Urge Incontinence (Overactive Bladder)
Overactive Bladder is a common and treatable condition
Urge incontinence is usually associated with a strong, almost overpowering sense of a need to urinate with concern that you will not be able to make it to the bathroom in time. Overactive bladder may occur with or without urine leakage (urinary incontinence). Common symptoms are:
- Frequent urge to urinate, in the daytime and at night
- Loss of urine without meaning to urinate
- Sudden and urgent need to urinate (urinary urgency)
- Bladder pain or discomfort
This condition may be due to actual spasms of the bladder muscle or increased sensitivity of the bladder. These bladder spasms often happen when your bladder is not very full and can be triggered by hearing or feeling running water, cold air or even arriving at home and putting your key in the door. Occasionally it is triggered by a particular amount of urine in the bladder.
We can help
If you have overactive bladder, you may attempt to manage symptoms yourself or start avoiding activities it affects. This can be difficult and very isolating. We encourage you to be properly evaluated so you can start a course of treatment that will improve your symptoms and get you back to the activities you enjoy.
Evaluation for Urge IncontinenceIf needed, we can perform so called “Urodynamic” tests. These will assess the function of your bladder and its ability to empty itself steadily and completely.
Non-surgical treatments for Overactive Bladder
Physical therapy for Pelvic floor muscles
Exercises called Kegel exercises strengthen your pelvic floor muscles and urinary sphincter — muscles that are critical for holding urine even if your bladder muscles involuntarily contract. These strengthened muscles are then contracted when you feel urge so that you can successfully suppress the bladder's involuntary contractions. Your doctor or a physical therapist can help you learn how to do Kegel exercises correctly.
Medications for Overactive Bladder
Medications that relax the bladder can be effective for alleviating symptoms of overactive bladder and reducing episodes of urge incontinence. These drugs include tolterodine (Detrol), oxybutynin (Ditropan), an oxybutynin skin patch (Oxytrol), trospium (Sanctura), solifenacin (Vesicare), darifenacin (Enablex) and now mirabegron (Myrbetriq). These medications are usually used in combination with other treatments.
Changes to your diet and schedule may improve or help you manage symptoms. We often recommend lifestyle changes to use in conjunction with other treatments to maximize their effect.
Surgery for Overactive Bladder
Interstim is an FDA-approved device. It is used to treat urge incontinence or overactive bladder that is not being adequately treated by the medications typically used in this condition. It can also be proposed if you are not able to tolerate these medications due to side effects. Interstim is a two-step outpatient surgical procedure that places a nerve stimulator at the level of the low back where the nerves that control your bladder function are located. This stimulator is attached to a small battery that allows you to set the level of nerve stimulation required to control your overactive bladder. The system functions much like a pacemaker for your bladder.