Providers often recommend a combination of treatment strategies for overactive bladder syndrome. There are four basic types of treatment strategies.
- Pelvic floor muscle exercises, such as Kegel exercises, can strengthen the muscles of the pelvic floor and urinary sphincter, which can help stop involuntary contractions of the bladder or help to suppress the urgency when it occurs.
- Reaching a healthy weight may ease symptoms.
- Drinking less fluid if you drink more than normal and drinking at certain times may help control urges.
- Double voiding is a strategy of urinating twice within a few minutes to try to empty the bladder more completely.
- Schedule trips to the toilet every two or four hours to get your body in the habit of urinating at certain times rather than waiting until you feel the urge.
- Intermittent catheterization means using a catheter periodically to empty your bladder completely if your bladder is unable to do so by itself.
- Wearing absorbent pads or undergarments can help you avoid embarrassment and protect your clothing.
- Bladder training involves training yourself to delay urinating when you feel the urge, beginning with small delays of 30 minutes and working your way up to urinating every three to four hours.
- If you snore or have been told you have sleep apnea, make sure to ask your doctor about the workup as this can cause nocturia. If you have a CPAP machine, be sure to use it.
Anticholinergic medications relax the bladder and can relieve symptoms of overactive bladder syndrome and reduce instances of urge incontinence. Many of these medications can cause dry eyes, dry mouth, and constipation as side effects. While these bladder medications may help with some symptoms of overactive bladder syndrome, they are unlikely to help with nocturia. Other medications can be used at night to help with nocturia.
Botulinum Toxin Type A
Symptoms of overactive bladder syndrome can improve with injections of botulinum toxin type A into the muscle of the bladder. This is done in the office or the operating room and involves placing a cystoscope or long telescope into the bladder. Numbing medication is often used. A small needle is then used to inject botulinum toxin type A in multiple areas of the bladder. This is very effective and can be repeated every four to six months.
Symptoms of overactive bladder syndrome can also improve with nerve impulse regulation. A thin wire or permanent electrode is placed near the sacral nerves, which carry signals to your bladder. A device connected to the wire sends electrical impulses to your bladder, much like a pacemaker does for the heart. This is often done in the operating room with sedation and numbing medicine. Alternatively, in the office a needle can also stimulate your bladder nerves on the inner side of your ankle. This can be done weekly for 12 weeks and achieve similar results.