Overactive Bladder

Tens of millions of people are affected by problems with bladder control. If you are one of them, now is the time to take action and get relief.

You Deserve Relief from Bladder Control Problems

Overactive bladder (OAB) is not a normal part of aging, and is a treatable condition. Help is available. Do you qualify?

Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information. Important Safety Information.

Symptoms of Overactive Bladder

If you are dealing with bladder control problems associated with overactive bladder, you owe it to yourself to see a urinary incontinence specialist like Academic Urology & Urogynecology of Arizona. A symptom tracker may help get a better idea of our daily symptoms and help confirm the diagnosis.

What is Urinary Retention?

Urinary retention happens when one loses the ability to partially or completely empty their bladder. You may or may not be able to start urination, but if you do start, you cannot fully empty your bladder.

Does This Sound Familiar?

• Difficulty starting to urinate
• Difficulty fully emptying the bladder
• Weak dribble or stream of urine
• Loss of small amounts of urine during the day
• Inability to feel when bladder is full
• Increased abdominal pressure
• Lack of urge to urinate
• Strained efforts to push urine out of the bladder
• Frequent urination nocturia (waking up more than two times at night to urinate)

Why Is This Happening?

Urinary retention comes in two types: obstructive and non-obstructive. When there is an obstruction like kidney stones, urine cannot freely flow through the urinary tract. A weak bladder muscle or nerve problems that interfere with signals from the brain are examples of non-obstructive causes. Nerve problems can also mean that you don’t realize your bladder is full.

Treat Your Urinary Retention and Worry Less

Urinary retention is treatable. Make sure your doctor knows about your symptoms and how they affect your daily life, so your doctor can find the right treatment for you.

Treatment Options for Overactive Bladder (OAB)

There are many treatment options for overactive bladder. If conservative treatments aren’t working for you, it may be time to explore other options.

Lifestyle Changes

While some experience relief from more conservative treatments, they don’t help everyone. The below are some examples of common behavioral changes you may have already tried.

• Diet and exercise: Decreasing caffeine intake and exercising more are common examples.
• Bladder retraining: This involves delaying going to the bathroom and sticking to a strict schedule, and is called biofeedback.
• Pelvic floor strengthening: This involves repeatedly contracting and relaxing the muscles of the pelvic floor, also known as Kegel exercises.

Oral Medications

When these simple interventions don’t yield the desired results, oral medications are often tried next. While these medications can help control symptoms, they sometimes cause other issues.

When using oral medications, you need to take them every day. Side effects such as blurry vision, constipation, dry mouth, and hypertension can be unpleasant. Others are more serious. One class of OAB drugs, anticholinergics, may even increase dementia risk in elderly people.⁴ Furthermore, medications don’t always work. One survey found that 72% of people stopped taking medication for overactive bladder after just six months.⁵

Advanced Therapies

When lifestyle and medication interventions fail, it’s time to explore other options.

• Medtronic Bladder Control Therapy delivered by the InterStim Systems*
• Try it during an evaluation
• Proven long-term relief ⁶

The InterStim system carries similar risks to other surgical procedures, including swelling, bruising, bleeding, and infection. Your doctor can tell you how to minimize these risks. The evaluation can also bring complications, including movement of the wire, technical problems from the device, and potentially some temporary pain. Your doctor or nurse at AUUA will explain how to operate the test device, and inform you of all precautions related to the evaluation and activity restrictions.

*Medtronic Bladder Control Therapies do not treat obstructive urinary retention.

Medtronic Bladder Control Therapy Delivered by the InterStim Systems

There is increasing evidence suggesting that breakdowns in the brain-bladder communication pathway may be at the root of overactive bladder (OAB) and non-obstructive urinary retention.^{7, 8, 9} This is precisely why conventional treatments can often be disappointing—they don’t address the root cause. Unlike other treatments, the Medtronic InterStim systems provide gentle stimulation to the sacral nerves in the pelvic area responsible for controlling the bladder.^{10, 11} This may help restore* brain-bladder communication and reduce symptoms.

Take Control with the InterStim Systems^{12, 13}

In addition to risks related to surgery, complications can include pain at the implant sites, new pain, infection, lead (thin wire) movement/migration, device problems, undesirable changes in urinary or bowel function, and uncomfortable stimulation (sometimes described as a jolting or shocking feeling). Talk with your doctor about ways to minimize these risks.

Is InterStim Right for You?

If the following apply to you, you may be a good candidate for Medtronic Bladder Control Therapy delivered by the InterStim systems:

• You have significant overactive bladder (OAB) symptoms or non-obstructive urinary retention
• You’ve tried oral medications and lifestyle changes
• Conventional therapies haven’t given you the relief you want

Take the Test and Take Control

The first step to taking back control is to contact Academic Urology & Urogynecology of Arizona for an evaluation for an InterStim system.

Unlike other bladder control treatments, the InterStim lets you try it first with an evaluation, so you can have a test run before deciding on a long-term commitment.

Here’s how it works:

• The simple test starts at your doctor’s office or an outpatient center.
• A lead (thin wire) is inserted in the upper part of your buttock.
• The lead attaches to a small external device worn discreetly under your clothes.
• Stop, start, or adjust the therapy settings, with an easy-to-use programmer that resembles a smartphone.
• Go about most of your regular activities for 3 to 14 days
• Track your symptoms to see if they improve

Complications can occur with the evaluation, including movement of the wire, technical problems with the device, and some temporary pain. Your doctor or nurse will show you how to use the system and inform you of any activity restrictions and other precautions related to the evaluation.

