What is an Overactive Bladder (OAB)?
According to the definition of the International Continence Society (ICS), it is a disorder characterized by urgent urge to urinate (sudden urgency), frequent urination day and night, and urinary incontinence in some patients with a sudden feeling of urgency.
What is the incidence in the society?
OAB symptoms are seen in 17% (7-26%) in the societies. The incidence of this condition, which is more common in women than in men, increases with age in both genders.
Why Is Overactive Bladder Important?
OAB is a disorder that seriously affects the social and psychological status of the person, as well as physical effects such as frequent urination and urinary incontinence, and puts a significant burden on the health economy. Due to frequent urination at night, problems such as daytime sleepiness, distraction, and decrease in work efficiency are observed in these patients. Fear of urinary incontinence and the need to go to the toilet frequently limit the social life of the person and affect the quality of life negatively.
Why Does It Occur?
Involuntary and sudden contractions in the bladder, the feeling of bladder filling more sensitive, the increase in nocturnal urine production with increasing age, and small bladder are hypotheses to explain the causes of this disease.
Overactive Bladder Diagnosis
First of all, your doctor will take your medical history and perform a physical examination. Then, the bladder will fill in a diary and, if necessary, request additional examinations (urine analysis, ultrasonography, uroflowmetry, urodynamics, cystoscopy) to exclude some diseases with similar findings.
What Are The Treatment Methods In Overactive Bladder?
- Regulation of fluid intake: adequate amount (at least 1.5 lt / day) and regular fluid intake
- Restricting fluid intake before long trips and before going to bed at night
- Restricting diuretic drinks such as tea, coffee and alcohol
- Exclusion of artificial sweeteners (aspartame, etc.), carbonated drinks and some foods (excessively spicy foods, citrus fruits, tomatoes, etc.) that irritate the bladder.
- Weight control is particularly effective on urinary incontinence
- Exercises to strengthen the pelvic floor muscles (Kegel Exercises)
With medication, it is aimed to prevent sudden contractions in the bladder muscles, to increase the bladder volume, and consequently to reduce the urge to urinate frequently and urgent.
- Muscarinic receptor antagonists: darifenacin, fesoterodine, oxybutynin, propiverine, solifenacin, tolterodine, trospiumchloride
- Beta-3 agonists: mirabegron
Intrabladder Botox Application
It is a treatment method we use in the treatment of overactive bladder and neurogenic bladder. In this procedure, which we frequently apply under local anesthesia, botox injection is applied to 20-30 points of the bladder with the help of a special needle.
In this procedure, which has an activity of approximately 6-12 months, it is aimed to reduce the involuntary bladder contractions of the patients and to increase the bladder capacity, thus improving the complaints such as frequent urination and urinary incontinence.
Neuromodulation (Nerve Stimulation)
It is a treatment that uses electrical current to stimulate the sacral nerves that control the bladder. There are two types of nerve stimulation:
Tibial Nerve Stimulation: A needle for electrical current is placed near the ankle. The needle passes through the skin and stimulates the tibial nerve that runs from the inside of the ankle to the sacral nerves along the leg. Treatment for tibial nerve stimulation usually takes 12 sessions. The treatment session is 30 minutes and is administered once a week.
Sacral Neuromodulation (Bladder Pacemaker): It is a method used in the treatment of urinary incontinence, inability to urinate, resistant overactive bladder and painful bladder syndrome. In this process, electrodes placed in the sacrum stimulate the nerves that provide the functions of the bladder with the help of a battery and provide relief from the patient’s complaints.
Bladder Augmentation Surgery: It is a very rarely used method in severe and resistant cases where other treatment methods have failed.
NOTE: The content of the page is for informational purposes only, consult your doctor for diagnosis and treatment.