An overactive bladder causes you to urinate so often that it becomes bothersome; this includes waking up to go at night. It also means rushing to the bathroom and feeling that you only have a little time to get there before you leak. When urine is leaked one the way to the bathroom it is called urge incontinence.
There are many different reasons why people may go to the bathroom frequently. In order to control when you urinate, the nerves to your bladder have to communicate with the nerves to your brain. When these nerves are disrupted there are mixed signals making it difficult for you to hold your urine.
Conditions that can prompt overactive bladder:
- Heart disease and uncontrolled diabetes, which can affect the nerves to the bladder
- Pelvic floor nerve damage after a vaginal birth
- Low levels of estrogen after menopause
- Uncontrolled diabetes and/or sleep apnea, which can cause hormonal changes that affect how the body processes urine
Dietary Changes
What and how much liquid you drink, can affect how much you urinate. There is no need to drink excessive amounts of water unless you have another medical condition where your doctor told you to increase your water intake. If you’re healthy, you should only drink water when you’re thirsty. If you wake up frequently at night to urinate, decreasing the amount of liquid you drink after dinner could be helpful. Caffeine, carbonated beverages and alcohol increase urination, which means reducing your intake of those drinks could also be helpful.
Behavioral Changes
Sometimes we get in the habit of going to the bathroom frequently, not from urgency, but due to habit. By distracting yourself, you can retrain your bladder to be less bothersome. Our physicians can help you learn how to do this at your clinic visit.
Medication
If dietary and behavioral changes don’t help, we recommend various medications that act on the nerves to your bladder. These medications help you go longer between voiding, and leak less urine.
More advanced treatment options include:
Percutaneous tibial never stimulation (PTNS)This is an electrical ankle treatment that stimulates a nerve to your bladder. It is similar to acupuncture, but involves electrical stimulation. You come for once a week visits with our nurse for 12 weeks to the clinic. The nurse will place a small needle near your ankle and stimulate your bladder nerve for 30 minutes.
Cystoscopy with BotoxIn our office we look inside your bladder with a small camera and then inject Botox into the base of your bladder. The Botox affects how your bladder cells come together and helps to prevent urinary urgency, decreases the strong urge to urinate. It also helps control urine leakage. It lasts on average for nine months and only needs to be repeated if you feel your symptoms are returning.
Sacroneuromodulation (Interstim)With this treatment we place a wire next to a bladder nerve to stimulate it. We first do a testing period to see if the treatment works with the wire placed in the office or in the operating room. If you find that your symptoms improve more than 50 percent, we proceed to the operating room to implant a pacemaker. The pacemaker controls the stimulation to your bladder and you can change your programs over time with a remote control device. Sacroneuromodulation also helps urinary retention and fecal incontinence, and is a successful treatment option for patients that have both urinary and fecal incontinence.
