Your physician may recommend a number of corrective actions if you are experiencing signs and/or symptoms of an overactive bladder. These can include things like behavioral modifications, medication and, in extreme cases, surgical intervention.
Lifestyle changes. Reducing fluid, especially near bedtime, may help manage urges and incontinence. According to the Mayo Clinic, “People who are safely able to reduce their fluid intake by about 25 percent may experience a decrease in overactive bladder symptoms.” Other lifestyle changes include bladder re-training, double voiding, scheduling bathroom trips, pelvic floor muscle exercises (Kegels), intermittent catheterization and wearing absorbent pads.
Medications. There are several medications that your physician may prescribe that are used in conjunction with behavioral or lifestyle changes. These prescriptions are available in both pill form and extended release type skin patches. These medications work by causing the bladder to relax, thereby reducing episodes of urge incontinence. Side effects that these medications can cause include an abnormally dry mouth and dry eyes. Your physician may advise you to use eye drops to alleviate dry eyes and suck on a piece of candy or chewing gum to relieve the abnormally dry mouth. There are over-the-counter medications that can also help alleviate dry mouth. Additionally, a medication called onabotulinumtoxinA can be injected by your doctor, which can help to paralyze the muscles of the bladder for about six months. While it can help to relieve the signs and symptoms of an overactive bladder, it has not been approved by the Food and Drug Administration (FDA) for this use.
Invasive treatments. A thin wire can be placed near your sacral nerve where it passes near the tailbone. Applying a very tiny amount of electricity to stimulate that sacral nerve can stimulate your bladder much in the same way that a pacemaker can stimulate the heart. If the sacral stimulator alleviates the signs and symptoms of an overactive bladder, the wire and a small power source can then be permanently implanted under the skin.
Surgical intervention. When all other methods of treatment have been unsuccessful at relieving an overactive bladder, there are a couple of surgical procedures that can be employed. As they are both relatively major procedures and carry all the attendant risks associated with surgery, they are usually methods of last resort. The first procedure is called an ileo-cystostomy, where a piece of small bowel is removed and used to expand the urine carrying capacity of the bladder. The second procedure involves removing the entire bladder and creating an opening in the skin where the urine empties into an external bag called a stoma. These measures are only used when all other methods fail.