Overactive bladder is a condition that affects nearly 37 million people. And if you’re not sure exactly what overactive bladder is, you’ll probably recognize it when you hear the symptoms. Needing to run to the bathroom a million times a day, that feeling of needing to go right this second. That is what overactive bladder feels like. It’s the urgent and frequent need to use the bathroom, and it’s safe to say that it is annoying at best, debilitating at worst.
Overactive bladder, also known as OAB, often also involves bladder leaks when a patient isn’t able to make it in time. This is more than just an inconvenience – patients who experience bladder leaks often report feeling shame, embarrassment, and even loneliness if their condition is severe enough to keep them from spending time with friends and family. Even without leaks, OAB can hamper your lifestyle by making you feel that you’re chained to the bathroom all day, every day. It’s not a condition that anyone should have to live with.
Fortunately there are many treatment options available for OAB. To better understand how the treatments work, it’s important to know what causes overactive bladder.
What Causes Overactive Bladder.
First, let’s begin with an overview of how the urinary system generally works.
Your kidneys produce urine and then send it to the bladder. The bladder expands to hold the urine and the sphincter muscles act as the “on/off” button to control the flow of urine. Once your bladder reaches a certain point of fullness, it sends a signal to the brain that it’s time to empty it.
Sometimes though, there is a problem with the connection between the bladder and the brain, allowing the bladder to get too full. Someone with Overactive Bladder may not realize before it is too late that their bladder is full, and may be unable to get to a toilet before having an accident. Overactive bladder is also sometimes referred to as “spastic” bladder because the bladder muscles contract involuntarily, even when your bladder may not be holding much urine. This can create an urgent need to urinate.
There can be many causes for a spastic or overactive bladder, including neurological conditions, diabetes, abnormalities in bladder function, the medication you’re taking, or even the types of food and drink you’re eating.
Treatment Options Available – And Why You Should Ask About 3rd Line Therapies
If you have overactive bladder, chances are you’ve tried one or two treatments already. Many people start with absorbent products, but an absorbent pad or pull up can only manage the problem, not treat the condition. Medication is often a second step in the treatment process, but can be difficult to adhere to, especially if one experiences undesired side effects.
Unfortunately, many men and women think their only other option from here is some type of surgery, but that couldn’t be further from the truth. Other therapies do exist, and are worth seeking out.
PTNM and SNM are two types of treatments that may not be quite as common as medication, but it’s no less effective. In fact, these treatments have been used for years to successfully treat overactive bladder. While slightly different, they each work by stimulating nerves that control the signals between the brain and the bladder, ensuring that the bladder can function normally. Here’s a closer look at how each one works:
Sacral Neuromodulation
How Does SNM Work?
Sacral neuromodulation is a procedure that’s performed in your doctor’s office. A neurostimulator is implanted parallel to the sacral nerve. This neurostimulator generates mild electrical pulses, which stimulate the sacral nerve, and normalizes the communication between the bladder and the brain, helping to control symptoms of overactive bladder Unlike oral medications that target the muscular component of bladder control, SNM controls the symptoms of OAB through direct modulation of the nerve activity.
Are there side effects?/Is it safe?
SNM is considered an effective therapy for overactive bladder, and has few side effects. It is a minimally invasive procedure that can be reversed if the patient experiences discomfort or is unsatisfied. The most common reported side effects are pain where the device has been implanted, or undesirable stimulation.
However, SNM is not for everyone. Those with mechanical obstruction, such as benign prostatic hypertrophy, cancer, or urethral stricture should not use SNM for bladder control.
Percutaneous Tibial Neuromodulation
How Does It Work?
PTNM is thought to normalize control of the bladder’s natural reflexes by gently stimulating the tibial nerve with an acupuncture-like needle which is placed in the skin near your ankle. The needle produces an electrical pulse that travels to the sacral nerve plexus, via the tibial nerve. Your doctor can administer PTNM in his or her office.
Therapy often starts with a 12 week trial, delivered to the patient through weekly, 30-minute in office sessions. If improvements have been seen over the 12 week period, patients may be able to increase the amount of times between sessions to monthly maintenance sessions.
Are there side effects?/Is it safe?
Side effects are typically temporary, and are most commonly reported as mild pain or inflammation at or near the stimulation site.
How Do I Get These Treatments?
If you’ve tried behavioral changes and medications and they haven’t helped your symptoms of overactive bladder, ask your doctor about SNM or PTNM. Not all doctors offer it, so it’s important to be persistent and keep asking until you find one that does. You may want to ask your doctor to refer you to a specialist, such as a urologist, who may be more familiar with SNM and PTNM.
It’s also important to note that these therapies are not a good fit for everyone. Your doctor will often start you with an evaluation phase for about 2 weeks to see if it SNM seems like it will be a successful option for you. If it is, he or she will remove the temporary wire used for the evaluation phase and insert a more permanent device.
Don’t Give Up.
Just because you’ve tried a couple of options and they haven’t worked the way you wanted doesn’t mean you have to throw in the towel and succumb to bladder leaks for the rest of your life.
It’s important to remember that you are your own advocate for your health. You have the ability, and the obligation, to research your options, and to find a doctor willing to explore every one of them. After all, if you don’t fight for treatment, who will?
So put on your reading glasses and start learning more about some of these new-to-you options. You may be surprised at how well they work for you and how much better your quality of life becomes.
