Most of us don’t spend much time thinking about our bladders, but for some, the bladder makes excessive demands for attention. Frequent, urgent trips to the bathroom interrupt meals and movies, force frequent bathroom stops on road trips, and prevent a good night’s sleep. If your bladder seems to control you life, you may be suffering from a condition know as overactive bladder.

According to Dr. Brad Stevenson, MD, over 40 million Americans are dealing with an overactive bladder. The sufferer of OAB has to deal with much more than the inconvenience of visiting the bathroom multiple times a day. In fact, those added trips to the bathroom, which quite frequently occur during the night, can keep you from getting a good night’s rest, which can impact your health and energy levels throughout the following day.

In a recent interview, Stevenson explained a little more about what OAB is and what the effects of it can be over the long term.

Q: What exactly is an overactive bladder?

A: Overactive bladder, or OAB, is a condition characterized by feelings of urinary urgency, frequency and nocturia, which is the need to wake up during the night to urinate. It also may be accompanied by incontinence, which is having the urge to urinate and not being able to hold it in before you can get to the bathroom.

Q: What causes an overactive bladder?

A: Overactive bladder can be caused by bladder inflammation or neurologic disease, but in most cases, we can’t find a specific cause for the problem. OAB is typically more common in women who are increasing in age, who have a history of vaginal deliveries, and who are postmenopausal.

Q: What are some of the symptoms associated with OAB?

A: Some people will have feelings of incomplete emptying, needing to urinate soon after they have finished urinating, frequent urination, strong urge to urinate and waking up at night to urinate.

Q: What treatments are available?

A: The first line treatment centers on bladder training, which has to do with bladder-control strategies, pelvic floor muscle training and fluid management -- controlling when and what you drink.

The second line of treatment involves medications, and the third line of treatment may call for bladder botox, sacral nerve stimulation (Interstim) and tibial nerve stimulation.

Q: You mentioned Interstim therapy? What exactly is that, and what does it entail?

A: The Interstim modifies the voiding reflex, which decreases the frequency of the “I need to go to the bathroom” signals sent from the bladder to the brain. It also helps increase the sufferer’s ability to postpone urination. This procedure is sometimes thought of as being similar to a pacemaker for the bladder.

Q: What are the advantages of doing this procedure/therapy?

A: People really like not having to take daily medication. Plus, once the implant is placed, it can last 5-7 years until the battery runs out, and replacement is a quick, outpatient procedure, so the level of effort for this therapy is relatively minimal.

Q: How is the procedure done?

A: The procedure is done in two stages. The first stage is placement of the lead followed by a trial lasting 1-2 weeks to see if the therapy is going to be effective.

During this time, the patient has a temporary external generator.

If the patient has a good response, the second stage is the placement of a surgically implanted generator. A trial lead can be placed in the office. Implantation of the device can be done under light sedation or as an outpatient procedure.

Q: What is recovery typically like?

A: Recovery is not extensive because the implant is only skin deep with a small incision. We instruct our patients to refrain from heavy lifting or excessive stretching after surgery to prevent dislodgement of the leads. Otherwise, the patient can resume normal activity the day following surgery.

If you want to see if you qualify for Interstim or you’re looking for more information about Interstim, the availability of the procedure or anything else related to OAB, visit the Ogden Clinic’s website.

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