By Alexander Berger, MD, MPH
If you have an overactive bladder, you may be reluctant to venture too far from a bathroom and avoid social and other activities for fear of embarrassing leakage.
However, with the right treatment, overactive bladder can be controlled so it doesn’t control you.
Urogynecologists at Penn Medicine Princeton Health offer a full range of effective treatment options from non-invasive methods to advanced procedures.
Understanding Overactive Bladder
Your bladder is an organ made of muscle that expands and contracts to store and control urine.
With a healthy bladder, nerve signals between the bladder and the brain alert the body when your bladder is full and signal that you need to urinate, usually giving you time to get to the bathroom.
When the nerve passages along the pathway from the bladder to the brain are damaged, it can cause bladder contractions (spasms) that cannot be consciously stopped and the need to go becomes urgent.
Often this results in leakage — or even the whole bladder emptying — on the way to the bathroom.
Additionally, overactive bladder may cause you to urinate more frequently throughout the day and may wake you up at night with the need to go to the bathroom.
While men can suffer from overactive bladder, the condition is more prevalent among women.
An estimated 15% of women across all ages suffer from overactive bladder, according to the American Urogynecologic Society.
Risk Factors
Increasing age is one of the main risk factors for overactive bladder, though it is important to note that overactive bladder is not a normal part of aging. Other risk factors include:
- Neurologic disorders
- Hormone changes.
- Pelvic muscle weakness or spasms.
- Diabetes.
- Poor kidney function.
- Urinary tract infections.
- Bladder stones.
- Bladder cancer.
- Bladder obstruction.
- Medication side effects.
In some cases, there may be no known cause of overactive bladder.
Complications
Overactive bladder can interfere significantly with daily activities and diminish your quality of life.
Many people with overactive bladder end up staying home and avoiding socializing with friends and family, which can lead to feelings of loneliness, isolation and depression.
Moreover, if overactive bladder keeps you up at night, it can leave you feeling tired during the day which can exacerbate depression.
Additionally, regularly occurring leakage associated with overactive bladder can lead to uncomfortable skin problems and infections.
Diagnosis and Treatment
If you have symptoms of overactive bladder, don’t hesitate to talk with your healthcare provider. Once diagnosed, overactive bladder can usually be controlled so you can get back to living your life.
Diagnosis typically begins with a physical exam and review of your medical history and symptoms. Your healthcare provider will likely refer you to a urogynecologist for tests to assess your bladder function and for a treatment plan.
At Penn Medicine Princeton Health, treatment for overactive bladder is highly personalized and tailored to each individual patient’s needs. Treatment options include:
- Dietary changes. Overactive bladder can often be triggered by certain foods and drinks, such as coffee, tea, soda, alcohol, some citrus fruits, chocolate, tomato-based foods, and spicy foods. Limiting these foods can sometimes help reduce overactive bladder symptoms.
- Pelvic floor physical therapy. Exercises specifically targeted at strengthening your pelvic floor can help relieve symptoms. The Center for Pelvic Wellness at Princeton Medical Center offers specialized physical therapy for the pelvic floor.
- Bladder retraining. With overactive bladder, the bladder can become conditioned to holding less urine and releasing more quickly and frequently. Bladder retraining exercises and techniques can help the bladder relearn how to store urine longer.
- Medications. Certain medicines can help improve your bladder’s ability to store urine longer and reduce urine leakage.
- Botox injections. Botox injections into the bladder wall can help the bladder relax and prevent contractions.
- Tibial nerve stimulation. This nonsurgical technique involves placing a thin needle under the skin of your ankle near the tibial nerve. A stimulator sends mild electrical pulses through the needle to the tibial nerve and then to other nerves that control bladder function.
- Sacral nerve stimulation. Sacral nerve stimulation restores communication between the brain and bladder using a device that is surgically implanted in the lower back and acts like a pacemaker for the bladder. The device delivers gentle electrical pulses to the sacral nerves, which are located near the tailbone. These nerves control the bladder, pelvic floor and bowel. The electrical pulses tell the nerves to communicate with the brain, which helps you gain better bladder control.
Overactive bladder does not need to take over your life. With the right treatment approach, you can regain control so that you can start enjoying social and other activities again with confidence.
To find a urogynecologist affiliated with Penn Medicine Princeton Health, call 888.742.7496 or visit www.princetonhcs.org.
Alexander Berger, MD MPH, is double board certified in obstetrics and gynecology, and urogynecology and pelvic reconstructive surgery. He is a member of the Medical Staff at Penn Medicine Princeton Health.
