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How Does Overactive Bladder Medication Work

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Interstitial Cystitis And Overactive Bladder

Meet Dr. Ashley Tapscott

Overactive bladder is also one of the main symptoms of interstitial cystitis , a condition with symptoms including intense pelvic pain, bladder frequency, and bladder urgency.

Interstitial cystitis is a spectrum disorder that can be mild in some patients and severe in others. While IC was once seen exclusively as a bladder condition, it is now viewed as a condition of the bladder, pelvic floor muscles, and often the nervous system. Medical professionals say that all aspects of the condition need to be addressed for healing to occur.

What Can Cause Slow Urine Flow

A variety of medical conditions may affect normal urine flow. The most common cause of slow urine flow in men is having an enlarged prostate, or Benign Prostatic Hyperplasia . An enlarged prostate can press on the urethra, which is the tube through which urine travels from the bladder out of the body. If the urethra is compressed from the enlarged prostate, less urine can pass through, so the urine flow is slowed down. This is further exacerbated in people with diabetes that have diabetic neuropathy.

Other possible causes of slow urine flow are prostate or bladder cancer, blockage along any part of the urinary tract , neurogenic bladder dysfunction, frequent urinary tract infections , and any other conditions that cause scarring or damage to the urinary tract.

Recommended Reading: What Causes Bladder Control Problems

Altering The Bladder With Bladder Augmentation Surgery

When all other approaches to strengthen and retrain the bladder have failed, you may need to alter the bladder itself. This surgery is typically used as a last resort and in only the most severe cases of an overactive bladder.

Bladder augmentation involves enlarging the bladder with a section of your large intestine, so theres more physical space to store urine in and less pressure to urinate frequently. The surgery is the most invasive and complicated procedure for solving overactive bladder problems, and includes a long recovery time and possible lasting consequences. Once you have bladder augmentation surgery, you will cease to be able to urinate naturally you will have to use a catheter or stoma.

The good news is that many, if not most cases of an overactive bladder can be very well controlled with healthy lifestyle changes, and natural and traditional medical treatments. Its important to remember that not all of the listed treatment options may work for everyone.

Remember to discuss the above overactive bladder treatment options with your doctor before beginning them.

Also Check: Natural Ways To Prevent Bladder Infections

What Other Lifestyle Changes Can A Person Make To Control Their Symptoms

A lot of OAB management comes down to lifestyle.

Certain foods and drinks can worsen symptoms, such as coffee, alcohol, spicy foods, and chocolate. Cutting back on these items or avoiding them altogether can make a big difference for some people.

Smoking, having obesity, and drinking carbonated beverages can also worsen symptoms. Weight loss and smoking cessation may help OAB symptoms and benefit overall health.

Prognosis Of Overactive Bladder

Botox for Overactive Bladder in Multiple Sclerosis

Overactive bladder is a set of symptoms, not a disease in its own right. How long your OAB lasts, and whether it gets better or worse, will depend on the underlying causes.

You may be able to reduce the burden of OAB through lifestyle changes, drug treatments, or certain nonsurgical or surgical procedures.

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Other Options For Overactive Bladder

If medications arent working for you, talk to your doctor or a urologist about other approaches. They range from injections to implants, and each approach has pros and cons. Here are three of the most common alternatives:

1. Onabotulinum toxinA

Botox® is well-known for smoothing wrinkles, but onabotulinum toxinA injections can also benefit your bladder.

Injecting the drug directly into bladder muscles helps to calm the bladder and prevent urinary urgency and related leakage, says Dr. Slopnick.

The big advantages are that injections are done in the office and are usually only required two or three times a year. Side effects like dry mouth and constipation arent an issue. However, there are other possible side effects, Dr. Slopnick points out. About 6% of patients have a hard time urinating and require intermittent self-catheterization until the Botox starts to wear off. Also, about 20% develop urinary tract infections.

2. Sacral neuromodulation

This treatment uses a device that works like a pacemaker for your bladder. The device is placed in two stages, so you can test drive it first to see if it works for you. The first stage is either done in the office with local anesthesia or under sedation. Your doctor will insert a thin wire lead into your back to stimulate your bladder nerve roots.

