Treatment of Overactive Bladder may include Behavioral and Lifestyle options such as pelvic floor muscle exercises, bladder retraining, biofeedback, and dietary changes. Medications are often effective. Surgery is usually not done until behavioral therapy and medications are tried.7 Combining these treatment options may provide the best improvement.
See your doctor to determine the best treatment options for you.
Often the first approach to treating OAB is conservative lifestyle changes and physical therapy. The following are common approaches for the treatment of bladder control problems, including OAB.
These exercises were designed to strengthen the muscles around the bladder and the urethra. Toning the pelvic floor muscles can help support the bladder, which can decrease frequency and urgency.13 These exercises are commonly called "Kegel" exercises, after the doctor who developed them.13 Click here for information on how to do pelvic floor muscle exercises.
How to do pelvic floor muscle exercises:
Pelvic floor muscle exercises, also known as Kegel exercises for the doctor who invented them, are done to strengthen the muscles that support the urethra, bladder, uterus and rectum. The best way to do them is to lie on the floor and squeeze your genital area as if you are trying to keep your urine in. Hold this squeeze for the count of four. Then relax for the count of four. Try to do this for five minutes, twice a day.
Bladder control can be improved by "bladder retraining," which involves developing a schedule for your bathroom trips. The objective is to have the brain take control of bladder emptying. By changing your schedule over a period of weeks or months, retraining helps to gradually increase the time between trips to the bathroom. Over several weeks or months, the cycle approaches a normal interval of about four hours.13
Click here for more details on how to retrain your bladder.
Retraining your bladder is as easy as 1, 2, 3:
Biofeedback uses a probe or electrode to help identify the pelvic floor muscles. When the correct muscles are contracted, the machine emits a signal.13 Biofeedback helps to ensure that the correct muscles are exercised for bladder control.
You may want to limit your consumption of foods and drinks containing caffeine, which cause the body to lose water. Caffeine is found in chocolate, coffee and tea as well as many soft drinks (which also contain high amounts of sugar). You may also want to reduce foods and drinks containing alcohol or sugar (including artificial sweeteners), which can irritate the bladder. Drinking lots of liquids, particularly water, and eating foods high in fibre can help alleviate constipation, which can also contribute to urinary incontinence.13
When urinary incontinence is not controlled with treatment, many absorbent products, including shields, pads, and undergarments, are available. There are also devices that can be worn internally by women. These devices, inserted by a physician, support the bladder to improve control.7
Treatment with medications is aimed at reducing the frequency and severity of involuntary contractions of the detrusor muscle.9 There are drugs available in Canada to treat Overactive Bladder. They help reduce symptoms by controlling bladder muscle contractions, which helps to reduce the frequency and urge associated with Overactive Bladder.3
Detrol is a drug for the treatment of symptoms of Overactive Bladder, which may include frequency, urgency and urge urinary incontinence (involuntary loss of urine). Detrol stops abnormal bladder contractions resulting in, more bladder capacity and fewer symptoms. The usual starting dose is 2 mg two times per day. The most common side effect associated with Detrol is dry mouth. Any side effects should be reported to your doctor or pharmacist. These could include dry irritable eyes, heartburn, blurred vision, dizziness, palpitations (irregular heart beat), fainting or difficulty in urination.14
Detrol LA is a drug for the treatment of symptoms of Overactive Bladder, which may include frequency, urgency and urge urinary incontinence (involuntary loss of urine). Detrol LA stops abnormal bladder contractions and reduces the symptoms associated with those contractions. This results in more bladder capacity and less frequency, urgency and involuntary loss of urine. The usual starting dose is one 4 mg capsule once a day. The most common side effect associated with Detrol LA is dry mouth. Any other side effects should be reported to your doctor or pharmacist. These could include stomach pain, dry irritable eyes, heartburn, blurred vision, dizziness, palpitations (irregular heart beat), fainting or difficulty in urination.15
Ditropan is a drug for the relief of symptoms associated with Overactive Bladder including urgency, frequency and urge urinary incontinence. It relaxes the bladder muscle, which results in decreased urgency and frequency of urination. The usual dose is one 5 mg tablet two or three times a day. The most common side effects associated with Ditropan are dry mouth and throat. Other side effects include difficulty swallowing, decreased sweating, urinary hesitance and retention, and blurred vision.16 Talk to your doctor or pharmacist if you experience these or other side effects.
