In addition to medication, behavioral interventions for an overactive bladder may help reduce episodes and strengthen bladder muscles. Bladder training, which includes the delay of voiding from 10 minutes to two hours, can be done to strengthen bladder muscles. Pelvic floor muscle exercises, also called Kegel exercises, can improve function of the pelvic floor muscles and urinary sphincter to hold urine and suppress involuntary movement of the bladder. Vaginal weight training is a process by which small weights are held within the vagina through the tightening of the vaginal muscles. These exercises are recommended twice daily for approximately 15 minutes for four to six weeks. Biofeedback in combination with Kegel exercises can also help the patient build build awareness and control of pelvic muscles.
Other possible treatments include adjusting fluid intakes and reducing irritants, such as limiting caffeine and alcohol. Patients can also try increasing fiber intake or taking supplements for constipation, which can reduce the symptoms of overactive bladder.
In some cases, absorbent pads can be worn to protect undergarments and prevent embarrassment.
Medication for Overactive Bladder
The use of antisasmodics, also called anticholinergics can reduce bladder urge episodes. These include:
- Tolterodine (Detrol)
- Oxybutynin (Ditropan)
- Oxybutynin skin patch (Oxytrol)
- Trospium (Sanctura)
- Solifenacin (Vesicare)
Surgery for Overactive Bladder
For severe cases of overactive bladder, a sacral nerve stimulator may be recommended. This is a pacemaker-type device placed under the skin of the abdomen and connected to a wire near the sacral nerves (near the tailbone). The sacral nerves are the primary link between the spinal cord and bladder tissue. Modulating these nerve impulses has been shown to be an effective treatment for overactive bladder.
In some cases, augmentation cystoplasty may be recommended. This is a reconstructive procedure that uses parts of the bowel to replace parts of the bladder. It can improve bladder capacity, although the use of a catheter for voiding may still be necessary.