Do not make a habit of starting and stopping your stream. If you repeatedly start and stop your urine flow it can make OAB worse or actually lead to incomplete bladder emptying which increases risk of urinary tract infection.
Surgery may be the best choice for some, but it is not best for choice for everyone. That is why it is important to get the proper diagnosis and can depend on bladder testing.
Strengthening the pelvic floor muscles which support the uterus, bladder, small intestine and rectum can help prevent pelvic organ prolapse, maintain pelvic tone and health, improve sex and help stool leakage or fecal incontinence.
Don’t be embarrassed to ask for help, some have trouble doing Kegel exercises. You can be given feedback so you can learn to isolate and exercise the correct muscles.
Vaginal weighted cones or biofeedback might help. The vaginal cones are used by inserting into the vagina and holding in place while going about your activities. Biofeedback is done by your provider, a pressure sensor is placed into your vagina or rectum. The sensor measures and displays your pelvic floor activity as you relax and contract.
If you do the exercises regularly, you can expect results such as turning off the urge when you use the muscle to stop the spasm or bladder contracting and less leakage. Improvement can occur within a few weeks or take months to achieve maximum benefit. Think of it like working out your biceps, it takes repeated consistent sessions before you see improved tone and muscle strength!
If your bladder doesn’t empty when you urinate, remaining urine called post void residual (PVR), may cause symptoms identical to an overactive bladder. When you urinate you can’t tell whether the bladder emptied or not, the urine just stops. To measure the PVR, a bladder ultrasound scan can be done in the office or a thin tube (catheter) can be passed through the urethra and into the bladder to drain and measure the remaining urine.
- Need another reason to aim for a healthy waistline. If you are overweight, losing weight may ease symptoms. Weight loss may also help if you also have stress incontinence. Carrying around extra pounds puts excess pressure on the bladder.
- Sometimes the bladder does not give you the right signal to urinate so when it gets too full it just gushes out. Scheduling toilet trips every two to four hours, instead of waiting until you “feel” the urge, can stop the bladder from emptying when you’re not seating on the toilet!
- Using a catheter to periodically empty your bladder completely can help your bladder do what it can’t do by itself. This may be needed if the bladder muscle is weak and doesn’t contract strong enough to squeeze the urine out of the bladder or the urethra is pinched off to much (obstructed) from things like previous surgery or benign prostatic hyperplasia in men. Ask your provider if this approach is right for you.
- Bladder training involves training yourself to delay voiding when you feel an urge to urinate. You begin with small delays, such as 15 minutes and gradually work your way up to urinating every 3-4 hours. Bladder training is possible only if you’re able to contract your pelvic floor muscles.
- Drinking enough water is essential for health. Too little fluid can lead to concentrated urine, which can irritate the bladder lining increasing urgency. Too much fluid may worsen frequency. Fluid intake before bed can increase nocturia ( getting up frequently at night).
- Double void technique. This technique is helpful for those who feel like they do not empty fully. It is also a good idea to double void before bedtime. Sit on the toilet leaning slightly forward, rest hands on your knees or thighs, point your toes to the floor or try elevating your feet on a stool, urinate as normal, remain on the toilet for 30 seconds lean forward and go again. Some stand up then sit back down, or stand up do something else like brush teeth then sit back down and go again.
- Certain medication can lead to bladder leaking. Talk to your provider about other alternatives if you have OAB and take:
- Alpha-adrenergic medication
- Muscle relaxants and sedatives
- Narcotics such as oxycodone and morphine
- Medications that relax the bladder can be helpful for relieving symptoms of OAB. Common side effects of most of these drugs include dry eyes and dry mouth. Drinking water to quench the thirst cause worsening bladder symptoms! Extended-release forms of these medications, including skin patches or gel, may cause fewer side effects. Over-the-counter Biotene or Aquaphore products, sugar free candy or gum can be helpful for dry mouth. Some find the symptoms improve with time, others take the medication at night so there is less bother. Regular dental exams are important, dry mouth can lead to increased cavities.
- Non-Western based medicine or complementary therapies have not been proven to successfully treat OAB however, they may be helpful. Acupuncture (using extremely thin, disposable needles) may ease the symptoms of OAB. Complementary treatments may not be covered by insurance, so check with your insurance company first.
- Several herbs and natural supplements have been used for treatment of OAB. Research on these supplements are limited or nonexistent. Ask your pharmacist or provider prior to using regarding side effects and drug interactions:
- Vitamin D: higher vitamin D levels were associated with lower risk of pelvic floor disorders such as leaking, low vitamin D levels may be linked to increased episodes of urinary leakage in the elderly.
- Gosha-jinki-gan: a blend of 10 traditional Chinese herbs can help bladder contraction
- Magnesium hydroxide: can improve symptoms of urinary incontinence and nocturia
- Ganoderma lucidum: herbal extract from East Asia may improve bladder symptoms
- Corn silk: A traditional medicine used for centuries for conditions like bladder irritation and nighttime incontinence
- Pumpkin seed extract: may be beneficial for nighttime urination and OAB
- Capasaicin: comes from chili peppers may be in inexpensive treatment for OAB and highly sensitive bladders
- Diuretic medications or “water pills” are commonly prescribed for high blood pressure. These medications cause your body to get rid of water and salt faster through the urine, As a result, this can cause the bladder to fill up faster and leak. Ask your primary care provider if there are other alternatives for treatment. If not, take your water pill at the same time each day. Most start working within an hour with peak effect within the first hour or two so stay close to a bathroom, try urinating before you get too full and practice urge suppression.
- A healthy functioning bladder holds urine until it gets full and is prompted to empty by nerve signals. When nerve damage occurs, signals to the bladder can be messed up and lead to unexpected leakage. Some conditions the can lead to nerve signal problems include:
- Back or pelvis surgery
- Herniated disc
- Multiple sclerosis
- Parkinson’s disease
- The reasons to stop smoking cigarettes are basically endless. Here is another. Smoking not only irritates the bladder, it increases the risk of urologic or bladder cancer. Smoking cigarettes can also lead to coughing spasms that increase problems with stress incontinence. Anyone with OAB who smokes should quit right away.