Ditropan XL is a drug used for the relief of symptoms of urge urinary incontinence, urgency and frequency in patients with Overactive Bladder. It relaxes the bladder muscle, which results in decreased urgency and frequency of both urinary incontinence episodes and voluntary urination. The usual dose is one 5 mg once daily. The most common side effect associated with Ditropan XL is dry mouth. Other side effects include constipation, somnolence, headache, diarrhea, nausea, and blurred vision.17 Talk to your doctor or pharmacist if you experience these or other side effects.
Enablex is a drug used for the treatment of Overactive Bladder with symptoms of urge urinary incontinence, urgency, frequency and nocturia. Enablex reduces abnormal bladder contractions, which results in decreased symptoms of urgency and frequency of urination and incontinence. The recommended starting dose for most adults is 7.5 mg once daily. The most common side effect associated with Enablex is dry mouth. Other side effects include constipation, headache, abdominal pain, indigestion, nausea and dry eyes.18 Talk to your doctor or pharmacist if you experience these or other side effects.
Oxytrol is a drug for the treatment of Overactive Bladder with symptoms of urge urinary incontinence, urgency and frequency. Oxytrol increases bladder capacity, which results in decreased symptoms of urgency and frequency of urination and incontinence. The starting dose for most adults is one 3.9 mg/day Oxytrol patch applied twice weekly. The most common side effects associated with Oxytrol are skin reactions, including redness and itchiness, where the patch is applied. Other side effects could include dry mouth, constipation, abnormal vision, and headache.19 Talk to your doctor or pharmacist if you experience these or other side effects.
Trosec is a drug for the treatment of Overactive Bladder with symptoms of urge or mixed urinary incontinence, urgency, and frequency. Trosec blocks involuntary contractions of the bladder, allowing the muscle to relax and giving better control of the bladder by reducing symptoms of urgency, frequency and incontinence. The recommended dose is 20 mg twice daily on an empty stomach. The most common side effects associated with Trosec are dry mouth, constipation and abdominal pain. Other side effects include upset stomach, nausea, dizziness, flatulence, chest pain, dry eyes, blurred vision, increased heart rate, palpitation, urinary retention and heat prostration.20 Talk to your doctor or pharmacist if you experience these or other side effects.
Urispas is used for a variety of urinary and bladder problems. It acts by relaxing the muscles of the urinary tract, which allows it to relieve pain and discomfort accompanying a variety of urological disorders, e.g., frequency, urgency, nocturia and incontinence. The usual dosage is 1 tablet 3 or 4 times daily. The most common side effects are nausea and vomiting. Other side effects include dry mouth, nervousness, vertigo, headache, and drowsiness.21 Talk to your doctor or pharmacist if you experience these or other side effects.
Uromax is a drug used for the treatment of Overactive Bladder with symptoms of urge incontinence, frequency, urgency or any combination of these symptoms. Uromax relaxes the bladder muscle, which results in decreased symptoms of urgency, frequency and incontinence. The recommended starting dose is 10-15 mg once daily. The most common side effects associated with Uromax are dry mouth and throat. Other side effects include blurred vision, constipation, dizziness, drowsiness, dry skin, headache, nausea, sleeplessness or weakness.22 Talk to your doctor or pharmacist if you experience these or other side effects.
Vesicare is a drug used for the treatment of Overactive Bladder with the symptoms of urgency and frequency of urination and incontinence. Vesicare reduces bladder contractions, which helps reduce the symptoms of urgency, frequency of urination and incontinence. The recommended starting dose is 5 mg once daily. The most common side effects associated with Vesicare are dry mouth and constipation. Other side effects include dry eyes, urinary retention and blurred vision.23 Talk to your doctor or pharmacist if you experience these or other side effects.
In many instances, combining drug treatment with some of the other non-medical management options (pelvic muscle exercises, bladder retraining, dietary modifications) may provide the best improvement of the symptoms of Overactive Bladder.
Surgery for the management of Overactive Bladder is a last resort treatment option. It is more common for the treatment of stress urinary incontinence.3 Talk to your doctor to find out what the best treatment options are for you.