When Your Bladder Works Overtime: New Medical Solutions May Provide Relief
SIOUX FALLS (April 1, 2013) - Do you seem to be running to the bathroom more often than most people? Do you get up several times at night? Do you hesitate to go to the movies, to church or on long drives because of this? It may seem like it, but you are not alone!
One in six adults, or 33 million Americans, suffer from what’s known as overactive bladder. With this condition, the bladder contracts more often than it should, making you feel like you need to go to the bathroom very frequently. Your bladder may even contract prematurely, causing you to leak urine on the way to the bathroom. “The urge and frequency should not be passed off as normal, and leaking is never normal,” said Dr. Matthew Barker, urogynecologist with Avera Medical Group Urogynecology Sioux Falls.
Overactive bladder is two to three times more common among women than men. “We’re not always sure what causes it,” Dr. Barker said. “It may be part of the aging process, or a neurological condition.” Most women who develop this condition are between 45 and 60 years old.
Unfortunately, many people suffer in silence, not realizing there are solutions available, or feeling too embarrassed to ask. “There is a stigma attached to incontinence,” Dr. Barker said.
For the first time in 30 years, a new medication has been approved to treat overactive bladder – a once-daily pill called mirabegron. A type of drug known as a beta-3 adrenergic agonist, it relaxes the muscles in the bladder, causing its capacity to increase. For the past three decades, the standard treatment has been oral medications known as antimuscarinics, which are known for side effects including dry eyes, dry mouth and constipation. “This new medication offers a choice for patients who are not helped by antimuscarinics, or who cannot tolerate the side effects,” Dr. Barker said.
Also, the FDA has recently approved the first over-the-counter treatment for overactive bladder, which is the drug Oxytrol in a patch. It is expected to be available in stores this fall. The drug is an antimuscarinic, with similar side effects, although the patch generally has less side effects because the medication is not taken orally. Also, it may also cause a skin reaction in about 20 percent of patients. “It’s a good tool. Patients can start therapy before seeing a physician,” Dr. Barker said. “It provides better access to treatment at a potentially lower cost.”
Another newly approved treatment by the FDA is injecting Botox into the bladder using cystoscopy. The Botox injection causes the bladder to relax, increasing its storage capacity. “It is typically for patients who have failed other treatments,” and can be performed in the physician’s office, Dr. Barker said.
Sacral neuromodulation is another option, which is an implantable system in the lower back that sends mild electrical pulses through a lead to the sacral nerves that control the bladder. “It’s almost like a pacemaker for the bladder,” Dr. Barker said.
Percutaneous tibial nerve stimulation (PTNS) is an office treatment in which a needle electrode, similar to an acupuncture needle, is inserted near the tibial nerve near the ankle. The impulse travels via the tibial nerve to the sacral nerve. “It’s a minimally-invasive procedure, and provides one more tool in the arsenal against overactive bladder,” Dr. Barker said.
“There are a lot of exciting changes in how we manage overactive bladder,” Dr. Barker said. “There are ways we can get it under control, so you can get back to doing what you enjoy.”
What constitutes overactive bladder? Dr. Barker said it’s normal to void your bladder six to eight times a day, and no more than once during the night. Yet few people keep track, he added. Perhaps a better gauge is how overactive bladder limits your activity. “Does it get in the way of what you enjoy – like going to the movies, church or social activities?”
To learn more, go to AveraUrogyn.org.