Bladder Category

Originally posted: March 31st, 2021. Last updated on September 1st, 2021

Bladder Treatments

Living with a bladder condition such as overactive bladder can be both physically and emotionally demanding. When your bladder doesn’t want to cooperate, it can be more than just annoying. 

Living with an overactive bladder may make you feel that your independence and social life has been taken away from you because of your frequent urges to go to the bathroom. We know this is no way to live your life and you shouldn’t have to suffer.

Thankfully, there are numerous methods to get your bladder issues under control and if self-care doesn’t bring the improvement you were hoping for, you can team up with your doctor to find a more active overactive bladder treatment plan with a combination of any of these approaches.

Treating An Overactive Bladder

Before we can look at the different ways you can treat an overactive bladder, it’s important to understand what it is and what causes it.

What Is An Overactive Bladder?

The term overactive bladder treatment involves the diagnosis and treatment of someone with an overactive bladder, or OAB for short. OAB occurs when someone gets a regular and urgent need to pass urine. This feeling is hard to ignore and put off, and it can happen in the morning, afternoon or evening and often without any prior indication.

What causes OAB?

Having an overactive bladder is not uncommon and people of all ages can suffer from this condition. According to the NHS, roughly 12% of the UK adult population experience some form of OAB. The actual cause of OAB is not known, but mental states, such as anxiety, can cause the problem to worsen. Those with a neurological disease are also a high risk group when it comes to an overactive bladder.

Another factor in the severity of your symptoms is the type of fluid that you drink and when you drink it. Normally it’s better not to drink fluids right before you go to bed.

Bladder Training

The first step in any bladder training plan is trying one or more recommended solutions, such as though outlined below. These are varied, and since no two people are the same, the process of finding the right solution is different for each person. 

However, with perseverance and the option of additional support from your family and doctor, one or a combination of the bladder training solutions listed below can help you to reduce your OAB problem and possibly to solve it once and for all.

Kegel Or Pelvic Floor Exercises for Bladder Training

The first step to a stronger bladder is with physical strengthening. Making the decision to get into the habit of exercising your bladder every day with kegel or pelvic floor exercises will help immensely.

Pelvic exercises are as helpful for stress incontinence as they are for urge incontinence (which comes with an overactive bladder). Training exercises for OAB are more passive, but just as targeted: you can set an urge schedule and stick with it, and when the urge to go comes you force your bladder to wait for a while.

This may feel uncomfortable at first, but soon enough you’ll be able to hold it in for an extra minute, then a few minutes, and eventually up to an hour.

Using Vaginal Cones to Assist with Pelvic Floor Exercises

Not commonly known, but vaginal cones can be used to help with pelvic floor muscle training. This involves inserting small weights into the vagina and then, using your pelvic floor muscles, you can train in holding the weights in place. 

As and when you feel ready, you can further improve your ability to cope with OAB by increasing the weight of the cone. Some women can feel some discomfort when using them, but with practice you can come to experience the benefits for your OAB condition, and also with mixed urinary incontinence and stress reduction.

Biofeedback to Further Improve Pelvic Muscle Strength

With Biofeedback, you can make further improvements to your pelvic muscle strength. This involves connecting the patient to electrical sensors which enables the reception and measurement of different aspects of their bodily functions. Using biofeedback sensors, the patient can learn how to make minor changes to their body, and which can have a significant positive impact in dealing with their OAB treatment.

The main benefit is knowing the strength of your pelvic muscles and whether you need to do more training. Using biofeedback over a prolonged period, and with ongoing pelvic training, you will eventually be able to improve your ability to feel when the urge to pass urine is arising and so you will be better able to hold back for a more convenient time.

Dietary Changes to Reduce Urges

A few dietary changes in your daily food choices can have a profound effect on your bladder control. There aren’t many foods that directly improve bladder function, but there are plenty of ingredients known to irritate the bladder and these should be avoided.

Start by eliminating diuretics, such as caffeine and alcohol, as they encourage the kidneys to produce more urine. Also, be sure to reduce or eliminate artificial sweeteners and acidic fruits, including citrus, pineapple, and tomatoes.

Water plays a significant role in our daily diet. It may seem like a strange idea to increase your water intake, but interestingly, too little water can lead to constipation and concentrated urine, which may irritate your bladder and increase the feeling of urgency.

Developing Better Bowel Habits

The bladder and the bowel work together and when one isn’t working correctly, the other trends to compensate. Constipation is uncomfortable, but a full bowel will also press on the bladder, making overactive bladder urgency and incontinence worse.

