery can be done to increase the capacity of the bladder, using bowel pieces to replace portions of the bladder. A catheter may have to be used after this surgery to empty the bladder for the rest of your life. The absolute last resort in treating OAB is a bladder removal surgery, where the bladder is replaced with surgically constructed replacement, or an opening in the body is made to attach a bag to collect urine.
Again, it is important to speak to a health care provider about your symptoms before beginning any OAB treatment.