Treatments for overactive bladder can be classified into three categories:
- Nonmedical therapy (behavioral therapy)
- Medical therapy
- Surgical therapy (seldom)
The combination of behavioral therapy and medications has been particularly effective in treating irritable bladder.
Nonmedical (behavioral) therapy
This treatment can be done at home. It often includes five steps:
- Education (understanding the causes and risk factors, recognizing the signs, implementing a therapy plan)
- Lifestyle and dietary changes (e.g. limiting the consumption of alcohol, caffeinated drinks, carbonated sodas)
- Bladder training (scheduled voiding times with progressively less frequent intervals in order to reduce the number of incontinence episodes)
- Pelvic floor muscle therapy (exercises to improve function and strength of muscles of the pelvic floor)
- Voiding diaries
Medical therapy
To treat overactive bladder, the doctor often prescribes anticholinergic drugs. They diminish the activity of the detrusor muscle and help the muscle relax. However, the medications also have side effects, such as dry mouth, constipation, blurry vision. Older people might even suffer from confusion. Therefore these drugs should only be taken under the supervision of the prescribing physician. Postmenopausal women with incontinence sometimes use estrogen preparations. Which medication works best, should be talked through with the doctor.
Quite a few people might prefer herbal medicaments: Although natural remedies for irritable bladder have been traditionally used for many years, their effectiveness is greatly unknown. That’s why it’s recommendable to take them with caution.
Surgical therapy
Surgery is only reserved for patients with severe symptoms who don't respond to all other forms of therapy. The aim is to improve the bladder's storing ability and reduce pressure in the bladder. However, bladder pain won’t disappear.
There are two types of interventions: surgery to increase bladder capacity and bladder removal (a replacement or opening in the body is constructed to attach a bag on the skin to collect urine). Reconstructive bladder surgery is the most commonly performed operation.
Preventive measures
Although there is no specific prevention for irritable bladder, healthy lifestyle changes might reduce the symptoms:
- Daily physical activity
- High-fiber diet
- Limited consumption of caffeine and alcohol
- Avoidance of spicy foods, chocolate, carbonated beverages
- Quitting smoking
- Managing chronic conditions, e.g. diabetes
- Strengthening of pelvic floor muscles, e.g. with Kegel exercises
