Overactive Bladder

Overactive bladder (OAB) is an uncomfortable and, in many cases, debilitating condition in which the bladder contracts and expels urine inappropriately and often at opportune times. Typically, patients without an overactive bladder will progressively feel an increase in the bladder’s fullness. At that point, they can fire the bladder muscles and allow urine to be expelled. Many patients with OAB do not have this level of control, and the results can be the urge to urinate, frequency of urination, leakage and other bothersome urinary symptoms.

Estimates of Americans suffering from overactive bladder vary significantly between studies; however, it wouldn’t be unreasonable to suggest that around 15% of men suffer from this condition.

Causes and Lifestyle Changes for Prevention

The causes of overactive bladder (OAB) are many and varied. Sometimes, OAB is idiopathic, meaning we don’t know why it occurs. Occasionally, it can result from neurologic damage that alters the signal between the brain and the bladder or trauma in the groin area. Lifestyle factors are probably the most significant contributors to OAB. Smoking, alcohol, obesity, diabetes, and more all contribute to the development or worsening of OAB.

Treatment Options

Fortunately, modern treatment options for overactive bladder are safe and effective, and in most cases, they do not preclude other OAB treatments from being tried. Below, we will review each:

Percutaneous Tibial Nerve Stimulation (PTNS)

Percutaneous tibial nerve stimulation, or PTNS, is a first-line, minimally invasive treatment for overactive bladder. PTNS is a tried and true, straightforward procedure that takes advantage of the connection between the tibial and sacral nerve – the latter controls bladder function. During this procedure, a small electrified needle is placed into the ankle area, and low-level electrical impulses are passed through this electrode and into the nerve. Learn more about PTNS.

Bladder BOTOX®

Yes, you heard it right, there are many medical uses for BOTOX – not just the aesthetic ones we all know of. During this procedure, BOTOX is injected into the bladder to relax the muscles, reducing the inappropriate contractions that characterize an overactive bladder. Bladder BOTOX is a relatively affordable, semi-permanent option for qualifying patients. Of course, the patient should not have a significant contraindication to BOTOX, like an allergy to milk protein. Learn more about bladder BOTOX.

Sacral Neuromodulation

The sacral nerve influences bladder function, and stimulating it with an implanted pacemaker-like device can relieve and regulate an overactive bladder. This procedure involves surgically implanting an electrical stimulation device under a flap of skin in the lower back, which sends a small electrical signal to the bladder when needed. Dr. Natale uses both Boston Scientific’s Axonics and Medtronic’s Interstim device. Learn more about sacral neuromodulation.