Irritable bladder or overactive bladder produces a sudden, uncomfortable urge to urinate that is sometimes associated with urine leakage, notes the Mayo Clinic. The pathology of overactive bladder is unknown but the condition may be linked to medication side effects, nerve damage, neurological disease, urinary tract infection, obstructions such as benign prostatic hyperplasia and other medical conditions. The choice of treatment will depend on the severity of the patient’s symptoms and the underlying cause.
Diet and Lifestyle Changes
Patients suffering from an overactive bladder may benefit from behavioral interventions, reports the Mayo Clinic. Reducing caffeine and alcohol consumption, limiting fluid intake, losing weight and eating more fiber to relieve constipation can be helpful. Some patients benefit from scheduling regular trips to the bathroom. Voiding twice at each sitting or learning to delay urination may be helpful. Kegel exercises that strengthen the pelvic muscles can help to prevent leaking of urine. In some cases, patients are advised to empty their bladders by inserting a catheter periodically.
Drug Therapy
Several types of medications may be helpful in relieving the symptoms of an overactive bladder. Antispasmodics such as tolterodine, oxybutynin, trospium, solifenacin and darifenacin, reduce symptoms by relaxing the bladder, according to the Mayo Clinic. Small doses of Botulinum toxin can relieve overactive bladder symptoms by paralyzing the muscles, but the U.S. Food and Drug Administration has not improved the toxin for this purpose. Tricyclic antidepressants such as imipramine and doxepin may also relax the muscles of the bladder, according to the University of Maryland Medical Center. Drug therapy by itself reduces symptoms by 73 percent, reports Dr. Matt T. Rosenberg in the May 2007 issue of "Cleveland Clinic Journal of Medicine." Combining medications and behavioral therapy, including education, exercise and bladder re-training, increases the symptom reduction rate to 84 percent.
Surgery
Surgical intervention is sometimes required if the patient has severe symptoms after less intrusive interventions have been tried. The most common procedure, augmentation cystoplasty, enlarges the bladder to increase the storage capacity and reduce pressure, according to the American Urological Association. Segments of the bowel are used to replace part of the bladder, so serious side effects and complications such as blood clots, bowel obstruction and infection can occur, according to the Mayo Clinic. Cutting the nerve supply to the bladder is rarely done, but correction of vaginal prolapse in women can reduce the symptoms of an overactive bladder in women.
Electrical Stimulation
Electrically stimulating nerves in specific areas of the body can reduce overactive bladder symptoms in some cases, according to the American Urological Association. Since the nerves in the sacrum or lower back area link the spinal cord to the nerves affecting the bladder, implanting a unit that sends electrical pulses to the sacral nerve can reduce the impulse to urinate before the bladder is full, reports the Mayo Clinic.