You do a two-week test stimulation with a temporary battery, explains Dr. Slopnick. And if you have 50% improvement in your symptoms then you go on to full implantation.

How And When To Take Tolterodine

Always read the information that comes with your medicine.

Tolterodine capsules release the medicine evenly during the day. This means you do not need to take them as often as the standard tablets.

Swallow the tablets or capsules whole with a drink of water. Do not chew the capsules. You can take the tablets or capsules with or without food.

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Find The Best Overactive Bladder Medications For Your Body And Lifestyle

With contributions from Olivia.

Its helpful when overactive bladder can be traced to a specific disease or ailment once you begin to treat the root problem, bladder issues often clear up as the disease is brought under control. On the other hand, many cases of OAB have no distinct root or cause, and that calls for a different approach to medication and therapy.

Most doctors will suggest making some key lifestyle changes before turning to medication for relief. But if bladder training, adjusting your fluid intake, and creating a bathroom schedule arent bringing you the improvements you need, it might be time to try one of the leading OAB medications.

Evidence And Implications For Clinical Practice

Medtronic Bladder Control Therapy: Sarahs Story

The information presented in this review poses a number of questions relating to the treatment and diagnosis of OAB. Chief amongst these include the potential use of antibiotics and anti-inflammatory drugs in the treatment of subsets of OAB patients. And could the presence of specific inflammatory mediators or intracellular bacterial colonies in the urine be exploited as a novel diagnostic biomarker for identifying these otherwise overlooked patients?

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Coffee Or Tea Which Makes You Pee

Starting the day with a cup of coffee may be routine, however studies have shown that greater than 250 mg of caffeine daily can irritate the bladder causing urinary urgency and frequency.

Of note, Starbucks has some of the highest caffeine amounts of any coffee chain. One eight-ounce cup of brewed coffee contains approximately 180 mg of caffeine while a large, 20-ounce cup contains 415 mg. Cappuccino, espresso and the iced coffees contain slightly less caffeine than the brewed coffees.

Interestingly, the darker the roast, the less caffeine is present in ground coffee by volume. This is due to a) the longer a bean is roasted, the more caffeine in it is vaporized out of it, and b) the darker the roast, the larger the roasted bean becomes because it expands, producing more ground coffee by volume than a more lightly roasted bean will yield.

As caffeine is a diuretic, women may be causing their kidneys to produce more urine. This can overwhelm the bladder and cause frequent trips to the restroom or urinary leakage. Accordingly, it is good practice to drink at least eight ounces of water for each cup of coffee that you consume especially 30 minutes prior to engaging in an exercise routine to avoid dehydration.

What Is Overactive Bladder And How Can You Treat It

Overactive bladder is estimated to affect between 12-14% of the UKs population. It can feel like an embarrassing condition to have, but it is treatable, and major strides have been made in treatment in recent years.

Consultant urologist Mr Jeremy Ockrim talks through the definition of overactive bladder, some potential causes and cutting-edge treatment options.

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Weak Urine Flow Along With Other Symptoms

Weak urinary flow may come not alone. It may occur along with painful urination and burning sensation in case of UTI.

When weak urine flow comes with frequent urination, it is a sign of lower urinary tract obstruction like prostate enlargement or urethral stricture. In these cases, there may also be poor ejaculation.

If a stone gets stuck in the urethra, the urine flow will be in scattered and possibly painful drops.

Fever and poor urine stream are always an urgency and sometimes a real emergency.

Your Medication Has Become Less Effective Over Time

Overactive Bladder FAQ

Its important for patients to know that, even if a medication works very well, it may become less effective after a year or two. We dont know why this isit may be either due to the progression of the OAB disease process, or maybe blocking the receptors in the bladder isnt as effective after a while. Long-term studies have shown that patients tend to stop taking their medications after a few years because they feel that theyre not working as well, but before stopping your medication, ask your doctor about other options. Another medication can give you the results youre looking for if your current drug isnt cutting it anymore.

