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
- sexual function
Causes of OAB include:
- kidney or bladder stones
- enlarged prostate
Sometimes the cause can’t be identified. OAB is sometimes called “irritable bladder.”
If treatment hasn’t alleviated your symptoms, there are several surgical options available that can greatly improve your quality of life.
Sacral nerve stimulation, also known as sacral nerve modulation, is a procedure that regulates nerve impulses to your bladder. During the surgery, the surgeon implants a small pulse generator under the skin of your buttocks or lower abdomen. The device corrects misfiring signals, sending them directly to nerves that control your bladder. It can remain in place indefinitely.
This treatment can cause frequent negative reactions and result in the need for repeat surgeries. It is generally considered a third-line therapy for patients with OAB that hasn’t responded to other therapies.
Augmentation cystoplasty increases the size of your bladder. It’s often used in severe cases when other treatments have failed.
During the procedure, your surgeon will take a small piece of tissue from your intestine and add it to the wall of your bladder. This enables your bladder to store more urine.
Following the surgery, you may be able to urinate normally. In some cases, people who undergo this procedure are no longer able to pass urine and will need to use a catheter to empty their bladder.
In this procedure, the ureters, the tubes that lead from the kidneys to the bladder, are rerouted to bypass the bladder. The tubes will lead to the outside of your body through the abdominal wall. Urine is collected in a bag worn on the abdomen, called an ostomy bag. The bag requires simple maintenance, and 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 your 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.
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:
- issues with the tube that remains outside your body
- issues with skin at the surgical site
- urine leakage
Ask your doctor to explain the potential benefits and risks of your particular procedure.
Before considering surgery, your doctor likely will try less invasive treatments. They may recommend fluid and dietary changes and pelvic muscle exercises.
In many cases, people are able to retrain their bladders 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 your bladder. Intermittent catheterization is another alternative.
When untreated, OAB can impact your quality of life. According to the Cleveland Clinic, about 33 million people in the United States have OAB. Unfortunately, people 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 with your doctor. Treatment may improve or solve the problem.