The American Urological Association recommends a thorough evaluation before
treatment of OAB, and the Urology Care Foundation suggests that the first thing
to try to manage overactive bladder is lifestyle changes. In their experience, most
patients don’t get rid of all their symptoms with lifestyle changes, but many do
have fewer symptoms.

The following advice is modified from that provided by the
Urology Care Foundation.

Limit food and drinks that you find “bladder irritating”
Foods and drinks that increase OAB symptoms among some people include coffee,
tea, artificial sweeteners, caffeine, alcohol, soda, and other fizzy drinks, citrus fruit,
food made with tomatoes, chocolate, and spicy foods. One strategy is to avoid all
“bladder irritating” foods and then add them back one at a time.

Keep a daily “bladder diary”
Write down what you eat and drink, and when and how many trips you make to the
bathroom for a few days. This can help you and your health care provider better
understand your condition. A diary may help identify foods or other things that
make symptoms worse. For example, are they worse when you don’t drink enough
or drink too much liquid?

Double voiding (emptying your bladder twice)
This may be helpful, especially for men with enlarged prostates who have trouble
emptying their bladder completely. After you urinate, wait a few seconds or minutes
and then try again to urinate.

Delayed voiding
To retrain your bladder, put off urination, even when you feel an urge. At first, you
wait just a few minutes. Gradually you will be able to wait much longer between
bathroom visits. The Urology Care Foundation suggests that it is important to try
this only if your health care provider tells you to. Some people will have worse
symptoms or have urine leaks when they ignore an urge or wait too long to urinate.

Scheduled voiding
Instead of going when you feel the urge, you urinate on a schedule at set times
during the day. Depending on how often you urinate now, your health care provider
may ask you to urinate every 2 to 4 hours, whether you feel you have to go or not.

Exercises to relax your bladder muscle
These can help decrease urgency. Some call these exercises “quick flicks” because
you quickly squeeze and release the muscles in your pelvis several times. When you
get the urge to urinate, squeeze, and then relax your pelvic floor muscles as quickly
as you can. Do this several times in a row when you feel the urge to go. This sends
a message to your nervous system and back to your bladder to stop contracting. As
your bladder stops contracting and starts relaxing, your urge to urinate should lessen.
When you do this exercise, it helps to be still, relax, and concentrate just on the
“quick flick” contractions. Your health care provider can explain this exercise in
more detail. Regularly doing these “Kegel” pelvic floor exercises may benefit both
women and men by reducing the involuntary contraction of bladder muscles. It can
take up to two months for these exercises to be beneficial.

Prescription drugs and injections
When lifestyle changes don’t help enough, your health care provider may offer a
prescription drug to relax the bladder muscle. Common side effects include dry
mouth and eyes, constipation, and blurred vision. If lifestyle changes and prescription
drugs don’t work, a urologist may recommend injections of botulinum toxin
(Botox®) into your bladder muscle to partially paralyze and relax it. The drug may
help keep your bladder from contracting too often, but it could cause urinary retention
(not emptying your bladder completely) and require temporary use of a catheter
to empty your bladder.

Nerve stimulation
When drugs or lifestyle changes don’t work, neuromodulation therapy can be used
to deliver electrical pulses to nerves to change how they work. There are two types
of neuromodulation therapy. Sacral neuromodulation (SNS) entails the placement
of a “bladder pacemaker,” a device that delivers electrical impulses via the sacral
nerves to the bladder to stop the signals that can cause OAB. The other form is percutaneous
tibial nerve stimulation (PTNS). This therapy stimulates the tibial nerve,
which runs along your knee to the sacral nerves. The electrical pulses help block the
nerve signals that aren’t working correctly.

Finally, if treatment is not successful in controlling urinary incontinence, a person
can manage their bladder problems with one of the many devices and products that
collect and hold urine.

This blog presents opinions and ideas and is intended to provide helpful general information. I am not engaged in rendering advice or services to the individual reader. The ideas, procedures and suggestions in that are presented are not in any way a substitute for the advice and care of the reader’s own physician or other medical professional based on the reader’s own individual conditions, symptoms or concerns. If the reader needs personal medical, health, dietary, exercise or other assistance or advice the reader should consult a physician and/or other qualified health professionals. The author specifically disclaims all responsibility for any injury, damage or loss that the reader may incur as a direct or indirect consequence of following any directions or suggestions given in this blog or participating in any programs described in this blog or in the book, The Building Blocks of Health––How to Optimize Your Health with a Lifestyle Checklist (available in print or downloaded at Amazon, Apple, Barnes and Noble and elsewhere). Copyright 2021 by J. Joseph Speidel.