Treatment of overactive bladder disorder can be divided into three main areas, one is medication; the other is surgery. In addition, some bladder function training can be considered to enhance the treatment effect. However, the most important is also the use of medication, and only in the absence of progress, surgery is considered.
1, drug therapy anticholinergic drugs are oral and are now the main method of treatment of overactive bladder because of their high safety, most patients can reduce the abnormal contraction of bladder muscles and improve bladder urinary control after the correct use of drugs under the guidance of the doctor.
Medications are prescribed for various symptoms to relieve symptoms of overactive bladder, such as: (1) reducing abnormal contractions of the bladder muscles, i.e., reducing the number of sudden urinary urgency each day (2) increasing bladder capacity, i.e., reducing the frequency of urination (3) improving the function of the bladder in controlling urination, i.e., reducing urinary leakage Side effects of anticholinergic medications Side effects of medications vary from person to person. Traditional anticholinergic drugs, such as oxybutynin, do not target only the bladder tissue, but also the whole body. Therefore, there are more side effects, such as dry mouth, blurred vision and constipation, so patients taking traditional anticholinergics are more likely to give up and stop taking them on their own, affecting the progress of treatment.
The new generation of anticholinergic drugs, such as solifenacin, are more selective to bladder tissue and can target bladder tissue more intensely, so the side effects are relatively less, which is easier for patients to accept and greatly reduces the chance of giving up the medication.
Botulinum toxin injections are one of the methods used for more severe cases. Botox is often used in cosmetic applications, such as wrinkle removal and facial slimming, mainly to inhibit muscle contraction to achieve cosmetic results. Injections into the bladder are based on the same principle, mainly to stabilize the pelvic muscle tissue so that the bladder does not contract excessively. This method is more risky and expensive, and its efficacy can only be maintained for about 6-10 months, and patients need to receive injections again when the drug loses its power.
2. Surgical treatment Surgical treatment is only considered for patients who are more serious and whose conservative treatment with medication does not work. Surgery can be divided into two categories, one is traditional open surgery and the other is the newer minimally invasive treatment.
Traditional surgery involves cutting open the bladder, then cutting out a section of the patient’s small intestine and sewing the small intestine to the gap in the bladder, with the goal of increasing the capacity of the bladder so that the patient’s urine storage capacity rises. This surgical procedure is destructive and irreversible, so patients should be careful when choosing this surgical procedure.
The new minimally invasive procedure is sacral nerve electrical stimulation, commonly known as a bladder pacemaker. This surgical method does not damage the nerves or the body at all and does not change any structure of the body. This treatment is more common abroad because of its safety and effectiveness, and it is recommended that patients with good financial conditions and high quality of life requirements choose this surgical method.
Patients can use other complementary therapies, such as pelvic floor muscle training (i.e., bladder function training), to enhance the therapeutic effect. However, to effectively perform this adjunctive therapy, the correct position of the pelvic floor muscles must be identified, so the patient should be instructed by a physiotherapist or nurse specialist before performing this training on his or her own for better results.