Overactive Bladder

Behavioral therapy, in the form of bladder


retraining and biofeedback, seeks to reestablish cortical control of the bladder by having the patient ignore urgency and void only in response to cortical signals during waking hours.

Pharmacologic agents may be given empirically to women with symptoms of overactive bladder. Table 3 lists the most common medications used to treat women with overactive bladder. It is important for patients to understand that there may
be a "trial and error" process involved in finding an effective drug and dosage.

As with stress incontinence, ERT is also an effective treatment for women with overactive bladder. Even in patients taking systemic estrogen, localized ERT (i.e., estradiol-impregnated vaginal ring) may increase inadequate estrogen levels and decrease the symptoms associated with overactive bladder.

Likewise, pelvic floor electrical stimulation is also effective in treating women with overactive bladder. This procedure is widely used in Europe.

Neuromodulation of the sacral nerve roots through electrodes implanted in the sacral foramina is a promising new surgical treatment that has been found to be effective in the treatment of urge incontinence, urgency/frequency syndrome, urinary retention and even pelvic pain. Patients first undergo implantation of a temporary test stimulator. If a significant reduction in symptoms occurs, the permanent device is implanted one week later. Given the cost and invasive nature of this modality, it should be reserved for patients who do not respond to more conservative options.

The FDA has recently approved extracorporeal magnetic innervation, a noninvasive procedure for the treatment of incontinence caused by pelvic floor weakness. The patient sits fully clothed in a pulsating magnetic chair that stimulates the pelvic floor. A typical treatment session lasts approximately 20 minutes and includes high- and low-frequency stimulation.

Extracorporeal magnetic innervation may have a place in the treatment of women with both stress and urge incontinence.





Comments

sexy12, Egypt

relax idea of exam i like that exam (Amanda)

JoeHeller, United States

It's super cereal. You should put your damn grandma in a wheelchair and take her to a doctor.

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sulochana, India

My mother is 86. She passes urine on laughing, coughing etc. She canot move out because of incontinence. So I can't take her to a doctor.She is not diabetic. Can somebody please suggest a tested medicine for it. Thanks.

Lisa4588, United States

After my stroke is when it started for me. I'm sure that is just one of the results but can it be corrected without a pill?

esco198025, United States

Urinary Incontinence is a serious problem. I know, I had to deal with it with my mom/ This is a great article and will help many women