Also Check: How Do Males Get Bladder Infections

Pelvic Floor Exercises Can Help Immensely

You cant see your pelvic floor muscles however, just like other muscles in your body they lose their strength if they are not put to use.

Pelvic floor exercises help strengthen the pelvic floor when done consistently at least twice a day. How are they done?

  • Imagine you are holding back gas or urine.
  • Squeeze and lift the rectal area without tightening your buttocks or belly. Try and hold it for a count of three before relaxing. Repeat this cycle 10 times. Do 10 sets of Kegel exercises, at least 3 times a day.
  • Increase your contractions as your doctor recommends.
  • Do not hold your breath when you do Kegel exercises. Keep your stomach, back, and leg muscles relaxed.
  • Dont use Kegel exercises to start and stop your urine stream which can lead to incomplete emptying of the bladder and an increased risk of a urinary tract infection.

Review our information about Kegel exercises for both women and men to learn more about the techniques.

low risk . This includes bladder training.

You may feel some discomfort while holding your urine, particularly after starting bladder training or after adjusting the interval between bathroom trips. Distraction techniques can help you to manage this sensation.

If you have any concerns regarding your bladder training, its important to raise them with your doctor.

Drug Therapy For Overactive Bladder

Home » Treatments » Drug therapy for overactive bladder

  • Go to:
  • 4.1 What if my drug treatment does not improve my OAB symptoms?
  • OAB symptoms are more common as people age, but they are not a normal part of ageing. They can be treated.

    If you have bothersome symptoms, it is important that you go to your doctor. Try not to be embarrassed in discussing your situation. If self-management and lifestyle changes cannot control your symptoms, your doctor may suggest drug therapy. The goal is to reduce the urgent need to urinate and the number of times you need to go, as well as to prevent leakage episodes. Drugs used for OAB are antimuscarinic drugs or mirabegron . Together with your doctor, you can decide which type of drug treatment is best for you.

    Factors which influence this decision include:

    • Your symptoms
    • Any other medication you are taking
    • Drugs available in your country
    • Your personal preferences and values

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    How Do I Know If Its Frequent Urination

    The characteristics of frequent urination are easy to spot. If you feel the need to pee more than four to eight times in one day, odds are that you have issues with frequent urination. Your healthcare provider may ask you a few questions to confirm this symptom. These could include questions like:

    • What medicines are you taking?
    • How much fluid do you usually drink?
    • Are you drinking more than usual?
    • Do you drink alcohol or caffeine?

    During a visit, the healthcare provider may also take a urine sample to test for bacteria and white blood cells. UTIs are typically discovered this way. An ultrasound could be used to look for tumors or other structural issues that might be causing frequent urination. Another test you may have is a cystoscopy, which is used to look inside your bladder.

    Pathophysiology Of Oab Syndrome


    According to the ICS, detrusor overactivity is defined as: a urodynamic observation characterized by involuntary detrusor contractions during the filling phase which may be spontaneous or provoked . The etiology of OAB is not well known, but all theories are related to the term detrusor overactivity, suggesting that the sensory mechanisms of the bladder are affected in these situations, which leads to the creation of an urgency in emptying the bladder at smaller or much smaller quantities than under normal conditions. This is because the detrusor is very strongly innervated, and the function of the bladder is ensured by a complex mechanism of interactions between the central and peripheral nervous system .

    Read Also: Does Alcohol Cause Bladder Infections

    Tibial Nerve Stimulation For Overactive Bladder Treatment

    Tibial nerve stimulation for overactive bladder is a treatment that uses electrical signals to help control bladder contractions. It can reduce the number of times a person feels the urge to urinate and can also help reduce urinary leakage.

    OAB is the term experts use to describe urinary symptoms, including urinary incontinence and a frequent, urgent need to empty the bladder.

    According to the National Association for Continence, OAB affects an estimated 33 million people in the United States.

    Symptoms of OAB include urinary incontinence, urinary frequency, an urgent need to urinate, and waking up to urinate.

