Neurogenic Bladder: Bladder Treatment
What are the treatments for overactive bladder?
The treatment for a bladder control problem depends on the cause of the nerve damage and the type of voiding dysfunction that results.
In the case of overactive bladder, your doctor may suggest a number of strategies, including bladder training, electrical stimulation, drug therapy, and, in severe cases where all other treatments have failed, surgery.
Bladder training. Your doctor may ask you to keep a bladder diary—a record of your fluid intake, trips to the bathroom, and episodes of urine leakage. This record may indicate a pattern and suggest ways to avoid accidents by making a point of using the bathroom at certain times of the day—a practice called timed voiding. As you gain control, you can extend the time between trips to the bathroom. Bladder training also includes Kegel exercises to strengthen the muscles that hold in urine.
Electrical stimulation. Mild electrical pulses can be used to stimulate the nerves that control the bladder and sphincter muscles. (See Figure 2 above - A device can be placed under your skin to deliver mild electrical pulses to the nerves that control bladder function.) Depending on which nerves the doctor plans to treat, these pulses can be given through the vagina or anus, or by using patches on the skin. Another method is a minor surgical procedure to place the electric wire near the tailbone. If you have this procedure, it will involve two steps. In the first step, the wire will be placed and connected to a temporary stimulator, which you carry with you for several days. If your condition improves during this trial period, then you go on to the second step. The wire is placed next to the tailbone and attached to a permanent stimulator under your skin.
Adapted and excerpted from the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health.
Reviewed by Francine Kaufman, MD. 01/09
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