Overactive bladder (OAB), also known as overactive bladder syndrome, is a condition where there is a frequent feeling of needing to urinate to a degree that it negatively affects a person's life. The frequent need to urinate may occur during the day, at night, or both. If there is loss of bladder control then it is known as urge incontinence. More than 40% of people with overactive bladder have incontinence. While about 40% to 70% of urinary incontinence is due to overactive bladder, it is not life-threatening. Most people with the condition have problems for years.
Interstim Therapy
There are many different methods to treat incontinence. Sacral stimulation is one of the new techniques developed for this condition. Interstim is a small device which is of a size of a pacemaker. It is fitted in the buttock under the skin. One set of leads are attached to the sacral nerves that supply the bladder and the other set is connected to a control that is tied at the wrist. When the person feels a need to void, he can press the wrist band. This sends signals to the sacral nerves and their action and influence on the pelvic floor muscles, urinary tract, bladder muscles and sphincters is modulated. The person can then void at his own wish.
This therapy is relatively new and it has to be tried for 3-7 days to determine whether a person is suitable for it. The surgeon fits it to the ankle and then connects the leads to the sacral nerves in the lower back and the other set to the control tied at the wrist. The person is sent home and asked to see for a change in the urine output frequency. If the number of visits to the washroom reduces significantly, then the therapy is considered useful for long term.
There are few disadvantages of this technique. There can be a new pain, infection, lead migration, technical errors because of the device. The technique can only be used for various types of neurogenic bladder and not for incontinence due to any mechanical obstruction.
Botox
This is another new technique which is still in its infancy. It can be used for spasmodic or overactive bladders. Botox is a chemical that causes temporary paralysis of muscles. When Botox injections are given to spasmodic bladder muscles, they undergo relaxation. As a result they do not undergo immediate contraction when the bladder fills with less amount of urine. The method is useful as you can control the bladder emptying, but as the effect is transient, repeated injections at an interval of 6 months are required to sustain the desired effect. The drawback is that the bladder may become flaccid with repeated injections causing urine retention and infection.
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