To develop better bowel habits, start by increasing your soluble and insoluble fibre intake, since both are important for a healthy digestive tract:

  • Whole grains like barley and oatmeal
  • Fresh and dried fruit
  • Green veggies
  • Beans

These food options will help to get you back on track, but if diet doesn’t do the trick, discuss the idea of laxatives with your doctor.

Weight Loss & Health Improvements To Reduce Your Symptoms

Studies suggest that losing excess weight can reduce the symptoms of stress incontinence and an overactive bladder.

What does this mean exactly? If you can lose about 8 percent of your body weight – that’s typically around 15 to 20 pounds – you will likely see remarkable results. In fact, even just a few pounds of weight loss can reduce incontinence episodes by over 25%.

Aside from all the other health benefits, by losing weight the abdomen will alleviate pressure on all the organs in the area, including the bladder.

As well as weight loss, getting regular exercise can reduce overactive bowel symptoms. Exercise can help to reduce the strain on your bladder which ultimately means less urine leaks. 

Stopping smoking can also help with OAB problems since the smoke from cigarettes can irritate your bladder. Smoking can also lead to hacking cough – a loud, dry cough – which can cause further leaks.

Consult Your Doctor

When you have been diagnosed and know what is causing your bladder problem, you will be able to discuss possible treatments with your doctor or continence advisor. They will help you to understand what is causing your problem and how the different treatments can help. Your doctor will also talk to you about the potential side effects or problems of any particular treatment. Together, you can decide which treatment is the most suitable for you.

Once diagnosed you will first be offered what are known as conservative treatments, which include ways in which you can help yourself, such as lifestyle changes.

Medication may also be offered to you as an option, alongside some conservative treatments, depending on your symptoms and medical history. Surgery is a final option and will not normally be considered until you have tried other treatments for a length of time without success.

What to expect from your doctor

In terms of an assessment, your nurse or doctor will ask you about your general health and in particular, about your OAB problem. You may be examined orally and internally, and you might be asked to give a urine sample to see if you have any obvious problems.

As part of your treatment programme, you may be asked to keep a bladder diary for roughly 3 days, which typically involves making a record of the time of each time you pass urine and how much urine was passed.

You may also be asked to take a flow test, and in some cases a post-flow ultrasound test. This involves using a special machine which checks whether you completely empty your bladder  and also measures how strong your flow is.

Here is a short list of possible questions your doctor may ask and the tests they may ask you to complete:

  • An overview of your medical history.
  • A physical examination, which could include a rectal exam and a pelvic exam in women.
  • Whether or not you leak urine unexpectedly and if so, how often it happens.
  • For how long you have had an OAB problem.
  • Whether or not you leak urine during your daily activities, including for example, bending down or walking.
  • What activities your overactive bladder symptoms prevent you from doing, if anything.
  • You may be asked to give a urine sample, which will be used to test for infections, traces of blood or other abnormalities.
  • In some cases it may be necessary to complete a neurological examination, which may help to identify sensory problems or abnormal reflexes.

Medical Treatments for An Overactive Bladder

Depending on how successful they were and the strength of your condition, your doctor may recommend that you continue with the above treatments and return for another check-up after a specific period of time. 

However, if they decide, usually in consultation with the patient, that medical treatment may be beneficial or necessary, they may choose to prescribe one or multiple medical treatments, some of which are detailed below.

Anticholinergic Drugs for Overactive Bowel

This particular class of medication is used to control the muscle spasms that lead to overactive bladder. Anticholinergic drugs focus on blocking the nerve signals that typically trigger inopportune bladder contractions, reduce the frequency, and the severity of your urge to urinate.

There are several anticholinergic drugs to choose from and they all require a doctor’s prescription. Most people have very favourable reactions to anticholinergics, though there are a few possible side effects which may include dry mouth, constipation, increased heartbeat and/or drowsiness.

Botox For An Overactive Bladder

Although not commonly used, Botox is a handy muscle relaxer for a variety of conditions, including an overactive bladder. The compound is injected right into the bladder, and patients can experience fewer uncomfortable contractions and increased bladder capacity for up to a year after the injection has taken place.

However, Botox isn’t without its dangers. Some patients find that after the procedure they retain urine too much, and experience pain and complications (such as urinary tract infections). For these reasons, Botox for overactive bladder treatment is only considered for certain people.

Specific Antidepressants May Suppress Symptoms

Specific antidepressants – such as Tofranil, Tyramine and Norfranil – may help to suppress overactive bladder symptoms. Which one your doctor chooses to prescribe will depend on your particular symptoms.

For example, the SSRI class of antidepressants works better for stress incontinence than for urge incontinence, although it’s not clear how it helps. Alternatively, tricyclic antidepressants are known to have anticholinergic side effects, which relax the bladder muscle and cause the muscles of the bladder neck to contract.