Personalize Your Treatment

After your test you will talk to your doctor at AUUA about the results. Your provider will help you choose a personalized solution for you that leads to long-term results. The evaluation device can be replaced with an implantable device called a neurostimulator in a short, outpatient procedure.

Like any surgical procedure, bladder control therapy has risks. Pain at the implant sites, new pain, lead migration, infection, technical or device problems, adverse change in bowel or voiding function, and undesirable stimulation or sensations are among the most common adverse reactions. These may cause a return of symptoms or require additional surgery. Discuss the potential risks and benefits with your doctor.

Download Brochure

*Restored function defined as a 50% or greater reduction in dysfunctional voiding symptoms from baseline.

**Numbers reflect completers analysis defined as patients with diary data at baseline and 12 months (n=220). Clinical success was 82% at 12 months using the modified completers analysis (subjects who either had a baseline and 12-month evaluation or withdrew early due to device-related reasons and are considered failures). Success defined as a 50% or greater reduction in your troublesome bladder symptoms.

Frequently Asked Questions

Why is this therapy different?
Medtronic’s InterStim allows you to try it before you decide, and is totally reversible. Unlike injections, it doesn’t require self catheterization or repeated treatment visits.

What can this therapy do for me?
InterStim can significantly reduce symptoms in people who have frequent urges to urinate, have frequent leaks, or are unable to fully empty their bladder.¹⁶

Will it cure my condition?
No. While effective, it is not a cure. Symptoms can return if the neurostimulator is turned off or removed. What does the stimulation feel like? The stimulation from the InterStim is often described as a tingling, flutter, or vibration in the pelvic area. It shouldn’t be painful. Stimulation settings are adjustable, and the sensations vary from person to person.

Can I have an MRI?
People with an InterStim system can have a full-body MRI scan under certain conditions. Your doctor will determine whether you meet those conditions.

Will insurance cover the costs?
This therapy is covered under Medicare and by many private insurance companies. Talk to your doctor to learn more about your insurance coverage.

Informational Videos

Resources

Bladder Symptom Diary
Record your symptoms to help your doctor understand your condition.

Care Pathway for Bladder Control
Understand all of your treatment options for dealing with bladder control issues.

Doctor Discussion Guide
Starting the conversation can be hard. This guide can help you talk to your doctor.

Medtronic Bladder Control Therapies
Understand your options and decide if a Medtronic Bladder Control Therapy is right for you.

References

1. Stewart WF, Van Rooyen JB, Cundiff GW, et al. World J Urol. 2003;20(6):327-336.2. US Census Bureau 2020.
2. US adult and under-age-18 populations: 2020 census. https://www.census.gov/library/visualizations/interactive/adult-and-under-the-age-of-18-populations-2020-census.html. Accessed June 20, 2022.
3. Leede Research, “Views on OAB: A Study for the National Association of Continence.” December 16, 2015.
4. Gray S, Anderson M, Dublin S et al. Cumulative use of strong anticholinergics and incident dementia. JAMA Intern Med. 2015;175(3):401-407.
5. Yeaw J, Benner J, Walt JG et al. Comparing adherence and persistence across 6 chronic medication classes. J Manag Care Pharm. 2009:15(9): 724-736.
6. Siegel S, Noblett K, Mangel J, et al. Five year follow-up results of a prospective, multicenter study in overactive bladder subjects treated with sacral neuromodulation. 2018; 199(1), 229-236.
7. Dasgupta R. Critchley HD, Dolan RJ, Fowler CJ. Changes in brain activity following sacral neuromodulation for urinary retention. J Urol. 2005; 174:2268-2272.
8. Griffiths D, Derbyshire S, Stenger A, Resnick N. Brain control of normal and overactive bladder. J Urol. 2005; 174:1862-1867.
9. Griffiths D, Tadic SD. Bladder control, urgency, and urge incontinence: evidence from functional brain imaging. Neurourol Urodyn. 2008;27(6):466-474.
10. Kenefick NJ, Emmanuel A, Nicholls RJ. Effect of sacral nerve stimulation on autonomic nerve function. British Journal of Surgery. 2003;90:1256-1260.
11. Patton V, Wiklendt L, Arkwright JW, Lubowski DZ, Dinning PG. The effect of sacral nerve stimulation on distal colonic motility in patients with fecal incontinence. Br J Surg. 2013;100:959–968.
12. Siegel S, Noblett K, Mangel J, et al. Five-year follow-up results of a prospective, multicenter study of patients with overactive bladder treated with sacral neuromodulation. The Journal of Urology 2018; Volume 199(1), 229–236.
13. Medtronic InterStim Therapy Clinical Summary (2018).
14. Foster RT Sr, Anoia EJ, Webster GD, Amundsen CL. In patients undergoing neuromodulation for intractable urge incontinence a reduction in 24-hr pad weight after the initial test stimulation best predicts long-term patient satisfaction. Neurourol Urodyn. 2007; 26:213-217.
15. Siegel S, Noblett K, Mangel J, et al. Results of a prospective, randomized, multicenter study evaluating sacral neuromodulation with InterStim Therapy compared to standard medical therapy at 6-months in subjects with mild symptoms of overactive bladder. Neurourol Urodyn. 2015; 34:224–230. DOI: 10.1002/nau.22544.
16. Foster RT Sr, Anoia EJ, Webster GD, Amundsen CL. In patients undergoing neuromodulation for intractable urge incontinence a reduction in 24-hr pad weight after the initial test stimulation best predicts long-term patient satisfaction. Neurourol Urodyn. 2007; 26:213-217.