Overactive Bladder

Do you find yourself having to urinate more than 8 times in a 24 hr period?

Do you have bladder accidents (incontinence) if you wait too long to go to the bathroom?

Do you find yourself waking in the night just to go to the bathroom?

Do you find it difficult to make it inside your house or to get your pants pulled down as you get closer to the bathroom without having an accident?

Then you may suffer from a condition called overactive bladder.

Overactive bladder is a very common non life-threatening, urologic problem that can affect both women and men. It is often characterized by the sudden, uncontrollable urge to urinate which can often lead to the loss of urine.   Many people will have these same symptoms during the night time hours causing someone to awaken from sleep to empty their bladder (nocturia).  The symptoms can be very troublesome causing people to seek the locations of restrooms wherever they go. Sometimes it will limit people from travelling due to their fears of not finding a restroom. Overactive bladder is also an economic burden due to the ongoing cost of pads, laundry and beds and bed linens.

Overactive bladder may be caused by diseases such as diabetes, medications such as diuretics or excessive dietary intake of caffeine or alcohol. The condition is not caused by an infection though the symptoms may be similar.

There are many suggestions that can be made to ease the struggle of frequent and urgent urination. First, evaluate your dietary choices. You may be consuming too much caffeine, alcohol, spicy or acidic foods. You May be consuming too many diet sodas or fruit juices or not including enough water in the day.  Often, the bladder can be retrained to allow for longer time in between voids or trips to the restroom.  The use of “urge suppression” will allow for enough time to actually make it to the restroom without an accident.

Other therapies are available ranging from the use of medications, nerve stimulators and even Botox. Medications have long been on the market and have proven to be moderately effective. The nerve stimulator can be placed as outpatient procedure and works to decrease the stimulation from the nerves to the bladder. Lastly, the newest of the remedies, Botox, is placed into the bladder muscle to stop it from contracting or squeezing and losing urine. This treatment is also able to be performed in the office and has a good success rate.

If you feel that you may have this condition, please contact our office and allow us to help with an initial evaluation which will include a  relevant  history and a 24 hour voiding diary. Let our team of experts help you minimize the symptoms and give you some reassurance and a feeling of control.

Interstitial Cystitis / Painful Bladder Syndrome

IC ( interstitial cystitis) is described as an unpleasant sensation (chronic pain, pressure or discomfort) thought to be related to the bladder and this sensation has been present for more than 6 weeks. The condition is not associated with an infection or other identifiable cause.

The nerves of the bladder originate in the lower spine and cover a large area of the pelvis. This may explain why some people will feel discomfort in their lower abdomen, along the outside of the vagina( vulva), the opening of the bladder ( urethra) , the vagina or even the rectum.

The cause of interstitial cystitis is not completely understood but is thought to be related to an incomplete protective barrier layer on the inside of the bladder. This allows urine to leak out into the bladder muscle and cause symptoms of urgency, frequency , and bladder and/or pevlice pain. Other possibilities include an exaggerated allergy response, or pelvic muscle spasm.

The diagnosis of interstitial cystitis can be made with a thorough history and physical to include a pelvic exam. A urine specimen may be required to evaluate for infection. A symptom questionnaire may be administered to help make the diagnosis. Other tests may include looking into the bladder with a telescope while the bladder is being filled with water ( cystoscopy with hydrodistention).

Treatment strategies often include dietary restriction of bladder irritants such as acidic foods, caffeine and alcohol. Oral medications may also be given to reduce the symptoms. In some cases, medications are placed or instilled into the bladder with a tiny catheter to allow the medication to come into direct contact with the bladder wall. Techniques of stress reduction are quite helpful to lessen the symptoms associated with the painful bladder. Often, physical therapists trained in the area of the “pelvic floor” are recruited to help with therapy, providing not only assistance with the muscles of the pelvic floor but also the nerves.

If you feel that you may have a painful bladder condition then please call our office to schedule an appointment. Our trained staff members will be glad to meet with you and suggest a care plan to reduce your symtpoms and improve your quality of life.

Botox for the bladder

Do you suffer from symptoms of overactive bladder (OAB)?

Have you tried but either failed or didn’t tolerate the medications often used for OAB?

Then Botox may be a good option for you!

Botox is often used for minimizing the crow’s feet and the fine lines often associated with aging but how is it used for the bladder?

Overactive bladder (OAB) is described as the sudden, uncontrollable urge to urinate sometimes causing the loss of urine or incontinence. Botox can be injected into the bladder wall to reduce or lessen the squeeze of the bladder muscle which is used to empty the bladder. Botox actually works on the nerves that feed or send messages to the bladder.  In 2013, the FDA approved the use of Botox for urinary leakage associated with overactive bladder.  The injection of Botox is thought to be as effective as the use of medications for the treatment of overactive bladder symptoms.  Botox is not a permanent treatment and the effects can be seen for approximately 6 months.

Traditionally medications have been used for therapy of OAB. This form of therapy is often associated with dry mouth, dry eyes and constipation.  The side effects of Botox may be a temporary inability to empty the bladder, noted in about 6% of patients, painful urination in 9% of patients and an increased risk of infection in 18% of patients.

Botox can be administered in the office.  A numbing agent is placed into the bladder making it comfortable for patients to undergo the procedure. The procedure involves the injection of the Botox via a cystoscope (or bladder telescope) along the back of the bladder. The results of the injection should be evident in approximately 2 wks. Patients noted fewer accidents, fewer  trips to the bathroom, and an increased amount of urine when voiding.

If you suffer from OAB and have not been satisfactorily treated with the medications that your physician has prescribed, then Botox may be for you. Please call our office and allow our team of experts to evaluate your condition and recommend Botox if appropriate.