Identifying the cause of your overactive bladder (OAB) is key to finding the right medication and treatment options. The urologists at Urology of Greater Atlanta perform many diagnostic tests to identify your specific cause or causes. Once your urologist understands your condition and its cause, they create a customized treatment plan to restore your normal bladder function and relieve your symptoms.
Today there are more viable options than ever before to treat and manage bladder control problems. You may initially be given conservative treatments, including behavioral therapies such as diet modifications, biofeedback, bladder training, or exercises for the pelvic floor muscles.
Many medications can help relax the bladder and decrease the urge to urinate as often. For example, BOTOXⓇ injections directly into the bladder can partially paralyze muscles to relieve the feeling of constantly having to urinate. There are also nerve stimulation techniques that can help.
This article discusses the various medications and treatment options.
What Medications Can I Use for Overactive Bladder?
Your doctor may suggest trying behavioral techniques before having you use medication to treat overactive bladder. However, medications can work very well to return normal function to the bladder. Ask your doctor about the risks and benefits of using the following commonly prescribed medications:
Anticholinergics
How they work:
Anticholinergic drugs work by reducing the abnormal bladder contractions associated with an overactive bladder. These bladder contractions cause urge incontinence, the need to go when your bladder isn’t full.
Anticholinergic medications include:
- Oxybutynin (Ditropan®), oxybutynin XL (Ditropan XL®), oxybutynin TDDS (Oxytrol®).
- Tolterodine (Detrol®).
- Solifenacin (Vesicare®).
- Fesoterodine (Toviaz®).
- Darifenacin (Enablex®).
- Trospium (Sanctura XR®).
- Oxybutynin Gel (Gelnique®).
Most commonly administered as an oral medication but also available as a cream or skin patch.
It may take up to 12 weeks to experience full benefits.
Side Effects:
The most common side effect is dry mouth. Less commonly you might experience:
- Heartburn
- Blurred vision
- Increased heart rate
- Flushed skin
- Urinary retention
- Impaired memory
- Confusion
Mirabegron (MyrbetriqⓇ)
How it works:
Mirabegron relaxes the bladder muscles and can increase the volume of urine your bladder can hold. It may also help you to empty your bladder more completely.
Side Effects:
Common side effects include:
- Nausea
- Constipation
- Dizziness
- Headache
- Increase blood pressure
It also interacts with other medications, so you will need to tell the Urologist what medications you are taking before taking mirabegron.
Onabotulinum Toxin type A (BotoxⓇ )
How it works:
BotoxⓇ blocks chemical messengers that cause abnormal bladder contractions and paralyzes the bladder muscle. The effects usually last several months and you may have to repeat them once or twice a year.
Side Effects:
Studies have shown that BotoxⓇ is a highly effective treatment for an overactive bladder and helps with both urinary urgency and urge incontinence with very few if any, side effects. Some inconclusive data suggests that it might increase urinary tract infections.
Imipramine
How it works:
Imipramine (TofranilⓇ ) works by relaxing the bladder muscle, while the smooth muscles at the bladder neck will contract. It may be used to treat different causes of urine leakage, including urge and stress urinary incontinence.
It can sometimes cause drowsiness and is therefore used a lot to treat nighttime incontinence.
Side Effects:
The more serious but rare side effects can include cardiovascular problems including
- Irregular heartbeat
- Dizziness
- Fall in blood pressure when standing
These tend to be more in the case of young children and older adults.
Other less serious side effects include:
- Dry mouth
- Blurred vision
- Constipation
Duloxetine
How it works:
Duloxetine (CymbaltaⓇ) can help the urethral sphincter relax, to improve urinary incontinence in some women. It also works as an antidepressant.
Side Effects:
Side effects of duloxetine can include:
- Nausea
- Dry mouth
- Constipation
- Insomnia
- Fatigue
Women who have chronic liver disease should not take duloxetine. Be sure your doctor knows your full medical history before you begin using this drug.
Nerve Stimulation Treatment for Overactive Bladder
Your nerves play an important role in bladder control. They help the brain to communicate with the bladder.
The urologists at UGATL use the following nerve stimulation treatments:
- Uroplasty: a series of 12 weekly 30-minutes in-office treatments that use mild electrical impulses to reduce the frequency and urgency of urination. It is also known as percutaneous tibial nerve stimulation.
- InTone®: a device that uses noninvasive electrical stimulation and biofeedback to strengthen pelvic floor muscles.
- InterStim™: a small device implanted under the skin of one of the upper buttocks that gently provide electrical impulses to the sacral nerve. Sacral nerve stimulation can reduce the number of voids and/or the number of wetting episodes, and has very good overall efficacy.
Call or book an appointment online with Urology of Greater Atlanta to learn more about overactive bladder and the many treatments available.
