Urge Incontinence
Overactive bladder, or OAB, is an involuntary bladder overactivity concern that leads to a sudden need or urge to go to the bathroom. “I’m not going to make it!” is typical. The urge is often hard to control and may result in bladder leakage. Some women with OAB also need to go to the bathroom frequently. This treatable condition usually affects women 40 or older but younger women may also experience OAB.
Causes
OAB happens when your bladder muscles contract involuntarily, even if there isn’t a lot of urine in your bladder. These contractions make you feel that you need to use the bathroom immediately.
Sometimes the cause of OAB is never identified. However, there are some known health conditions, lifestyle behaviors, and risks that are associated with symptoms of OAB. They include:
- Urinary tract infections
- Constipation
- Incomplete bladder emptying
- Medications
- Excessive alcohol or caffeine intake
- High urine production, which might occur with kidney problems or diabetes
- Bladder tumors or stones
- Neurological disorders, such as stroke or multiple sclerosis
- Cognitive function problems associated with dementia or Alzheimer’s
Common Symptoms
Common OAB symptoms can include:
- Feeling a sudden urge to use the bathroom (and that you might not make it)
- Bladder leaking (urge incontinence)
- Getting up 2 or more times at night to use the bathroom, called nocturia
- Going to the bathroom 8 or more times in 24 hours
Diagnosis
We diagnose OAB in several ways. You will be asked to keep a bladder diary and our urogynecology specialists will complete the following:
- Medical history
- Physical exam
- Bladder assessment, to make sure you are emptying completely
- Urine tests, to look for infection or other health conditions
Non-surgical Treatment of OAB
There are a number of non-surgical options to treat OAB. These include:
Behavioral interventions: These interventions include specific exercises to strengthen your pelvic floor, manage fluid consumption, weight management, and bladder retraining to reduce the number of urge or leaking episodes.
Pelvic floor physical therapy: our in-house physical therapy specialists offer a unique and personal service that includes education and biofeedback. Treatment might include in-clinic and at-home training to teach you how to use your pelvic floor muscles correctly and help you get stronger.
Medications: There are a number of medications available that research shows are effective in treating overactive bladder.
Office Procedures and Surgical Options for OAB
Following a thorough health history and exam, our urogynecology and physical therapy team work with you to create a care plan and evaluate your progress over time. In-office and surgical options include:
Botox: This treatment is performed in the office and uses an injection to relax the bladder muscles and decreases bladder spasms. Botox may reduce symptoms for up to six months.
Sacral neuromodulation and eCoin: these are successful outpatient surgical procedures that target communication problems between the brain and the nerves that control the bladder, leading it to contract all the time. These procedures improve this communication to better control bladder contractions.
Surgical Treatment of OAB
OAB symptoms may be worsened by pelvic organ prolapse concerns that, when surgically corrected, lessen the OAB symptoms. If surgery is necessary, our GYN surgeons perform surgery at area hospitals and surgery centers.
Understanding Risks
Treatment for OAB may include medications and/or surgery. Each brings unique risks. Talk with our bladder health specialists about your questions and concerns.
What to Expect
Your bladder health specialist may first recommend non-surgical treatments.
Questions to Ask Your Provider
- What is the cause of my OAB?
- What lifestyle changes can I make?
- How can an pelvic floor physical therapist help?
- How do I know if I am emptying my bladder properly?
- Is there a link between OAB and pelvic floor strength?
- What tests do you recommend? Why?
- What treatment options are available to me?
- Do I need to see a specialist?