What are the Surgery Options for OAB?
What Is OAB?
An overactive bladder (OAB) contracts involuntarily, creating an urgent need to urinate. The urge can come on so suddenly that there’s no time to reach a bathroom. OAB can have an enormous impact on a person’s social life, work, sexual function, and sleep.
Causes of OAB include infection, a tumor, stroke, kidney or bladder stones, or enlarged prostate. Sometimes the cause can’t be identified. OAB is sometimes called “irritable bladder.”
If other methods of treatment haven’t alleviated your symptoms, several surgical options can greatly improve your quality of life.
Sacral Nerve Stimulation
Sacral nerve stimulation, also known as sacral nerve modulation, is a procedure that regulates nerve impulses to your bladder. During the surgery, a small pulse generator is implanted under the skin of the buttocks or lower abdomen. The device corrects misfiring signals, sending them directly to nerves that control the bladder. The device can remain in place indefinitely.
The goal of augmentation cystoplasty is to increase the size of the bladder. It’s generally used in severe cases when other treatments have failed. During the procedure, the surgeon takes a small piece of tissue from your intestine and adds it onto the wall of the bladder. This enables the bladder to store more urine. Following the surgery, you may be able to urinate normally. In some cases, patients are no longer able to pass urine and will need to use a catheter to empty their bladder.
In a procedure called urinary diversion, the tubes that lead from the kidneys to the bladder (ureters) are rerouted to bypass the bladder. The tubes lead to the outside of the body through the abdominal wall. Urine is collected in a bag worn on the abdomen (ostomy bag). The bag requires simple maintenance, but you’ll still be able to work and participate in a variety of physical activities.
You don’t need a bladder to live, but your doctor won’t remove it unless there is no other medical option to provide you with relief. If your medical condition warrants removal of the bladder, urinary diversion will be used to reroute the flow of urine from the kidneys to the outside of your body. You’ll need to use an abdominal ostomy bag from this point forward.
Risks of Surgery
Most people fully recover from bladder surgery and are able to return to normal activities. However, all surgery comes with risks, including:
- accidental injury
- problems with anesthesia
Post-surgical risks of bladder surgery include problems with the tube that remains outside your body, with the skin at the surgical site, and urine leakage. Ask your doctor to explain the potential benefits and risks of your particular procedure.
Other Treatments for OAB
Before considering surgery, your doctor likely will try less invasive treatments. They may recommend fluid and dietary changes or pelvic muscle exercises.
In many cases, patients are able to successfully retrain the bladder to function better. In bladder training, you practice delaying urination to build longer time intervals or schedule urination for appropriate intervals.
Your doctor may also prescribe medication to relax the bladder. Intermittent catheterization is another alternative.
OAB and Quality of Life
When untreated, OAB can impact your quality of life. According to the Cleveland Clinic, more than 17 million people in the United States have OAB. Unfortunately, patients wait an average of seven years before discussing it with their doctor. If you have an overactive bladder, don’t let embarrassment stop you from consulting your doctor. Treatment may improve or solve the problem.
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- Overactive bladder: Treatments and drugs. (2013, January 16). Mayo Clinic Staff, Mayo Clinic. Retrieved January 30, 2014 from http://www.mayoclinic.org/diseases-conditions/overactive-bladder/basics/treatment/con-20027632
- Overactive bladder syndrome. (2013, November 11). National Health Service, U.K. Retrieved January 30, 2014 from http://www.patient.co.uk/health/overactive-bladder-syndrome
- Sacral nerve modulation. (n.d.). Loma Linda University Health. Retrieved January 30, 2014 from http://lomalindahealth.org/medical-center/our-services/urogynecology/services-and-procedures/other-surgery/sacral-nerve-modulation.page?
- Urinary diversion. (2011, January). Urology Care Foundation, American Urological Association. Retreived January 30, 2014 from http://www.urologyhealth.org/urology/index.cfm?article=45
- What is overactive bladder? (n.d.). UCLA Health, Urology at UCLA. Retrieved January 30, 2014 from http://urology.ucla.edu/body.cfm?id=478&ref=6&action=detail