New Treatment for Overactive Bladder

Overactive bladder, overview

Overactive bladder (OAB) causes abrupt, urgent urination that can be difficult to regulate. Urination more than eight times a day and urgency incontinence, where urine spills before you reach the bathroom; results may follow.  Those with OAB may also develop nocturia or nighttime urination.

OAB can be caused by aging, nerve damage, bladder infections, or drugs. Lifestyle adjustments, including limiting coffee, fluid intake, and pelvic floor exercises, can help manage symptoms. Medication or other therapies may be needed.

If you have OAB symptoms, see a doctor for diagnosis and treatment.

stages of OAB

How is overactive bladder different from incontinence?

Despite its similarities, OAB and UI are different. Here are their differences:

Definition of Overactive Bladder (OAB):

• A sudden, overwhelming urge to urinate. 
• Frequent urination and nocturia may ensue.
• Urinating urgency is a symptom.
• Urinating frequently, often over eight times a day.
• Urinating frequently at night.
• Having a strong urge to urinate causes leaks.

Urinary incontinence (UI) is the loss of bladder control resulting in unintended urine leakage. 

It can indicate several conditions.

UI types:

• Coughing, sneezing, or lifting might cause bladder leakage.
• Urge Incontinence: abrupt, urgent urination followed by leakage or OAB.
• The inability to empty the bladder causes overflow and leaking.
• Functional Incontinence: Physical or mental disabilities prevent timely restroom access.
• Mixed incontinence: Multiple types.

Main Differences

• OAB has urgency and frequency symptoms, while UI is a symptom of bladder control issues.
• Focus: OAB addresses urge and frequency, while UI addresses leakage.
• Understanding these characteristics can help you diagnose and treat your condition. 

Reality of OAB

• Not just for women, OAB affects men's prostates.
• OAB is not caused by aging and is not something you did.
• Surgery is not the sole option.
• Multiple therapies exist for OAB symptoms.
• Even slight symptoms can be treated.

Who treats OAB?

• Urologists
• Gynecologists
• Urogynecology/Reconstructive Pelvic Surgery
• Primary care physicians
• Internists
• Nurse practitioners
• Physician Assistants
• Geriatricians
• Physical Therapists

What are typical OAB/UI treatments?

Also,  read https://www.manipalhospitals.com/symptoms/overactive-bladder/.

There are numerous OAB and UI treatments available. An overview:

• Treating Overactive Bladder (OAB) Medications:
• Anticholinergics diminish bladder urgency by relaxing muscles. Example: oxybutynin and tolterodine.
• Beta-3 Adrenergic Agonists: Mirabegron relaxes the bladder muscle during storage.
• Tricyclic antidepressants diminish bladder spasms.

Behavior Interventions:

• Urinating on a timetable gradually increases the duration of bathroom visits.
• Kegels, or pelvic floor exercises, strengthen urinary muscles.
• Consuming less caffeine, alcohol, and spicy foods helps alleviate symptoms.

Stimulation: Sacral Nerve Stimulation: 

• An implanted device sends electrical impulses to the sacral nerve, enhancing bladder control.
• PTNS: Electrical stimulation of the tibial nerve to decrease symptoms.

Surgery:

• Augmentation By adding the bowel, cystoplasty expands the bladder.
• Sacral nerve stimulation: A new surgical method using a tiny electrical device.

Management of Urinary Incontinence (UI) by behavioral techniques:

• Bladder training, like OAB, requires scheduled bathroom excursions and gradually increasing the time between them.
• Urinate, wait, and try again to empty the bladder.
• Bathroom breaks: Every 2–4 hours.
• Kegels strengthen bladder-supporting muscles.

Changes in lifestyle

• Minimizing coffee and alcohol intake, regulating fluid intake.
• Weight Management: Healthy weight reduces stress incontinence.
• Exercise: Regular exercise improves health and bladder control.

Medications:

• Anticholinergics relax bladder muscles like OAB.
• Topical estrogen helps postmenopausal women improve their urethra and vaginal tissues.

Surgery:

The video about the unique treatment of overactive bladder

• The urethra is supported and prevented from leaking with a sling.
• Artificial Urinary Sphincter: Implanted to control urine flow.

Medication, PTNS, Botox, and eCoin are new overactive bladder treatments.

