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Overactive Bladder (cont.)

Overactive Bladder Treatment

Treatments for OAB can be classified into three categories; nonmedical therapy or behavioral therapy, medical therapy, and rarely, surgical therapy. In general, the combination of behavioral therapy and medications has been proven to be more effective in treating OAB than either therapy alone.

Overactive Bladder Self-Care at Home

Behavioral therapy for OAB can be safely done at home. It generally involves five steps:

  1. Education
  2. Lifestyle and dietary modifications
  3. Bladder training
  4. Pelvic floor muscle therapy
  5. Voiding diaries

The educational component of behavioral therapy consists of understanding the causes and risk factors for the condition, recognizing the symptoms, and implementing a treatment plan.

Lifestyle and dietary modifications can play an important role in the treatment of overactive bladder. These modification include things such as limiting the intake of fluid, caffeinated drinks, carbonated sodas, and alcohol, as they can cause increased urination.

Bladder training entails implementing regimented and scheduled voiding times with progressively longer intervals. This type of training helps to normalize urinary control, reduce voiding frequency, increase bladder capacity, improve patient confidence, and decrease episodes of incontinence.

Pelvic floor muscle therapy (PFMT) involves exercises that improve the function and the strength of the muscles of the pelvic floor and the urinary sphincter. These exercises, such as the Kegel exercises, are thought to possibly inhibit the involuntary contraction of the detrusor muscle, thereby reducing the urge to void. They can be done between 30 to 80 times daily for about eight weeks before noticing significant results.

Biofeedback are techniques used to increase awareness in order to contract pelvic muscles during episodes of urinary urgency. These can be combined with pelvic muscle exercises.

Behavioral therapy has been recommended as the first-line therapy for overactive bladder and incontinence in general by the Third International Consultation on Incontinence as well as the Agency for Health Care Policy and Research.

Limitations of behavioral therapy have to do with patient motivation and ability to perform the necessary exercises or techniques. For many of the elderly, especially those with dementia or other neurologic problems, performing and adhering to these treatments can be very challenging and impractical.

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