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Overactive bladder treatment options

Overactive bladder (OAB) treatments range from medication, to behavioural changes and special exercises.

Seek medical advice about the best approach for your OAB.

Exercises for OAB

  • Bladder training. This is the most common OAB treatment that doesn’t involve medication. Bladder training helps change the way you use the toilet. Instead of going whenever you feel the urge, you urinate at set times of the day, called scheduled voiding. You learn to control the urge to go by waiting, for a few minutes at first, then gradually increasing to an hour or more between toilet visits.
  • Pelvic floor exercises. Just as you exercise to strengthen your arms, abs, and other parts of your body, you can exercise to strengthen the muscles that control urination. During these pelvic floor exercises, also called Kegels, you tighten, hold, and then relax the muscles that you use to start and stop the flow of urine. Using a special form of training can help you locate the right muscles to squeeze. Start with just a few Kegel exercises at a time, and gradually work your way up to three sets of 10. Another method for strengthening pelvic floor muscles is with electrical stimulation, which sends a small electrical pulse to the area via electrodes placed in the vagina or rectum.

Until you get your overactive bladder under control, wearing absorbent pads can help hide any leakage that occurs.

Medication for overactive bladder

In people with overactive bladder, nerves misfire, signalling muscles in the bladder wall to contract and release urine at the wrong time. A group of drugs called anticholinergics or antimuscarinics, combat this problem by blocking the nerve signals and reducing bladder muscle contractions. An example is oxybutynin. Research suggests that these drugs also might increase bladder capacity and decrease the urge to go.

The main side effect is dry mouth, but anticholinergics also can cause constipation, blurred vision, and increased heartbeat.

Anticholinergics aren’t right for everyone. Some people with glaucoma, urinary retention, or gastrointestinal disease should avoid using anticholinergic drugs.

Mirabegron is a newer class of therapy for OAB that may be beneficial when other treatments have not been effective or cause too many side effects. Mirabegron is from a class of drugs called beta 3 agonists. It works by stimulating certain receptors in the detrusor muscle of the bladder wall. This relaxes the muscle, meaning the bladder can hold more urine, reducing the need to go to the toilet as often. Doctors are warned to be cautious when prescribing this medicine to people with kidney problems, liver problems, high blood pressure or abnormal heart rhythm. It shouldn’t be taken by women who are breastfeeding. Side-effects include increased heart rate (tachycardia) and urinary-tract infections. Less common side effects include digestive problems, gastritis, increased blood pressure, vaginal infection, itching ( pruritus), joint swelling, and rashes.

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