Natural Supplements You Can Take At Home

While there have been very few scientific studies on herbal remedies as an option for overactive bladder treatment, some remedies have shown promising results for some people.

Studies from Japan have shown improvements in urgency, leakage and a reduction in night-time urination using a herbal remedy known as Gosha-jinki-gan. Also, the buchu plant from South Africa is thought to nourish the bladder tissue and fights inflammation which can lead to infections and incontinence.

There are also plenty of common herbs that may help with symptoms, including:

  • Corn silk
  • Capsaicin (the active ingredient in chili peppers)
  • Ganoderma lucidum

Remember to consult your doctor first before adding any of these herbal remedies into your overactive bladder management plan.

Using Nerve Stimulation for an Overactive Bladder

If you’re finding lifestyle changes and medication can’t control your overactive bladder symptoms, your doctor may recommend a slightly more invasive approach for long-term relief.

There is a procedure known as nerve stimulation which involves implanting a small electronic device into the body, almost like a pacemaker, which sits under your skin and sends electrical impulses to the sacral nerve, which plays a significant role in bladder emptying.

The aim of this treatment is to strengthen the supporting muscles of the bladder and leads to better control. At the moment, however, there’s no guarantee that this procedure will eradicate all of your overactive bladder symptoms.

Altering the Bladder with Bladder Augmentation Surgery

When all other approaches to strengthen and retrain the bladder have failed, you may need to alter the bladder itself. This surgery is typically used as a last resort and in only the most severe cases of an overactive bladder.

Bladder augmentation involves enlarging the bladder with a section of your large intestine, so there’s more physical space to store urine in and less pressure to urinate frequently. The surgery is the most invasive and complicated procedure for solving overactive bladder problems, and includes a long recovery time and possible lasting consequences. Once you have bladder augmentation surgery, you will cease to be able to urinate naturally – you will have to use a catheter or stoma. 

The good news is that many, if not most cases of an overactive bladder can be very well controlled with healthy lifestyle changes, and natural and traditional medical treatments. It’s important to remember that not all of the listed treatment options may work for everyone. 

Remember to discuss the above overactive bladder treatment options with your doctor before beginning them.

Coping and support

For those who decide to persevere with non-invasive, medical or natural treatments, it may be helpful to consider other techniques that help you to cope with your condition. In some cases, emotional and physical support can also be beneficial in reducing the stress of dealing with their overactive bladder symptoms.

Here are a few considerations to help you cope with OAB and some advice on where to get further support.

Make Regular And Controlled Visits 

Double void is another approach to dealing with OAB. This technique involves relieving yourself and then, a few minutes later, going again. This deliberate approach to bathroom visits helps you to make sure that after passing urine a second time, your bladder is mostly or completely empty. The main benefit of this approach is that you can avoid having to return to the bathroom just a few minutes after your initial visit, which is both a nuisance and sometimes embarassing.

Following A Schedule

It’s helpful to set yourself up with a schedule to follow and usually very easy to set up. This involves making a specific plan for when you visit the bathroom and allows you to space these visits out over the day. Eventually, you should aim for visits every 2 – 4 hours and in this way you can train yourself to pass urine at the same time, making it easier to plan your day and normal activities without interruption.

Trying Intermittent Catheterization

For those who are unable to empty their bladder effectively, using a catheter helps to ensure that your bladder functions properly. To find out if this approach is right for you, ask your doctor.

Wearing Absorbent Pads

Wearing undergarments, or absorbent pads, helps to protect your clothing and avoids embarrassing incidents. They also help to ensure you don’t need to change or restrict your normal activities. 

Absorbent pads and garments are usually available in different sizes and can vary in absorbency level.

Getting Emotional Support

Although it is quite common to suffer from an overactive bowel problem, people often feel embarrassed and therefore avoid talking about it. Try speaking with your family and friends first, as they can be a reliable source of emotional and practical support should you need it. 

You may also find that by opening up about your OAB problem, you may be surprised to learn that other people you know also suffer from overactive bladder problems.

If you don’t feel comfortable talking to a friend, colleague or family member, as a bare minimum you should at least talk with your doctor. Amongst other things, they can help you to find a support group where you can speak to other people who have similar problems.

Further Support

To find out whether or not you need further advice, you can use the NHS Bladder Self-Assessment survey. By answering just a few short questions, the survey provides you with a short summary of advice that you can follow and a set of useful links.

Reference: some of the above advice was provided by which aims to empower people living with chronic mental and physical health conditions, encouraging them to embrace a positive outlook despite unfortunate circumstances.

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