Overactive Bladder Treatment
In addition to drug therapies for OAB, 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.
Medications that relax the detrusor (bladder muscle) or prevent a bladder contraction are effective for OAB. These medications are called anticholenergics. A new class of medications, beta 3 agonists, are now also available to help with bladder over activity.
Sacral Nerve Stimulation
After a test procedure to confirm benefit, a small neurostimulator is implanted to help regulate unstable bladder contractions or help emptying of 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 time to recovery.
Botulinum toxin (Botox) may be injected into the bladder wall to control the overactive bladder muscle. This is mainly used in patients with neurological conditions which lead to unstable bladders.