Overactive Bladder

The following is an Editorial Resource from YourTotalHealth. 

Behavioral Techniques

Reviewed by: David O. Sussman, D.O., FACOS

Behavioral approaches to treating overactive bladder (OAB) are safe, noninvasive and have no side effects. Knowing that you can help control symptoms can promote your peace of mind.

Another benefit of behavioral therapies is that they can all be tried at once. They can also still be used if additional treatment is prescribed, such as medications. Behavioral techniques for OAB include a bladder diary, bladder training, Kegel exercises and biofeedback.

Bladder diary

Keeping a bladder diary is often a first step in treating overactive bladder. This is a written daily record of matters such as:

• What you drink (including the type, amount and when it’s consumed)
  
  
• How often you make trips to the bathroom
  
  
• How often you have an urgent or sudden need to urinate
  
  
• How often you have leakage and whether there may have been contributing factors (such as diet, stress or fatigue)

The facts noted in a bladder diary can help your doctor detect what may trigger your overactive bladder symptoms, and devise a treatment plan accordingly.

Bladder training

Your doctor can create a bladder training program for you. This technique involves making regular, timed trips to the restroom. Over time, the frequency of visits can be reduced.

Here’s an example of how bladder training works: Before training, let’s say you are urinating about every 40 minutes. Your bladder training program may start with trips to the bathroom every 60 minutes (during waking hours)—whether or not you feel the need to urinate. When you reach the 60-minute mark, the next goal could be every 90 minutes, then every two hours, and so forth.

Of course, the urge to urinate will likely strike before an assigned bathroom break. So, your doctor can help you learn techniques such as relaxation and Kegel exercises.

Kegel exercises

Developed in 1948 by Dr. Arnold Kegel, these exercises tighten the pelvic floor (the muscles and connective tissue that lie beneath and support the pelvic organs) and help treat incontinence stemming from conditions such as overactive bladder. As a bonus, they may improve your sex life because the same muscles are involved.

How can you tell if you’re working the right muscles during Kegel exercises? Well, if you can stop the flow of urine midstream and then resume urinating, you are working the correct muscles. However, this test should not be done more than about once a week, as it can interfere with bladder training. You also want to be careful to isolate these muscles by not holding your breath or contracting (tightening) the muscles of your stomach, thighs or buttocks.

To perform Kegel exercises:

1. Contract the pelvic floor muscles
   
   
2. Hold the contraction for as long as you can, up to 10 seconds
   
   
3. Relax for at least 10 seconds 
   
   
4. Repeat this 10 times, or as many times as you can, up to 10 (alternatively, you can do 5 to 10 short, fast contractions).

Perform these exercises 5 to 10 times a day for best results.

Biofeedback

Biofeedback is a technique that increases your control over bodily functions typically thought of as subconscious or involuntary. Various forms of biofeedback treat many medical conditions by lowering blood pressure, controlling pain, reducing stress and increasing relaxation.

Biofeedback may be used in combination with Kegel exercises. It can address overactive bladder by improving your ability to contract, relax and strengthen the pelvic muscles and bladder sphincter (the ring of muscle controlling the passage between bladder and urethra). A biofeedback therapist can teach you techniques you can practice at home.

Behavioral interventions are typically part of a doctor’s treatment plan for OAB. For some patients, they may be enough to control urinary symptoms. For others, they will be used in combination with other therapies, such as medications. Talk to your doctor to determine the best treatment plan for you.

What's Next: Medications

• Surgeries & Procedures
• Emotional Support

Review date: 07-31-2009