Overactive Bladder

Overactive bladder or OAB is a complex problem that refers to the feeling of needing to urinate more often than the average person and sometimes includes urinary leakage. It is estimated that more than 33 million people are affected by overactive bladder. This condition can affect both men and women and should not be considered a normal part of aging.

Proper bladder function is a delicate balance between nerves and muscles. The nerves tell the bladder and muscles involved with urination when to relax and when to contract or squeeze. When these signals are balanced, the bladder will remain relaxed until it is full. Once full, nerves will send signals to the brain telling it the bladder is full allowing us to make the decision of when and where it’s appropriate to urinate.

When that balance is upset there can be inappropriate communication between the bladder, brain and muscles that can cause bladder problems such as:

  • Frequent urination resulting from an overactive nerve signal telling the brain the bladder is full when it is actually not. This is called urgency-frequency.
  • Leakage of urine often with a strong sense of urgency resulting from the bladder telling itself to empty when you are not ready for it to do so. This is called urge incontinence.
  • Inability to empty completely, sometimes resulting in use of a catheter.

There are several effective therapies available for overactive bladder and my office offers a full spectrum of tests and treatments to find a beneficial solution for our patients.

The following step-by-step approach lets my patients know there are options available to them in my efforts to find an effective solution to improve their OAB symptoms.

STEPS to SUCCESS – Treating Overactive Bladder

Step 1

  • Bladder Satisfaction Survey
  • Discussion of history and symptoms
  • OAB* identified
  • Discuss Steps to Success and treatment options for OAB
  • Discuss behavioral modifications like diet change and timed voiding
  • Discuss pelvic floor exercises
  • A sample of an OAB medication can be tried for 2-4 weeks
  • Fill out a voiding diary for 3 days
  • Receive Educational Info ( UDX**, InterStim brochure)

Step 2

  • Bladder Satisfaction Survey
  • Discuss results of Step 1: If successful, continue treatment. If not…Start Step 2
  • Urodynamics Consult
  • Cystoscopy Consult
  • Possible pelvic floor physical therapy referral
  • A 2nd sample of OAB medication can be tried for 2-4 weeks
  • Appt scheduled for Urodynamics, Cystoscopy, and follow up

Step 3

  • Bladder Satisfaction Survey
  • Discuss results of Step 2: If successful, continue treatment. If not…Start Step 3
  • Discuss Urodynamics results
  • Consult InterStim Basic Evaluation Steps
  • Appts scheduled InterStim Basic Evaluation date

Step 4

  • Discuss InterStim Basic Evaluation results
  • If symptoms improved 50% or better then you’re a candidate for long term therapy
  • If trial is inconclusive, discuss Advanced InterStim Evaluation

Step 5

  • If Trial/Advanced test successful, Final Placement InterStim Therapy (1-2 weeks Post Trial)
  • If not successful, discuss other interventions



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