Overactive Bladder

The Primary Symptoms

Overactive bladder (OAB) is a very common problem for both women and men. The primary symptoms of OAB include urinalysis frequency (having to go often), urinary urgency (having to go urgently), getting up multiple times at night to urinate (nocturia), and urinary leakage (urge incontinence) when the urge to go is so strong that patients cannot make it to the bathroom in time. Overactive bladder is extremely common but underreported as some patients feel that it is just part of aging and nothing can be done. However there are multiple treatments that the experts at Associated Urological Specialists offer to get these bothersome symptoms under control am improve patient’s quality of life. These treatments may include medications, pelvic floor physical therapy, bladder injections of Botox, tibial nerve stimulation, and Interstim®.

The Diagnosis

The diagnosis of overactive bladder is primarily done by a thorough medical history. A voiding diary may also be given to patients to help understand symptoms better and also how much fluid a patient is consuming. Urodynamics also may be used to understand the nature and severity of a patients bladder dysfunction. In this test, a nurse places a small catheter in the bladder with a pressure monitor on end of it and the bladder is then filled. During filling, the patient is asked about their urge to urinate and the catheter will measure bladder pressure. A normal bladder will not have any significant contractions until the bladder is near capacity and then the pressure increases when a patient tries to urinate. Involuntary bladder contractions or bladder spasms are the hallmark of overactive bladder. The pressure and flow rate are then measured once the bladder is full as well as how much residual is left. All of this information is used to make an accurate diagnosis and to help develop a treatment plan. 

Treatment

There are multiple treatment options for overactive bladder. It is not something that patient's need to just live with. Initial treatment often will include an assessment of diet and fluid intake to see if any behavior modifications can help prevent bladder irritation. If this does not solve the problem, a once daily medication is typically the next option. For more challenging cases that do not respond to medication, we offer bladder injections of Botox®, nerve stimulation procedures in the office, or the Interstim® device which is a outpatient surgical option for the management of overactive bladder.