There are many treatment options available for people with OAB. As OAB is a group of symptoms rather than a disease, it is up to the individual to determine the level of treatment that they wish to have.
It is important to realise that although OAB is very common, people do not have to suffer in silence and live with symptoms that they find intolerable and which impact negatively on their quality of life.
The treatment options for OAB can be regarded as having different levels with a person progressing through the levels depending on the severity of their symptoms, their response to treatment and whether they have achieved what they regard as good control of their urinary symptoms.
Dr McKertich offers a range of treatment options for the treatment of overactive bladder and urge urinary incontinence. Treatment is modified to suit the individual’s problems after a full assessment of symptoms, physical examination and further testing and most importantly, the individual’s preferences for treatment.
First line treatments for Overactive Bladder
First line treatments for overactive bladder are also known as behavioural therapies as they do not involve medications. These include:
Behavioural therapies can be combined with medications.
Second line treatments for Overactive Bladder
Many drug therapies are available to treat OAB.
There are 2 main classes of drugs available to treat this problem- “anticholinergic” medications and “selective beta-3 adrenergic agonists”.
Both of these classes of medication are thought to act:
- By changing abnormal nerve signalling in the nerve pathways of the bladder and
- By relaxing the bladder muscle and helping to prevent involuntary bladder muscle contractions
Anticholinergic medications include (listed in alphabetical order; no hierarchy is implied):
- Darifenacin – marketed as Enablex®
- oral oxybutynin – marketed as Ditropan®
- transdermal (skin patch formulation) oxybutynin-marketed as the Oxytrol® Patch
- Solifenacin – marketed as Vesicare®
- Tolterodine – marketed as Detrusitol®
Selective beta-3 adrenergic agonist medications:
- First released in 2014 in Australia for the treatment of overactive bladder
- Mirabegron (marketed as Betmiga®) is the first drug of this class to be commercially available
Third line treatments for Overactive Bladder
- Botulinum toxin (Botox®) injections into the bladder
- Neuromodulation – altering nerve messages or signals to the bladder using electrical stimulation by:
- Posterior tibial nerve stimulation (PTNS) or
- Sacral neuromodulation using InterStim®