Overactive Bladder

Urology of Indiana Overactive Bladder

Overactive bladder (known as OAB) is a condition defined by bothersome symptoms of urinary frequency, urgency, leakage with urgency and/or getting up often at night to urinate.

Overactive bladder (known as OAB) is a condition defined by bothersome symptoms of urinary frequency, urgency (feeling like you have to rush to urinate), leakage with urgency and/or nocturia (getting up often at night to urinate). In addition to its physical symptoms, OAB can reduce one’s quality of life.

People who suffer from OAB are more likely to avoid physical activity and skip social outings. They may feel like they need to know the location of every bathroom when they go out. Some people also might have trouble performing well at work.

OAB is more common than you might think. It affects over 38 million Americans, including 36% of men and 43% of women aged 40 years and older. So, if you are experiencing symptoms of OAB, you are not alone. Now more than ever, there are promising treatments – from simple dietary and behavioral changes to medications and even more advanced, specialized therapies. It is important to realize that OAB is a chronic condition requiring ongoing management. Although it cannot be “cured”, getting the right treatment can help you greatly reduce your symptoms and have a better quality of life.

What Causes OAB?
The bladder is an organ lined by muscle fibers. Normally, unless you are urinating, your bladder muscle fibers should always be relaxed. This lets the bladder expand and fill gradually as the kidneys produce urine. The bladder should store the urine until you urinate. When you decide to urinate, nerve reflexes tell the bladder muscles to squeeze or contract and let the urine come out.

In people with overactive bladder, the bladder muscle fibers squeeze at times they should not.

This might happen when you get close to a restroom, hear the sound of running water, open the door to go into your house. Or, there may be no obvious reason at all. Although OAB has many causes, the basic problem is that the nerves going to the bladder are sending it the wrong signals, making the muscle fibers squeeze when they should be relaxing. These incorrect signals can cause urinary frequency, urgency and/or leakage.

OAB Nurse Navigator
Tammy Mullenix, MA is our Overactive Bladder Nurse Navigator and is available to make sure you understand your diagnosis and treatment options. Tammy primarily assists with our 3rd line therapy patients.

OAB Patient Care Coordinators
Catherine Houston and Dana Sailes are our Overactive Bladder Patient Coordinators and assist patients in 1st and 2nd line OAB treatments. They also help patients find affordable cost options for their OAB medication(s).

We are a group of urologists and urogynecologists with extensive expertise in treating patients with overactive bladder. Our team will help you develop a long-term Overactive Bladder treatment plan and work with you to regain your quality of life.

In order to diagnose OAB, our physician will take a detailed medical history of your symptoms, perform a physical examination of the abdominal and pelvic area and take a urine specimen. Sometimes additional special testing is needed, such as a urodynamic study or imaging tests, to help us get more information about your condition.

As an enrolled patient in our OAB program, you will be provided with medication management, cutting-edge procedures, ongoing communication with our OAB Nurse Navigator and more. Our team understands that there is no one-size-fits-all therapy, so we re-evaluate your progress and explore various treatments as part your personalized OAB management program.

Treatments for Overactive Bladder involve preventing the unwanted and inappropriate bladder muscle contractions. Urology of Indiana’s Overactive Bladder Program offers patients the latest, most complex therapies.

The Overactive Bladder Program will guide you through a clinically-proven care pathway, beginning with conservative treatment (called First-Line Therapy) and working through the care pathway until your symptoms are successfully managed. Continue scrolling for more information on treatments.

First-line treatment for patients with OAB include behavioral therapies such as lifestyle interventions, bladder training, pelvic floor physical therapy, fluid management and bladder-control strategies.

Second-line therapy includes two classes of oral medications known as anticholinergics and beta-agonists. These medications don’t work if taken on an “only when needed” basis. To be effective, they must be taken regularly, usually daily. When you are just starting on the medication, it may take several weeks to determine whether or not it is helpful for your symptoms.

Botox is a medication that is injected directly into the bladder wall. It is easily performed in the office and does not require anesthesia. Most patients need an average of 2 Botox injections a year to control their symptoms.

Sacral Nerve Stimulation
Also called sacral neuromodulation, this is an electrical nerve stimulation device that is implanted under the skin of your lower back, next to the nerve that controls the bladder. It is placed under local anesthesia, with testing performed to determine whether it is effective. Once the stimulator is in place, this therapy is long-lasting, with a battery that lasts an average of 10-15 years before needing to be replaced.

Posterior Tibial Nerve Stimulation (PTNS)
This procedure uses a small needle to stimulate a nerve in your ankle, with treatments given in the office once a week for 12 weeks and periodically thereafter.

This involves placement of a nickel-sized nerve stimulator surgically under skin near the ankle. It is performed with local anesthesia/numbing.