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Treating Overactive Bladder: An Overview The estimated 17 million Americans who suffer from overactive bladder may find that asking directions to the restroom when eating in a restaurant or visiting someone's home is more than a casual question. In people with an overactive bladder, the bladder muscles contract inappropriately. These contractions cause embarrassing wetting accidents, an intense unexpected need to urinate, often soon after the bladder has been emptied, and regularly urinating more than eight times per day (including at least two times during the night). Urinary incontinence can be humiliating, so much so, that many who suffer from OAB don't bring up the topic with their doctor and so they also suffer in other areas of their lives. According to a recent Decima Research poll conducted in Canada, the symptoms of OAB can be severe enough to significantly affect the sex lives and intimacy of many people who have the condition. Recognizing OAB and talking about it with a health care professional are important first steps toward improving the symptoms of OAB. Here are some tips for starting to talk about the disorder with your health care provider: Before your appointment, tell the doctor or nurse that you think you may have OAB. This will ensure that your doctor or nurse initiates the discussion about the disorder during your appointment. Make a list of all the medications you're taking and the symptoms you're experiencing. Give the list to your doctor or nurse during your appointment. Keep a diary of your bathroom habits. Note what, how much, and when you drink, how often you use the bathroom, when you have accidents, and what you were doing before the accidents happened. Commonly Recommended Treatments for Chronic OAB Pelvic muscle rehabilitation techniques improve pelvic muscle tone and prevent leakage: Kegel exercises—exercising pelvic muscles to improve the muscles and prevent urinary incontinence Biofeedback—used with Kegel exercises, biofeedback helps people gain awareness and control of their pelvic muscles Vaginal weight training—small weights are held within the vagina by tightening the vaginal muscles Pelvic floor electrical stimulation—mild electrical pulses stimulate muscle contractions, often done in conjunction with Kegel exercises. Behavioral Therapies Behavioral therapies to help regain bladder control include bladder training and toileting assistance. Bladder training teaches people to resist the urge to void, allowing them to gradually increase the intervals between voiding. Toileting assistance uses routine or scheduled toileting, habit training schedules, and prompted voiding to empty the bladder regularly to prevent leaking. Medications Medications to improve urinary incontinence medically include Ditropan, Detrol and hormone therapy. Ditropan (oxybutynin) prevents urinary incontinence by relaxing the sphincter muscles. Detrol (tolterodine) treats the frequent urination, urinary urgency, or urge incontinence associated with OAB. Estrogen, either oral or vaginal, may be helpful when used with other treatments for postmenopausal women with urinary incontinence. Self-help Self-help methods of treatment include weight loss and monitoring the intake of certain food and beverages. Obesity has been identified as a risk factor for urinary incontinence. Eliminating or limiting alcohol, caffeinated beverages, chocolate, and medications containing caffeine can help reduce OAB symptoms. Both caffeine and alcohol are irritating to the bladder. In addition to medical and self-help interventions, a number of urinary incontinence products are on the market today. These are not the old bulky "adult diapers" of yesteryear. They range from simple absorbent pads to streamline undergarments. The use of these products shouldn't, however, replace seeking medical treatment. Overactive bladder is a highly treatable condition. Resources Johnson & Johnson. (2002). Overactive bladder: A condition no one talks about. Retrieved August 11, 2002, from http://www.jnj.com/news/jnj_news/20020430_1350.htm. Medical Week. (2002). Poll: Overactive bladder symptoms significantly affect sex life and intimacy. Retrieved August 18, 2002, from http://www.seniorhealthweek.org/NewsStories/ bladder-story-a25.htm. Ortho-McNeil Pharmaceutical. (nd). Overactive bladder is not a natural part of aging. Retrieved August 11, 2002, from http://www.ditropanxl.com/consumer/info_center. Shiel, W. C., Jr., MD, FACP, FACR. (Reviewed 2002). Overactive bladder. Retrieved August 18, 2002, from http://www.focusonurology.com/script/main/art.asp? articlekey=18300&rd=1.

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