Overactive bladder treatment: help for urgency, frequent urination and leaks

Does this sound like overactive bladder?

Overactive bladder (OAB) is a group of symptoms, not a single disease. The main one is a sudden "gotta go" urge that is hard to hold off. Many people also have frequent urination (more than 8 times a day), wake repeatedly at night to pee, or leak on the way to the bathroom, which is called urge incontinence. It affects women and men, and in men it often comes along with an enlarged prostate.

See us promptly rather than routinely if the urgency comes with burning, fever, blood in the urine, or pain, because infection, stones and other causes need to be ruled out first. Our bladder leakage page covers the different kinds of leaks.

What happens at an overactive bladder visit?

The visit starts with your story: how often you go, how strong the urge is, what you drink and which medicines you take. We check a urine sample for infection or blood and do a quick ultrasound bladder scan to see whether you empty fully. A bladder diary kept for a few days of drinks, trips and leaks is one of the most useful tools, so bring one if you can. When symptoms are complex or treatments have not worked, urodynamic testing measures how the bladder fills and empties.

Which overactive bladder treatments do we offer?

The steps below follow the overactive bladder page on advancedurology.com, and most people start with the first steps.

• Bladder training and habit changes. Timed voiding, cutting back on caffeine, alcohol and evening fluids, and pelvic floor muscle exercises.
• Pelvic floor therapy. Guided exercises and magnetic pelvic floor therapy to strengthen the muscles that help hold urine.
• Medicines. Two main families calm the bladder muscle; our urologists choose between them based on your health and other medicines.
• Bladder Botox. Botox injected into the bladder wall during a short office procedure relaxes an overactive muscle; the effect wears off over months, so it is repeated.
• InterStim (sacral nerve stimulation). A small implanted device adjusts the nerve signals between the bladder and the brain, starting with a trial; see the nerve stimulation page.
• Altaviva. A small implant placed near the ankle that stimulates a nerve involved in bladder control; see the Altaviva page.

Where is overactive bladder treated?

Visits, bladder scans, bladder diaries and medicine follow-ups happen at Lawrenceville, Braselton or Oakwood. Our team tells you where a bladder Botox session or an InterStim or Altaviva procedure will be done when it is scheduled, and follow-up visits stay at the office you chose.

What if I also have bowel leakage?

Some people with overactive bladder also have accidental bowel leakage or a loss of bowel control. The sacral nerves involved in bladder control also help with bowel control, so tell us about both. Our bowel leakage page explains fecal incontinence treatment, and our InterStim for bowel control page covers the test phase when conservative bowel care is not enough.

What do patients ask?

How many bathroom trips a day is too many?

Urinating more than 8 times a day, or waking repeatedly at night to urinate, is worth discussing, especially if it disrupts sleep or work. Urgency with burning, fever or blood in the urine needs a prompt visit to rule out infection.

Should I drink less water to stop the urge?

Cutting fluids too much makes urine more concentrated, which can irritate the bladder and raise the risk of stones. It usually works better to spread fluids through the day and cut back on caffeine, alcohol and fizzy drinks, especially in the evening.

What if bladder medicines did not help?

That is common, and it is when bladder Botox, InterStim or Altaviva come in. Our urologists may order urodynamic testing first to confirm the bladder muscle is the cause.

Is bladder Botox done in the office?

Yes, bladder Botox is a short office procedure using a thin scope and numbing medicine. A follow-up checks how well you empty afterward, because a few people have trouble emptying for a while.

Can men have overactive bladder?

Yes. In men it often comes along with an enlarged prostate, so the visit checks both with a urine test and a bladder scan; our enlarged prostate treatment page covers the prostate side.

Does frequent urination always mean overactive bladder?

No. Diabetes, a urinary infection, some blood pressure medicines, an enlarged prostate and drinking a lot late in the day can all cause frequent urination. A urine test and a bladder diary help tell them apart.

Which video can help?

Who treats overactive bladder at our offices?

These are the urologists and physician assistants who see patients at our Lawrenceville, Braselton and Oakwood offices. Physician assistants see patients for evaluation and follow-up; implant procedures are performed by our urologists.

• Dr. Hemant Chaparala, Urologist: sees patients at Lawrenceville, Braselton and Oakwood
• Dr. Michael F. Nordsiek, Urologist: sees patients at Lawrenceville
• Dr. Mukesh Patel, Urologist: sees patients at Lawrenceville
• Dr. Vik Sabarwal, Urologist: sees patients at Lawrenceville and Braselton
• Dr. Nicholas Farber, Urologist: sees patients at Braselton
• Ian Thomas, PA-C, Physician Assistant: sees patients at Lawrenceville and Oakwood
• Jordon Blackmon, PA-C, Physician Assistant: sees patients at Lawrenceville
• Lucy Choi, PA-C, Physician Assistant: sees patients at Lawrenceville and Braselton
• Sarah Nayebosadri, PA-C, Physician Assistant: sees patients at Braselton

Where can you be seen for this?

Our Lawrenceville Clinic & Surgery Center on Crown Pointe Way has exam rooms, imaging and an outpatient surgery center under one roof. Our Braselton Clinic on Old Winder Hwy cares for Braselton, Hoschton, Jefferson and Buford families. Gainesville, Flowery Branch and other Hall County patients are seen at our Oakwood Clinic on Mundy Mill Road. Any procedure from the Braselton or Oakwood offices is done at the Lawrenceville surgery center.