How is OAB treated?
Treatment options for OAB and incontinence depend on the underlying cause and treatment needs to be tailored to the individual, depending on age, lifestyle, health and expectations.8
In general, treatment options for OAB include lifestyle interventions, behavioural techniques, medication, and, in some cases, surgery.8
1. Lifestyle modifications6,12,13
- While it is important to drink enough fluids to stay adequately hydrated, avoid excessive quantities of fluid intake especially from approximately 4 hours before going to bed
- Limit the intake of drinks that may increase urine production, e.g. alcohol, coffee, tea and drinks containing caffeine
- Remember that fruit and vegetables may contain a significant amount of water
- One study has shown that reducing daytime fluid intake by one quarter (25%) significantly improved daytime urinary frequency and urgency and was easily achieved by most people
- Empty your bladder before going out and before going to bed at night
- Avoid constipation by maintaining a healthy diet with sufficient fibre
- Stop smoking
- If you are overweight, get some advice about changing your diet and increasing your exercise to help you lose weight
2. Bladder training and pelvic floor muscle exercises
In some people with urgency urinary incontinence, bladder training and pelvic floor muscle exercises may be very helpful in helping to reduce episodes of incontinence. They are easy to perform and results may be achieved within 2-3 months.6
Bladder training
Bladder training involves gradually increasing the duration of time in between going to the toilet to pass urine. Start with an initial interval of 1 hour during waking hours and gradually increase this by 15-30 minutes per week until you reach a 2-3 hour interval between visits to the toilet.14
Pelvic floor muscle exercises (Kegel exercises)
The muscles of the pelvic floor, which surround the bladder outlet help to close the opening to the urethra and are important muscles in helping to control the passage of urine. However they may be weakened during pregnancy, childbirth, in overweight women and those with a chronic increase in abdominal pressure (e.g. chronic cough).5,14
Here is a technique for performing pelvic floor exercises:13†
- Identify the pelvic floor muscles by pretending that you are trying to avoid passing wind or a bowel movement and tighten these muscles*
- Bring the same tightening motion forward to the muscles around the vagina
- Move the contraction up your vagina toward the small of your back
- Contract only the pelvic muscles
- Do not strain or tighten your thighs or buttocks
- Exhale gently and keep your mouth open each time you tighten your muscles
- You can check the muscles you are using in the mirror, or by inserting a finger into the vagina
- Interrupt your urine stream once a week
*Concentrate on these muscles, rather than ‘trying to stop the urine flow’, and do not perform the exercises while urinating, as this may actually disturb your normal urinating reflex8,15
Each contraction should be sustained for 10 seconds with a 10 second interval between contractions. Do three sets of 15 contractions each spread out during the day – 15 contractions in a lying down position, 15 contractions in a sitting position, and 15 in a standing position.
If your pelvic floor muscles are weak, you can contract for 2 to 5 seconds and increase up to 10 seconds.
†Pelvic floor exercises from Kincade JE, Dougherty et al. Urol Nurs 2005; 25(5):353-36313
3. Medication for treating OAB
There are a variety of medications that are available to treat symptoms of OAB in both men and women. Some of these are specific for the bladder and reduce involuntary bladder contractions, thereby reducing symptoms of urgency and improving quality of life.14 Newer forms of treatments available have fewer side effects than the older ones, and are more convenient as they only need to be taken once a day.6
