Overactive Bladder Treatment for Seniors

May 16, 2016

Overactive Bladder Treatment for Seniors

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Overactive bladder is a huge inconvenience to seniors because it gets in the way of everyday life. There are about 33 million Americans suffering from the condition. You search for the restroom whenever you get somewhere, or you might not even go because your symptoms may get in the way. You may start to realize that many of your relationships are strained. The problem is that many do not talk to their doctor about it because they are either embarrassed, or they do not think there are treatments available for them. OAB is not just a part of getting older; it is a group of urinary symptoms that affect millions of Americans.

Treatment Options for Overactive Bladder

There are a number of treatment options available, but some are better for seniors than others. More times than not, a combination of different methods is the best treatment option. A lot depends on your physical and cognitive ability, so take that into consideration when determining the best choice for you. Speaking with your doctor, getting educated, and together working to find the best method can help with your OAB.

Behavior Intervention - Behavior intervention methods are typically the first choice for treating OAB because they have no side effects. Some of these options will not work for those that cannot control their muscles or can’t maintain a mental state.

Kegel Exercises - Kegel exercises are used to strengthen your pelvic floor muscles and urinary sphincter. It is best to have someone teach you how to do them correctly, and with continued use throughout the day and for a few weeks, your symptoms should begin to reside.

Scheduled Toilet Trips - Scheduling trips to the bathroom during specific times of the day should help to reduce the sudden urge to urinate. Go at the same time every day even if you don’t have to go.

Weight Loss - Losing weight can reduce the stress put on your bladder, therefore reducing your symptoms.

Bladder Training - Bladder training takes a significant amount of physical and mental control as well as motivation. It involves waiting to urinate after you have felt an urge to go. Typically beginning with short delays and moving on to longer and longer delays as you have mastered them is what is done. This is only really possible if you have learned how to tighten your pelvic floor.

Double Voiding - Double voiding is a method used to hopefully completely void your bladder. This is done by using the bathroom, and then waiting a few minutes and trying again.

Fluid Consumption - It may be recommended to adjust your fluid consumption. Your doctor can suggest what is best for you, which might be limiting the amount and the times of the day that you consume.

Medication- Medication is the most common treatment option for the elderly and is often used in conjunction with behavioral intervention. While medication options can be very helpful for overactive bladder, sometimes the side effects cause more problems or interfere with progress.

  • Anticholinergic Class - These are the most widely used type of medication and include oxybutynin (Ditropan), tolterodine (Detrol), solifenacin (Vesicare), darifenacin (Enablex), and fesoterodine fumarate (Toviaz). They are used to relax the detrusor muscle and treat the symptoms of OAB. There are a number of side effects that are common. Dryness in both the eyes and mouth happen to many. While drinking more water may not be the best option, sugar-free candy or gum can help combat dry mouth, and eye drops work well for dry eyes. Constipation is also a common side effect and can be helped by eating a fiber rich diet or using Biotene products.
  • B3-Agonist ClassThis is a newer type of medication used of OAB called mirabegron (Myrbetiq) and can be used in combination with anticholinergic medications as well. It has side effects in addition to those of the anticholinergic class and includes increased blood pressure, incomplete bladder emptying, and sinus irritation.

While there are a number of side effects associated with both of these classes of medication, they are often worth it if they are helping with your OAB symptoms. The side effects can usually be treated without much issue unless it is interfering with any sort of progress made.

Invasive Procedures

There are a number of procedures available for overactive bladder with some being more invasive than others. Be sure to research if it would be the best option for you before going through with it. The FDA, for the purpose of treating OAB, has not approved some methods, and some should only be used as a last resort.

Botox - Botox is injected into bladder tissue and partially paralyzes the muscles. While it has shown signs of being very helpful for those with severe urge incontinence, the FDA has not yet approved it for those without neurological disease. It is a temporary solution for approximately six to nine months and has the potential side effect of worsening bladder emptying abilities in seniors.

Nerve Stimulation- Nerve stimulation is usually done with a trial temporary wire and then a permanent electrode implanted as a longer trial. If all goes well, a battery-powered pulse generator, much like a pacemaker, is surgically implanted. The wire or electrode is placed near the tailbone where the sacral nerves pass. These nerves carry signals to the bladder, and using electronic stimulation can regulate the nerve impulses, which can help improve the symptoms of OAB.

Surgery

Surgery is the very last resort for individuals that have severe symptoms that aren’t affected by other methods. There are two options available.

  1. Increasing the bladder capacity is done by using pieces of your bowels to increase the size of your bladder. It should only be used with severe incontinence and the recipient should know how to use a catheter to empty the bladder entirely.
  2. Bladder removal is the very last resort and includes creating a replacement or an opening in the body with an attachment to collect urine.

It is also essential to make sure that you choose something that fits your physical and cognitive ability levels. Often, a combination of treatments has the best results. With so many treatment choices for overactive bladder, it is essential to talk with your doctor to determine what works the best for you.

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Frequently Asked Questions

Is overactive bladder a normal part of the aging process?

Though the occurrence of overactive bladder is prevalent among those 65 and older, OAB is not necessarily a normal part of aging. About 16% of Americans over the age of 40 and about 30% over the age of 65 have OAB. There is a wide range of ailments and related conditions that can cause an overactive bladder or urinary incontinence. If you or someone you know may have an overactive bladder, see a doctor to learn ways on how to manage OAB symptoms.

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What causes overactive bladder?

In many cases, an overactive bladder can result from the natural effects of old age as one's muscles associated with bladder function weaken. Other causes can include the amount and type of foods and drinks one consumes on a regular basis. 

Typically, an adult bladder can hold 600 cc of urine, although for individuals with an OAB that volume is less than 200 cc.

In more severe cases, overactive bladders can be the result of a nervous system problem or related health conditions. The following ailments can cause an OAB:

  • Spinal cord injury
  • Back problems
  • Strokes
  • Parkinson’s
  • Dementia
  • Multiple Sclerosis
  • Diabetic Neuropathy

Other causes may include urinary tract infections, bladder stones, urethral strictures, benign prostatic enlargement, or bladder tumors. If you suspect any of these conditions may be causing a frequent and premature urge to urinate, contact your physician immediately.

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