“How can I get my bladder under control?” ASK A DOC If you’re concerned that you might have an overactive bladder, you’re not alone. Jorge Arzola, MD, a urologist with Kettering Health, explains this common condition. Q: What is overactive bladder? A: Overactive bladder (OAB) is a syndrome that causes sudden, strong urges to urinate and frequent urination during the day or night. You may also have urine leaks, a condition known as urge urinary incontinence, that occur because of miscommunication between the bladder and the brain. Q: How common is OAB? A: Overactive bladder is extremely common, affecting approximately 37 million adults in the United States. That’s 1 in 6 adults, making OAB even more common than vision problems or diabetes. Q: What treatment options are available? A: The first line of therapy is behavior modification. You may learn lifestyle changes, including diet modifications, fluid restrictions, or using the bathroom only at certain times. Pelvic floor physical therapists can also help with pelvic floor strengthening and bladder training. Once conservative OAB treatment options have failed, medications that calm the bladder muscles are typically tried. Although these medicines do often help, they can be associated with side effects of dry mouth, constipation, confusion, memory loss, or hypertension, among others. If these treatments don’t work, we may consider advanced therapies such as botulinum toxin injections to calm the bladder muscles or neuromodulation to calm the nerves going to the bladder. Q: How does neuromodulation treat OAB? A: Neuromodulation corrects the communication pathway between your bladder and your brain by stimulating the nerves that control your bladder. • Peripheral tibial nerve modulation (PTNM) indirectly stimulates the nerves going to your bladder by stimulating the tibial nerve, located just above your ankle. The stimulation travels up the leg to a bundle of nerves at your sacrum, the bone at the bottom of your spine above your tailbone. We perform this stimulation in the office during weekly 30-minute sessions. After 12 weeks, you can move on to monthly maintenance sessions. • Sacrum neuromodulation directly stimulates the nerve going to your bladder (sacral nerve). We place a thin wire directly onto your third sacral nerve. This treatment involves two sessions. The first session is a test where we measure whether your symptoms improve. If you have at least 50% symptom improvement, we place a battery underneath your skin during a second session. Sacral neuromodulation is safe and effective, with a greater than 84% patient satisfaction rate. Have a question you’d like to Ask a Doc? Email it to strive@ketteringhealth.org IT’S COMMON AND TREATABLE If you think you might have overactive bladder, visit ketteringhealth.org/ urology to find a urologist. Jorge Arzola, MD, is a urologist with Kettering Health. ketteringhealth.org 17 Overactive bladder affects approximately 37 MILLION ADULTS in the United States.
RkJQdWJsaXNoZXIy NzIxMDA=