Treatment Options

Treatment Options for Overactive Bladder

The good news is that OAB isn’t something you have to live with. If you are experiencing any of the symptoms of OAB and they’re impacting your life, there are effective treatment options available to help you regain control of your bladder.

Treatment for Overactive Bladder (OAB) often involves a multi-pronged approach that can vary depending on the severity of symptoms and response to a particular treatment. Below are some common treatment options ranging from conservative methods to advanced procedures.

Lifestyle changes

Lifestyle changes are often the first step in helping manage an overactive bladder. Some these key strategies to reduce urgency, frequency, and leakage may include:

Gradually increasing the time between bathroom visits. To help your bladder become stronger and better at holding urine.

Scheduled voiding

Creating a bathroom schedule and following it closely at set intervals (e.g., going every 2-3 hours) to prevent sudden urges.

Delayed voiding

Gradually increasing the time between bathroom trips to improve bladder control.

Double voiding

Waiting a few seconds after urinating and trying again to ensure the bladder is empty.

Adjusting fluid intake, especially in the evenings.

Night time urination reduction

Limiting fluid intake 2-3 hours before bed to reduce nighttime trips.

Drink normal quantities of fluids each day

It may seem sensible to cut back on the amount that you drink so the bladder does not fill so quickly. However, this can make symptoms worse as the urine becomes more concentrated, which may irritate the bladder muscle. Drink adequate water but avoid excessive fluid intake and limit drinking before bedtime.

Limiting bladder irritants like caffeine, alcohol, and artificial sweeteners.

Eat a vitamin-rich diet

Vitamin C from fruits and vegetables (not a supplement) is associated with decreased urinary urgency.

Drink water

Water should be the majority of what you drink in a day (6-8 cups a day or 2 liters per day). Be sure to spread out the fluid intake over the course of the day.

If overweight or obese, weight loss can improve OAB symptoms as losing weight will ease the stress on your bladder.

Strengthening pelvic floor muscles can help improve bladder control.

Pelvic Floor Therapy

Pelvic floor therapy exercises called Kegels help reduce leakage when you cough, sneeze, and laugh. The muscle you relax to urinate is called the sphincter. Relax the sphincter and then tighten the sphincter for ten seconds. Repeat this 30x daily.

Medications

When lifestyle changes aren’t enough to improve your OAB symptoms, there are medications available that your doctor may prescribe which can help relax the bladder. It’s important to know that while medications can help manage your symptoms, not all patients are candidates for medications. They may also have disadvantages such as side effects including dry mouth or eyes, blurry vision, or constipation.

Medication coverage varies based on your insurance policy. GoodRx.com is a great option for savings on generic medicines. Medications can improve symptoms in some patients, but not in all. If one medication doesn’t work or you are experiencing adverse side effects, immediately share them with your provider. Your doctor may change OAB medications or recommend an advanced therapy.

Advanced Therapies

Based on your symptoms and if you are not satisfied with conservative treatment results, there are advanced treatment options that may be appropriate for you.

BOTOX® Injections
BOTOX® is a prescription medicine that is injected into the bladder muscle to temporarily relax the muscle and help decrease OAB symptoms. It is approved to treat overactive bladder symptoms in adults 18 years and older after you have failed lifestyle changes and medicines. This allows the bladder to hold more urine and reduces the frequency and urgency of urination. Botox injections are a simple office-based procedure that typically lasts for 6 months and repeated as necessary.

Sacral Neuromodulation
Sometimes an overactive bladder results from a miscommunication between the brain and the nerves that control the bladder, which are called the sacral nerves. If those nerves are not communicating correctly, you will have frequent urination, urgent urination, or leakage of urine. Sacral neuromodulation helps to correct the communication between the brain and bladder by using mild electrical stimulation to the nerves that control the bladder, helping to regulate bladder function. Patients often think of it as a pacemaker for the bladder. You and your doctor may decide to try the therapy by going through a “trial” assessment. The therapy typically begins using a temporary external device for the phase that normally lasts a few days. If the trial is successful, a longer-lasting device may be implanted to continue the success for long term therapy. You and your doctor determine if that next step is right for you.

PTNS (Percutaneous Tibial Nerve Stimulation)
PTNS is a non-drug and non-surgical option. It is an office-based weekly treatment where a small electrode is placed under the skin near the ankle. The electrode is then connected to a battery-powered stimulator, and it sends mild impulses through the needle electrode along your leg and to the nerves in your pelvic floor that control your bladder function. This stimulation can improve the communication between the brain and the nerves that control the bladder, helping to reduce symptoms by modulating nerve signals. This procedure takes about 30 minutes once per week for 12 weeks, and typically monthly maintenance treatments thereafter.

It’s important to discuss with your doctor which treatment options are most suitable for you based on your symptoms and medical history.