Posted by: Thixia | March 7, 2008

Treatment of Overactive Bladder

What are the treatment options?

Treatment of Overactive Bladder may include Behavioural and Lifestyle options such as pelvic floor muscle exercises, bladder retraining, biofeedback, and dietary changes. Medications are often effective. Surgery is usually not done until behavioural therapy and medications are tried. Combining these treatment options may provide the best improvement.

See your doctor to determine the best treatment options for you.

Behavioural and Lifestyle

Behavioural and Lifestyle approaches to managing OVERACTIVE BLADDER

Often the first approach to treating OAB is conservative lifestyle changes and physical therapy. The following are common approaches for the treatment of bladder control problems, including OAB.

Pelvic floor muscle exercises

These exercises were designed to strengthen the muscles around the bladder and the urethra. Toning the pelvic floor muscles can help support the bladder, which can decrease frequency and urgency. These exercises are commonly called “Kegel” exercises, after the doctor who developed them.


How to do pelvic floor muscle exercises:

Pelvic floor muscle exercises, also known as Kegel exercises for the doctor who invented them, are done to strengthen the muscles that support the urethra, bladder, uterus and rectum. The best way to do them is to lie on the floor and squeeze your genital area as if you are trying to keep your urine in. Hold this squeeze for the count of four. Then relax for the count of four. Try to do this for five minutes, twice a day.

Bladder retraining

Bladder control can be improved by “bladder retraining,” which involves developing a schedule for your bathroom trips. The objective is to have the brain take control of bladder emptying. By changing your schedule over a period of weeks or months, retraining helps to gradually increase the time between trips to the bathroom. Over several weeks or months, the cycle approaches a normal interval of about four hours.

Retraining your bladder is as easy as 1, 2, 3:

Set your schedule by completing a voiding diary for at least 2 to 3 days, taking note of the shortest interval between voids.

Control your urge to void by putting mind over matter. In other words, use distraction techniques to take your mind off your bladder. For example, when the urge hits, try doing some other activity that requires your concentration. Wait 1 to 2 minutes and then go to the bathroom – whether or not you feel the urge. For the next urge, try to wait 3 to 4 minutes before going. Keep doing this until you reach a point where you can wait until your next scheduled voiding time.

Gradually retrain your bladder to go longer between voids. After each week, try to increase the intervals between voids by 30 minutes. Your ultimate goals are to consistently have 2 to 4 hours between voids, and to significantly cut down the number of leaking accidents between these voids.1

Biofeedback

Biofeedback uses a probe or electrode to help identify the pelvic floor muscles. When the correct muscles are contracted, the machine emits a signal.13 Biofeedback helps to ensure that the correct muscles are exercised for bladder control.

Dietary changes

You may want to limit your consumption of foods and drinks containing caffeine, which cause the body to lose water. Caffeine is found in chocolate, coffee and tea as well as many soft drinks (which also contain high amounts of sugar). You may also want to reduce foods and drinks containing alcohol or sugar (including artificial sweeteners), which can irritate the bladder. Drinking lots of liquids, particularly water, and eating foods high in fibre can help alleviate constipation, which can also contribute to urinary incontinence.

Absorbent products and devices

When urinary incontinence is not controlled with treatment, many absorbent products, including shields, pads, and undergarments, are available. There are also devices that can be worn internally by women. These devices, inserted by a physician, support the bladder to improve control.

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