Overactive Bladder

What Is Overactive Bladder?

Overactive bladder (OAB) is a common condition that is characterized by a sudden and uncontrollable need to urinate, sometimes with leaking of urine or even fully emptying the bladder when you are trying to prevent it. While common, OAB is not normal and is a treatable condition that no one should have to live with. Other symptoms associated with this condition include incontinence, the need to urinate very frequently, and waking up several times a night. Overactive bladder is caused by abnormal nerve activity from the spinal cord to the bladder, making it difficult for your brain to overcome urges. The doctors at Women First offer a variety of treatments to address this condition.

What are Common Treatments?

Initial therapy for OAB involves emptying your bladder on a schedule, or “bladder retraining”. Since OAB is a neurologic condition, that is your brain is not able to overcome what your bladder wants to do, then you have to retrain it. It's much like when you were 3 years old and your Mom took you to potty every hour until you understood the process. There are various treatment options available for this condition. These may include medications that can help manage symptoms, as well as lifestyle modifications to reduce triggers. Pelvic floor physical therapy is another effective approach that can improve muscle control and alleviate discomfort.

How Does Botox® Treat Overactive Bladder?

BOTOX® is a prescription medicine that is injected into the bladder muscle which provides temporary paralysis for parts of the detrusor or bladder muscle. When medication and lifestyle changes do not achieve the desired results, or are not well tolerated, additional therapies such as botox may be needed. This is performed in the clinic and takes about 10 minutes. The effect can last for 5-15 months and varies from patient to patient, although for most, the lasting effect is around 6-8 months.  The injections can be repeated and the main risk is difficulty voiding afterward, with 4-6 % of women needing to self-catheterize for a short time thereafter. Although this is a rare complication and it resolves, we may make every woman aware and require that she learn the process for self-cath prior to Botox® injections.

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What Is Axonics® Therapy?

Axonics® Therapy is an advanced treatment option for regaining control of your bladder and bowel. It works by providing gentle stimulation to the nerves that communicate between the brain, bladder, and bowel. This FDA-approved therapy can help with conditions like urge urinary incontinence, urgency, frequency, retention, and fecal incontinence.

The process starts with a simple test to see if this therapy works for you. During this trial phase, you'll have a special wire placed near the nerves controlling bladder and bowel reflexes. You'll wear an external device for 3-7 days, keeping a diary of your symptoms. If you notice at least 50% improvement, you and your doctor may decide to move forward with the permanent implant.

The implantation is done under local anesthesia with IV sedation. A small incision is made below your waistline to place the device. The implant is inserted beneath the skin of your upper buttock where it can provide therapy for at least 20 years. Most patients go home the same day and can return to normal activities after about two weeks.

You'll have a remote to control the device, adjusting stimulation as needed. The implant is MRI compatible, so you can have future scans if necessary.

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