7 Overactive Bladder Treatment Options When Oral Medication Is Not Working

February 03,2022 |
Man talking to his doctor.

Overactive bladder (OAB) is a range of urinary symptoms that vary from person to person. It can present itself through the presence of urgency, frequency, nocturia, and more. These can be consistent or come and go over time. There are many potential causes for OAB, and many doctors prescribe medications to help control symptoms. However, sometimes medications aren’t effective. Here are 7 overactive bladder treatment options when oral medication is not working.   


  1. Lifestyle Changes

    One of the best ways to address overactive bladder is through lifestyle changes. What you eat, drink, and how you exercise has a huge impact on how your urinary system functions. Since lifestyle changes lead to healthier decisions overall and don’t rely on pharmaceuticals or invasive procedures, they’re also the safest place to begin.

    Keep a Log

    The best place to start when trying to treat overactive bladder through lifestyle changes is to keep a log. Throughout the course of a day or two, write down everything that you drink—including the type of drink and how much is consumed—how many times you urinate, and how many times you experience overactive bladder symptoms such as accidents or incontinence. Include the suspected reason for these incidents such as leakage after a sneeze, cough, laugh, or due to the inability to reach a bathroom in time. This will give you an overview and a starting point to track treatment efficacy.

    Bladder Training

    Bladder training has been shown to be effective in treating a number of urologic conditions. Overtime, when living with overactive bladder, your muscles are re-trained to act and react a certain way. Therefore, you need to correct these problems with bladder training. Bladder training involves the act of resisting the urgency of having to urinate, postponing voiding for increasing amounts of time, and urinating based on a schedule rather than in response to an urge.

    Bladder training should be done slowly at first to strengthen your muscles and retrain your nerves. By focusing on controlling the urge, you’ll help to further strengthen your training. Talk to your urologist for more information on how bladder training can help you regain control of your urinary system.

    Dietary Changes

    There are certain foods that can exasperate the symptoms of overactive bladder. Try to limit these foods and see if they help you to overcome any major issues. Tomatoes and tomato-based products, chocolate, spicy foods, acidic foods, and foods that are filled with artificial sweeteners can negatively impact your bladder. Eliminate them and continue keeping your log to monitor the effects.

    Stay Properly Hydrated

    In conjunction with dietary changes, be more conscious of what you’re drinking. While many people think that avoiding fluid intake can help manage symptoms, you should be staying hydrated. Dehydration can worsen symptoms and cause problems elsewhere. Highly concentrated urine is considered a bladder irritant that can actually increase the number of times you feel the need to urinate. To hydrate, stick with water. Tea, coffee, alcohol, citrus juices and fruits, acidic drinks, drinks with artificial sweeteners, and caffeinated beverages should be eliminated or drank in moderation.

    Pelvic Floor Exercises

    Pelvic floor exercises help you strengthen the muscles that support your bladder. This helps to reduce stress and urge incontinence and limit the number and severity of accidents. The most popular pelvic floor exercises are kegels, but there are a number of different workouts that you can incorporate into your daily routine.

    Improving Bowel Regularity

    Working towards more regular bowel movements can help you avoid putting unnecessary pressure on your bladder. If you’re constipated, it negatively affects your bladder function, which is problematic in people with overactive bladder. To help improve bowel regularity, make sure that you’re eating a healthy amount of fiber every day, exercise regularly, and talk to your doctor about probiotic use.

    Maintaining a Healthy Weight

    If you’re overweight, try making healthy lifestyle changes to lose fat. The more weight that you carry, the more pressure your bladder is under. Weight loss can help you alleviate urinary problems and improve your health in other areas as well.

    Quit Smoking

    Smoking has a big impact on your urologic health. The smoke is extremely irritating to your bladder and increases your tendency to cough, which can lead to leakage and other overactive bladder symptoms. If you need help quitting, ask your doctor for resources.


  2. Consider at Home Remedies

    There are a few natural remedies that some people have found successful at treating their overactive bladder symptoms. However, even though many of these options include herbal supplements or natural products, you still need to check with your doctor prior to adding them to your routine. If you’re taking other medications or supplements, the interactions may lead to side effects or problems.

    Chinese Herbal Blends

    Some people have found that Chinese herbal blends have been effective at reducing the severity of their symptoms. One option is Gosha-jinki-gan (GJG) and the other is Hachimi-jio-gan (HE).

    Ganoderma Lucidum (GL)

    Ganoderma lucidum is another natural supplement from Asia. It’s made out of a type of mushroom and has shown promising results in some studies at helping treat overactive bladder.

    Corn Silk

    Corn silk is used in many countries around the world to help address urinary ailments. Some researchers believe it could help to strengthen membranes in the urinary tract.


    Capsaicin is found in chilies and has been known to help a number of issues ranging from pelvic pain syndrome to metabolism problems. If you don’t like chile peppers, there are supplements for capsaicin without the heat.


  3. Vaginal Pessary

    Women suffering from OAB have the option to undergo vaginal pessary as a treatment. This involves inserting a small device into the vagina that is aimed at treating overactive bladder symptoms caused by bladder prolapse. The device is removable and comes in a variety of different shapes and sizes to fit each woman’s lifestyle.


  4. Botox Injections

    Botox is primarily associated with anti-aging procedures that aim to eliminate wrinkles, but there are actually quite a few other applications. Botox injections into the bladder muscles create a calming effect that can help target urinary urgency and leakage related to urgency. Botox injections are often only needed a few times a year to be effective and side effects are minimal for most people. Talk to your doctor about your risk for more serious side effects or for developing urinary tract infections. 


  5. Sacral Neuromodulation

    Another overactive bladder treatment involves targeting the nerves to help improve bladder control. One of the most popular types of nerve stimulation is sacral nerve stimulation. This targets the nerves that directly control the bladder using a neurotransmitter that’s implanted under the patient’s skin. It’s a small implantation device that sends electrical impulses to the sacral nerve, which in turn helps improve bladder control. By undergoing sacral neuromodulation, many patients have seen a decrease in the frequency in which they need to void and reduced incontinence problems.


  6. Percutaneous Tibial Nerve Stimulation (PTNS)

    Percutaneous tibial nerved stimulation is another common type of nerve stimulation used to treat OAB. PTNS is an outpatient procedure that needs to be repeated over time. It begins with weekly sessions for 12 weeks and then repeated once a month. PTNS helps to stimulate bladder control with impulses that are administered near a nerve branch that ends close to the ankle.


  7. Surgery

If all else fails, your doctor may recommend undergoing urologic surgery. This should be a last resort, as surgery is associated with higher risks of infection and complications. Bladder augmentation surgery is only recommended in severe cases and when other treatments don’t work. It involves using a section of your large intestine to expand the bladder, giving your body more room to store urine. This helps alleviate the pressure and subsequently eliminate or severely reduce any OAB symptoms. It should be known that when you undergo bladder augmentation surgery, you will no longer be able to urinate naturally. Instead, your doctor will work with you to teach you how to use intermittent self-catheterization to empty your bladder. While this process gets easier over time, many people do not want to rely on catherization to use the bathroom. Luckily, in most cases, alternative treatment options for OAB are sufficient to alleviate symptoms. 

If you’re suffering from the symptoms of overactive bladder, don’t hesitate to schedule an appointment with your urologist. It’s important to address any underlying causes and there are plenty of treatment options you can undergo to eliminate or reduce annoying and embarrassing symptoms. For more information on improving your urologic health, or for support of common urologic conditions like overactive bladder, Byram Healthcare is available to help.