Other surgery for overactive bladder (OAB)

The vast majority of patients with overactive bladder (OAB) will respond to the following treatment measures:

• 1^st line treatments
  • Behavioural changes
  • Bladder retraining
  • Pelvic floor physiotherapy
• 2^nd line treatments
  • Anticholinergic medication
  • Selective beta 3 agonist medication
• 3^rd line treatments
  • Posterior tibial nerve stimulation (PTNS)
  • Botulinum toxin (Botox®)
  • Sacral neuromodulation (SNM) with the InterStim® device

As a result major surgery for people with OAB is rarely necessary.

Other surgery for Overactive Bladder (OAB)

Patients who are refractory (poorly responsive or unresponsive) to the above treatment options are potential candidates for major surgical procedures such as:

• Bladder augmentation surgery
  • Use of a segment of bowel to enlarge the bladder which helps stop abnormal muscle contractions in the bladder.
• Urinary diversion surgery through a “conduit”
  • Use of a segment of bowel to divert urine away from the bladder, which results in the patient having a permanent urine drainage bag on the abdomen.
• Urinary diversion surgery with a continent catheterisable stoma
  • Use of a segment of bowel to divert urine away from the bladder to the skin with a small stoma (or opening) on the abdominal skin through which the patient performs intermittent self-catheterisation to empty the bladder.
• Other alternatives include the use of permanent catheters (permanent tubes to drain the urine) or managing and living with the problem when simpler options do not help or are not suitable.

It is important to remember that the vast majority of people suffering from OAB symptoms can be helped and their symptoms improved without any major surgery and often with medical management.

The first step is to ask for help as much can be done to improve the quality of life of people with OAB. Once treatment options are discussed, it will be up to the individual to decide how far to progress with treatment.