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 East Valley Urology Center offer a variety of treatments to address this condition.
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, much like when you were 3 years old and your Mom took you to potty every hour until you understood the process. Every treatment for OAB affects the nerves. There are many different medications that may help and there is non-surgical nerve stimulation called Percutaneous Tibial Nerve Stimulation, or PTNS. This is done weekly in the clinic and is non-invasive and painless.
BOTOX® is a prescription medicine that is injected into the bladder muscle which provides temporary paralysis for parts of the detrusor or bladder muscle. It is used to treat overactive bladder when other less invasive treatments do not work well enough or cannot be tolerated. This is performed in the clinic also 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, it is important that every patient is aware that they may have to perform self-catherization after Botox® injections.
Interstim® therapy is used to stimulate the sacral nerves responsible for the overactive bladder reflex. It’s a 2 step process including a testing phase to determine if the treatment will help you and a treatment phase if you are a suitable candidate. During testing, the technician will place a tiny wire near the appropriate nerves and a small stimulator on your body. The wire causes mild pulses that are carried to the sacral nerve. These pulses should be painless and most patients experience a pulling or tingling sensation. You will keep a diary of how often you urinate, any leaking episodes, or if you experience any side effects. If the test shows that the stimulation helps your condition, you will move to step to where a small implant is inserted beneath the skin of your upper buttock where it supplies up to 7 years of continuous stimulation.