Non-medication treatments

There are many non-medication treatment options available for overactive bladder (OAB), including:

• lifestyle changes
• bladder training
• Kegel exercises
• functional electrical stimulation (FES)
• biofeedback
• surgery

The Canadian Urology Association (CUA) recommends trying lifestyle changes and bladder training before considering other types of treatment. Non-medication treatments may be used alone or in combination with medications. Talk to your doctor about which treatments would be appropriate for you.

Lifestyle changes

Caffeine and alcohol can irritate the bladder and increase urination. Therefore, limiting your intake of caffeine and alcohol can help you manage your OAB.

Changing your fluid intake can also help relieve your symptoms.Your doctor may also ask you to limit your fluid intake to 1 to 1.5 litres per day. You should always discuss any change in fluid intake with your doctor first, especially if you have kidney stones or a urinary tract infection.

Other lifestyle changes that may help with managing OAB include losing weight, taking precautions against urinary tract infections, and preventing constipation.

Bladder training (bladder drill)

Bladder training can help your bladder hold a larger volume of urine. It can also help you gain more control over the urge to urinate. With bladder training, you gradually increase the time between bathroom visits. This will decrease urgency and leakage of urine over time. Your doctor can help you with this technique and help you schedule times to visit the bathroom. A bladder diary will help you keep track of your schedule.

Kegel exercises (pelvic floor muscle retraining)

Kegel exercises involve alternately contracting and relaxing the pelvic floor muscles. To find out if you are contracting the right muscles, try stopping your urine flow while you're urinating. The muscles you use here are the same ones that you will use for Kegel exercises.

Start by contracting and releasing the pelvic floor muscles for 5 seconds at a time. Keep increasing the time until you are tensing the muscles for 10 seconds and releasing them for 10 seconds. Do 3 sets of 10 Kegel exercises per day.

If you're having trouble finding the right muscles, talk to your doctor for help. Kegel exercises can help prevent involuntary contraction of the detrusor muscle by strengthening the muscles of the pelvic floor. To be successful, it's important to follow your health care professional's recommended program. When done diligently, the benefits of Kegel exercises are usually seen in about 6 to 12 months.

Functional Electrical Stimulation (FES)

A new procedure known as FES involves electrically stimulating a nerve in the pelvic floor to cause muscles to contract or prevent the bladder muscles from contracting. This is useful if you have difficulty contracting the pelvic muscles yourself.

Biofeedback

Biofeedback is a training process that helps people gain more control over their pelvic floor muscles. It can be used to help people gain more benefit from pelvic floor muscle exercises (e.g., Kegel exercises). Biofeedback can use FES and other techniques (such as vaginal balloons) to help identify the correct muscles.

Surgery

This treatment option is appropriate for people who don't get relief from other treatments. The most common surgical procedure involves implanting a device which continuously stimulates the pelvic nerve with small amounts of electricity. This prevents the detrusor muscle from contracting involuntarily.

Other surgical procedures involve removing certain nerves, making the bladder larger, removing part of the detrusor muscle to allow increased filling of the bladder or creating a different pathway for the urine to be drained (using other body tissue such as a part of the intestine).

Knowing what to expect from your treatment:

When starting a new treatment, it's important to know what to expect, including when it will start working, which symptoms it will help with, and how much you can expect it to help with your symptoms. To learn more about what to expect from your treatment, see Getting the most from your treatment, or speak to your doctor.

To learn more about how OAB can affect your life, visit www.overactivebladder.ca.