Jefferson University Hospitals

Overactive Bladder

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Overactive bladder (OAB) can have a major impact on your daily life when you limit your activities because of this condition. While the root cause of OAB is unknown, the condition can be an underlying symptom of bladder stones, drug side effects, nerve damage (which can be caused by abdominal or pelvic trauma or surgery) or neurological disease (such as multiple sclerosis, Parkinson's disease, stroke or spinal cord lesions). In addition, some experts believe that certain individuals – including those with depression, anxiety and/or attention deficit disorder – may be predisposed to OAB.

Fortunately, there are many treatment options available and expert Jefferson urologists can help identify an optimal course of action. We maintain a state-of-the-art urodynamics lab, where our physicians and nurses use the latest tools to diagnose bladder disorders. We also offer a full complement of established treatments, as well as access to emerging treatment options through clinical trials.

What is overactive bladder (OAB)?

Overactive bladder (OAB) is a form of urinary incontinence involving a sudden, uncontrollable urge to urinate. Some experts estimate that one in six adults over age 40 experience symptoms of OAB.

What are the symptoms of OAB?

Physical symptoms of OAB include an urgent need to empty the bladder, more frequent urination during both day and night, as well as incontinence.

OAB can affect daily living by interfering with work, everyday routines and even intimacy and sexual function. It can also take a toll on emotional well being, causing embarrassment, stress and, in some cases, depression.

What are the treatments for OAB?

Although OAB is highly common, studies suggest that many sufferers do not seek medical treatment. However, there are several treatment options that can help to alleviate the physical symptoms and, ultimately, the emotional "side effects" as well. Those treatment options include:

  • Bladder training, for which the patient urinates at designated times and uses relaxation techniques and distractions to help keep to the schedule. Gradually, the patient tries to lengthen the time between scheduled urination.
  • Medication, which may include oxybutynin chloride (Ditropan XL®) or tolterodine (Detrusitol®, Detrol LA®). These prescriptions are taken orally, once a day, for OAB. As antimuscarinics, these drugs affect the central nervous system and the muscarinic receptors in smooth muscle. These drugs typically show results within about two weeks. Newer medications indicated for OAB include trospium chloride (Sanctura®), derifenacin (Enablex®) and solifenacin (Vesicare®).
  • Oxybutynin transdermal system (Oxytrol®) is a clear patch that's thin and flexible. Twice a week, it's applied to the skin of the abdomen or hip. The patch delivers oxybutynin continuously through the skin into the bloodstream, thereby relieving symptoms for up to four days at a time.
  • Sacral nerve stimulation (InterStim®) therapy is an implanted neurostimulation system. It sends mild electrical pulses to the sacral nerve, which the nerve near the tailbone that influences bladder control muscles. Stimulation of this nerve may relieve the symptoms related to urge incontinence. This reversible treatment is best suited for patients who do not respond to behavioral therapies.

Surgical augmentation of the bladder is a last resort for those who do not respond to bladder retraining or to medication.