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Overactive Bladder (cont.)

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What are the treatments for an overactive bladder?

The treatment for overactive bladder can vary with each individual. Guidelines suggest starting with less invasive therapies first. The recommended first line of therapy is behavioral, dietary, and lifestyle therapies. In some individuals, the addition of biofeedback is helpful. Biofeedback may be done in the office or by a physical therapist. In those individuals who do not respond adequately to behavioral, dietary, or lifestyle therapies, the addition of medications (pharmacologic therapy) is recommended as a second-line treatment. Third-line therapies consist of less-invasive surgical options (injection of botulinum toxin into the bladder wall) and electrical stimulation therapies, including sacral neuromodulation (Interstim) and peripheral nerve stimulation (PTNS). More extensive surgical therapies are available but are rarely needed for treatment of OAB that is not the result of a nervous system condition.

Here are commonly recommended treatments.

First-Line Treatments

Dietary and Lifestyle

  • Weight loss in obese individuals may decrease incontinence episodes.
  • Reducing fluid intake to a recommended daily amount may be helpful in decreasing OAB symptoms.
  • Decreasing/eliminating caffeine intake may be helpful in some individuals.


Pelvic muscle rehabilitation to improve pelvic muscle tone and prevent leakage

  • Kegel exercises: Regular, daily exercising of pelvic muscles can improve, and even prevent, urinary incontinence. This is particularly helpful for younger women. These exercises should be performed 30-80 times daily for at least eight weeks. These exercises are thought to strengthen the muscles of the pelvis and urethra, which can support the opening to the bladder to prevent incontinence. Their success depends on practicing the proper technique and the recommended frequency. These exercises may be helpful for women with both stress and urgency urinary incontinence.
  • Biofeedback: Used in conjunction with Kegel exercises, biofeedback helps people gain awareness and control of their pelvic muscles. Biofeedback is often performed by a physical therapist but may also be performed in the office of a urologist or urogynecologist. Biofeedback can help identify the pelvic floor muscles to ensure proper contractions of these muscles.
  • Vaginal weight training: Small weights are held within the vagina by tightening the vaginal muscles. These exercises should be performed for 15 minutes, twice daily, for four to six weeks.
  • Pelvic-floor electrical stimulation: Mild electrical pulses stimulate muscle contractions. This should be done in conjunction with Kegel exercises.

Behavioral therapies to help people regain control of their bladder

  • Bladder training teaches people to resist the urge to void by conscious suppression of the need to urinate as well as using pelvic floor muscle contractions to suppress the urge to void and gradually expand the intervals between voiding.
  • Toileting assistance uses routine or scheduled toileting, habit-training schedules, and prompted voiding to empty the bladder regularly to prevent leaking.
Medically Reviewed by a Doctor on 9/14/2016


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