    This article looks at what TNS for OAB is, who can safely have TNS, and what the potential risks and side effects are.

    TNS, or percutaneous TNS , is a nonsurgical procedure that doctors may recommend for OAB.

    A 2017 review explains that PTNS derives from acupuncture, which has roots in traditional Chinese medicine.

    The TN is located above the ankle and runs up the leg to the sacral nerves, which control the bladder and pelvic floor muscles.

    According to the National Institute for Health and Care Excellence , scientists do not know exactly how PTNS acts on the bladder. They believe, however, that PTNS stimulates the posterior TN and the sacral nerve plexus, which can cause a change in a persons bladder activity.

    The posterior TN contains nerve fibers that stem from the part of the spine where the nerves to the bladder and pelvic floor are.

    Urinary Tract Infection In Overactive Bladder: An Update On Pathophysiological Mechanisms

    • 1Illawarra Health and Medical Research Institute and School of Medicine, University of Wollongong, Wollongong, NSW, Australia
    • 2Department of Urogynaecology, St George Hospital, University of New South Wales, Kogarah, NSW, Australia
    • 3Visceral Pain Research Group, College of Medicine and Public Health, Flinders Health and Medical Research Institute , Flinders University, Bedford Park, SA, Australia
    • 4Hopwood Centre for Neurobiology, Lifelong Health Theme, South Australian Health and Medical Research Institute , Adelaide, SA, Australia

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    Overcoming Barriers To Treatment

    Dr. Slopnick says there are a number of reasons why people with overactive bladder problems dont explore all treatment options.

    Most of the time, its two or three years before people are diagnosed or even have treatment, she says. Then, after patients try multiple medications without success, they may lose hope for an effective treatment and give up.

    But theres no reason to prolong treatment thats not working, she says.

    She suggests talking to a urologist after your first failed attempt at treatment with medication. The main point is that if youre having bothersome symptoms, talk to your doctor about them, she says.

    You Can Make Some Changes

    what is overactive bladder

    Sometimes called lifestyle changes or behavioral therapy, there are behaviors and practices you can stop, alter, or add to your daily life to reduce the symptoms of OAB.

    • Identify those drinks and foods that make you urinate more frequently. Then reduce their consumption or avoid them completely in the future. You may notice having coffee in the morning contributes to the number of times you need to urinate.
    • Totally empty your bladder each time. You can do this by waiting about 30 seconds after you urinate and then trying again. You may be surprised by how much this will help.
    • Maintain a healthy weight which lessens the pressure on your bladder.
    • Begin Kegel exercises to strengthen your pelvic muscles which will help control the urge.
    • Practice squeezes to help your muscles contract and relax to prevent not only the urge but leakage.
    • Delay going to the bathroom to increase the time between urinating.

    Also Check: How To Stop A Leaky Bladder Without Surgery

    What Can You Do For An Overactive Bladder


    OAB occurs in both men and women. Its possible to have overactive bladder at any point in your life. But, its especially common in older adults. The prevalence of OAB in people younger than 50 years of age is less than 10 percent. After the age of 60, the prevalence increases to 20 to 30 percent.

    The following are some of the other most common underlying causes and risk factors associated with OAB symptoms:

    Nerve Damage

    A healthy, normal functioning bladder holds urine until it gets full and is prompted to empty by nerve signals. However, when nerve damage occurs in the body, the muscles surrounding the urethra can be too loose. This undesirable looseness can cause someone to become incontinent. What can cause nerve damage that can then lead to bladder leakage? Some possibilities include:

    • Back or pelvis surgery
    • Stroke

    Weak pelvic muscles

    When a man or womans pelvic floor muscles are weak, bladder control issues can happen. The pelvic floor muscles are like a sling that holds up the uterus and bladder. For women, a pregnancy and childbirth can often lead to a stretching and weakening of the vital pelvic floor muscles. When pelvic floor muscles are compromised for this reason or another, the bladder can then sag out of place. The opening of the urethra also stretches and urine easily leaks out.


    Diuretic medications

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