Dr. Dean Elterman, MD, MSc, FRCSC Urological Surgeon

Duration: 2 minute 40 seconds

In terms of treating overactive bladder, the first thing you want to do is rule out other causes. Things like drinking too much fluid for example, or having a urinary tract infection, and other other medical conditions like diabetes or other comorbidities. And then if we really do think there's an overactive bladder, we have a first line approach, followed by a second line and third line treatments . First line treatments are really more things around lifestyle and behavior. In addition to reducing fluid, we can also reduce or cut out things that are considered bladder irritants. These include, caffeine, and alcohol and spicy foods. The other thing that we can do as a first line strategy is something called bladder retraining with pelvic floor physiotherapy. There are physical therapists who are specially trained to work on urinary symptoms. And it's not just for people who have leakage of urine. They're not just going to be doing Kegel exercises with you. They actually have a variety of different types of physiotherapy maneuvers and exercises that can help reduce and almost retrain the bladder to hold urine for longer periods of time.

If we try all these things, and we don't have much success or not enough success, then we can go to second line treatments and those are medications. There are prescription drugs that people can take one tablet per day. And as long as you're taking this medication, it can help control symptoms. This medication is designed to help work on the bladder to facilitate more bladder relaxation or more storage or prevent the bladder from being too overactive.

In very rare instances where the overactive bladder isn't being treated effectively enough with the medication, we then have third line treatments. These include things like the injection of liquid medicine into the bladder called Botox. We also have something which is really quite unique, which is a bladder pacemaker, also known as sacral neuromodulation. So it's exactly like taking a small battery, and we can use it on the nerves that control the bladder to help regulate those as well.

These are the various types of treatments from non invasive, behavioral and lifestyle modifications, through to prescription medications and all the way through to really specialized types of treatments.

Presenter: Dr. Dean Elterman, Urologist, Toronto, ON

Local Practitioners: Urologist