Medications

Besides anticholinergics and vitamin D, additional novel treatments.

Percutaneous tibial nerve stimulation

Stimulate the bladder-controlling tibial nerve with a tiny needle near the ankle.

Injecting Botox

Botox can treat hyperactive bladder and urgency incontinence.

eCoin

A home tibial nerve stimulator for urgent urine incontinence.

Alternative treatments

Dry mouth, impaired vision, constipation, and urine retention might result from hyperactive bladder drugs. These medications' extended-release variants may lessen negative effects.

Alternative OAB/UI treatments?

Alternative treatments for OAB and UI may assist. Some options:

Herbal Remedies:

• Traditional Chinese medicines like Gosha-jinki-gan lessen urine urgency and frequency, according to research.
• Pumpkin seed oil may improve pelvic floor muscles, according to research.
• Corn silk: traditional bladder irritation treatment and urinary tract mucous membrane strengthening.
• Acupuncture: Thin needles stimulate nerves and muscles in specific body sites to improve bladder control.

Biofeedback: 

Sensors observe body functions and teach you how to manage them, such as pelvic floor muscle strengthening with Kegels.

Supplements: Magnesium hydroxide may lessen incontinence-causing muscular spasms.

Alternative UI Treatments

• Kegels: Pelvic floor exercises Bladder control can be improved by strengthening bladder muscles.
• Begin by gradually increasing the time between bathroom visits to train the bladder to hold pee.
• Avoiding bladder irritants, including coffee, alcohol, and spicy meals, might help manage discomfort.
• Weight Management: Healthy weight reduces bladder and pelvic floor muscle pressure.
• Similar to OAB, acupuncture can increase bladder capacity and lessen urgency.
• Biofeedback: The UI can control bladder muscles via biofeedback.

Tell me about biofeedback.

Biofeedback provides real-time input on biological processes to assist people in controlling specific physiological functions. How it works:

What's biofeedback?

Biofeedback measures physiological processes like muscular tension, heart rate, and skin temperature using body sensors. These sensors deliver signals to a monitor, which displays the data visually or audibly.

How Does It Aid OAB/UI?

Biofeedback helps strengthen pelvic floor muscles for OAB and UI. How it works:

1. Electrodes on the skin near the pelvic muscles are sensors.

2. Monitoring: Sensors display muscle activity on a screen.

3. Training: You learn to distinguish muscle contractions and relaxation.

4. Control: Practice improves muscle control, reducing OAB and UI symptoms.

The benefits of biofeedback include being non-invasive and not requiring surgery or drugs.

• Customized to your needs and development.
• Empowering: Encourages active disease management.
• To improve results, biofeedback is commonly used with pelvic floor exercises (Kegels). It's ideal for non-pharmacological OAB and UI management.

How can I use biofeedback daily?

Using biofeedback regularly can help regulate OAB and UI. Here are some starting steps:

Steps to Use Biofeedback Daily

• Ask your doctor or biofeedback therapist for customized guidance and training.
• For equipment setup, use a portable biofeedback device or visit a clinic offering biofeedback sessions.
• Get sensors and a monitor to track your progress.
• Start Basic:
• Attend a couple of expert sessions to learn how to operate the equipment and evaluate feedback.
• Establish a routine:
• Set a daily biofeedback time like you would for other activities.
• Start with 10-15 minute sessions and increase as you get used to them.

Exercise the Pelvic Floor:

• Use the biofeedback device to track pelvic floor muscle activity during Kegels.
• Repeat 10-15 times, holding each contraction for 5-10 seconds and resting for 10 seconds.
• Track Your Progress:
• Record biofeedback sessions, muscle control improvements, and symptom changes in a notebook.
• Take advantage of the device's feedback to improve your technique and work appropriately.
• Consistency is crucial for achievements. Perform biofeedback activities three to four times a week.
• Make time for exercise while watching TV or during work breaks.

Add to Other Treatments:

• For comprehensive OAB and UI management, combine biofeedback with bladder training, diet, and medicines.
• You can gradually control your bladder muscles and lessen OAB and UI symptoms by using biofeedback regularly. Please ask if you need further information!

Conclusion

It is possible to treat overactive bladder. If your family doctor has not recommended a urologist or urogynecologist, be sure to choose one with experience.