Overactive Bladder Management

We Develop A Targeted Treatment Plan

Overview

Overactive Bladder

Overactive bladder is a common condition where people feel the need to urinate more frequently and with urgency. This can be associated with leakage of urine due to the urgency and inability to make it to the bathroom in time. This is not a life threatening condition but other possible causes of your symptoms should be ruled out by your doctor.
The normal bladder holds about 400 ml of urine (a can of soda is 360 ml). It is normal to urinate every 3-4 hours or 6 times a day and once at night. Increased fluid consumption will cause more frequent urination.
The goal of treatment is to minimize the distress of the overactive bladder and to avoid side effects from treatment.

Treatments

Behavioral Modifications

  • Avoiding bladder irritants such as coffee, tea, soda, chocolate spicy/acidic food and artificial sweeteners.
  • Voiding every few hours to prevent over distention of the bladder.
  • Weight loss.
  • Treatment of constipation.
  • Pelvic floor physical therapy to help learn techniques to hold urine longer.

Medications

There are several medications that can be used alone or in combination with other therapy to help relax the bladder. You should notify your doctor if you have been diagnosis with Closed Angle Glaucoma.

  • Antimuscarinics medications-Oxybutynin, Vesicare, Detrol, Toviaz, Trospium etc… Common side effects include, dry mouth, constipation, dry eyes, dyspepsia and some can contribute to confusion in elderly patients. Due to age, the only one of these safe for people over 65 years of age is Trospium.
  • Myrbetriq 25 or 50 mg daily is an antispasmodic with side effects of possible increased blood pressure, headaches, nausea, but lower rate of constipation and dry mouth.
  • Gemtesa is the newest medication which came out in April of 2021. Typically patients will see results within 2 weeks. This pill can be crushed if needed. This medication may cause loose stools.
  • Medications need to be taken on a daily basis. Symptoms will return if the mediation is stopped.

Surgery

  • Bladder Botox-(like used for wrinkles on your face) is injected into the bladder through a scope. It works to relax the bladder and help it store more urine without frequency or leaks. There is no recovery time. This lasts for 6-9 months on an average before needing to be repeated. Risks include urine retention about 10% of the time and requires cauterization but it will resolve with time. Other risks include infections, injection pain and small amount of blood in urine. This is typically performed while the patient is awake with numbing medicine in the bladder.
  • Sacral Neuromodulation (SNM)-this is a nerve stimulator that emits a current to the nerve that controls the bowel and bladder. It disrupts the over activity signals of the bladder and helps the bladder hold urine. We do a test procedure first where small wires are placed into the sacrum while you are awake. This takes approx. 10 minutes. You will be asked to wear these wires for 5-7 days to see if this benefits you. If it works a permanent implant will be placed under the skin while you are under sedation. The risks include pain at the lead site, migration of the leads, bleeding or infection. The battery needs to be replaced about every seven years. There is an external control so we can adjust the settings as needed. This has proven helpful for stool incontinence as well.

Your Visit

You will be expected to leave a urine sample and nursing staff may also check a post void residual using ultrasound technology.

If the urine is sent for Culture & Sensitivity (C&S), we will contact you with the results – this is usually three to four days after the specimen has been submitted to the reference lab. A C&S is done to confirm the infection is present, the type of bacteria causing the infection, and the best antibiotic to treat the infection. It also helps the provider make sure you are not developing a bacterial resistance to specific antibiotic.

Symptoms

Overactive Bladder

Symptoms of overactive bladder present as a strong and persistent urge to urinate. Additional signs include frequent urination, urinary incontinence in the form of leakage of urine or inability to make it to the bathroom in time.

DISCLAIMER: The symptoms listed are for informational purposes only and do not necessarily indicate the presence of a specific medical condition. It is important to consult with a qualified healthcare professional for accurate diagnosis and appropriate treatment. Any decision regarding medical care should be made in consultation with your healthcare provider based on individual circumstances and medical history.

Expert Urology Providers in Nebraska

Our urologists expertly diagnose and treat the full spectrum of urology conditions. Beyond their expertise, open communication and empathy guide our approach to patient care.

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What Our Patients Say

The staff is very welcoming and professional. My yearly checkup was thorough and informative. I would recommend this group to anyone interested in the best level of healthcare!

The staff is always so considerate and they really go above and beyond for my client. Never a doubt that we are in good hands – and leaving with smiles.

I had an issue and was worked into the schedule with no problem. I received the utmost care and concern from everyone I worked with. The nurses were patient with me, helping me try different approaches until we found the right solution. They were very helpful throughout the entire visit, and even afterward when I needed a replacement cap. Such a great relief to know that everyone is so caring. Thank you!

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You may call 402-421-8899 if your questions are related to your planned procedure, procedure instructions, postoperative care, etc. This will connect you with our surgery preadmission nurse. If your questions is more general or related to your clinic appointment or if you are calling for procedure results, please call 402-489-8888 to speak with a clinic nurse.

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