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Overactive Bladder - Severe Overactive Bladder Treatment

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The type of treatment that you receive depends on the cause of your overactive bladder.  Medications are commonly used in combination with behavioral interventions.  Surgical procedures may help people with severe overactive bladder.

Prescription medications (anticholinergics) are used to relax the bladder wall muscles to prevent episodes of overactive bladder.  Medications can help treat urge incontinence as well.  Prescription medications are usually an effective treatment for most people. 

Your doctor may recommend behavioral changes, such as limiting fluids, avoiding alcohol and caffeine, losing weight, and quitting smoking.  It can be helpful to go to the bathroom more often or do so on a regular schedule.  Bladder training involves holding urination for increasing minutes after feeling the urge to go to the bathroom to help lengthen the time between urinating.  Another strategy, double voiding, is to wait for a few minutes after you have urinated, and then try again.  Additionally, there are a variety of disposable or washable protective pads and briefs on the market today that can be worn to protect clothing.

It is common for people with incontinence to learn Kegel exercises to help strengthen the muscles that control urination.   You may be referred to a physical therapist that specializes in pelvic floor strengthening.

Surgery may be recommended for people with severe overactive bladder that fail to have symptom relief with other types of treatment.  Sacral nerve stimulation is used to help regulate the nerve signals between the bladder tissues and spinal cord.  It involves surgically placing a small device under the skin in the abdomen.  Wires from the device are placed near the nerves.

Another surgical option, augmentation cystoplasty, is used to enlarge a bladder that is too small or has very high pressure.  This is a major surgery that uses sections of your bowel to reconstruct the bladder. Following augmentation cystoplasty, you may need to use a catheter to empty your bladder.

Neurolysis is a surgery to cut the nerves that supply the bladder.  This prevents nerve signals from reaching the muscles in the bladder that cause it to contract.  Neurolysis is rarely used, but may be an option for people with severe overactive bladder.

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This service should be used for second opinions, additional medical reviews and consultations; not for primary diagnosis or treatment. Please always consult your primary doctor for final diagnosis and treatment.