Got an Overactive Bladder?

By Jane Farrell

If you have an overactive bladder, don’t despair. There are FDA-approved treatments that can help control your symptoms.

People with overactive bladder have a bladder muscle that squeezes too often or squeezes without warning. This can lead to troubling urinary symptoms such as:

The need to urinate too often (urinary frequency), which is defined as urinating eight or more times a day or two or more times at night (nocturia).

The need to urinate immediately (urinary urgency).

The involuntary leakage of urine as a result of the need to urinate immediately (urge urinary incontinence).

These symptoms affect more than 33 million Americans. Many people don’t seek treatment, possibly because they’re embarrassed or don’t know about treatment options. In the United States, 30 percent of men and 40 percent of women live with overactive bladder symptoms.

The good news is that there are therapies for these symptoms. They include oral medications, a patch or gel applied to the skin, the first over-the-counter (OTC) treatment for women with overactive bladder, and bladder injections for patients with more severe symptoms.

Causes

Some known causes of overactive bladder include neurological disorders, such as spinal cord injury, multiple sclerosis, Parkinson’s disease, and stroke. Often, however, the cause is unknown.

“Some conditions—such as urinary tract infection, early pregnancy, uncontrolled diabetes mellitus, prostate disease and bladder tumors—have symptoms similar to overactive bladder and should be excluded before a proper diagnosis can be made. Also, certain medications, especially diuretics, may cause overactive bladder symptoms,” says Suresh Kaul, M.D, M.P.H., a medical team leader for urology in FDA’s Division of Bone, Reproductive and Urologic Products.

The risk of overactive bladder increases with age. “This condition especially affects elderly women,” says Olivia Easley, M.D., a senior medical officer with the FDA Division.

Options for Consumers

There are several treatment options for overactive bladder that help the bladder muscle relax and stop it from contracting at the wrong times. Easley says that anticholinergics are a widely used class of medications for overactive bladder. These drugs contain oxybutynin, tolterodine, fesoterodine or solifenacin, and are believed to work by inhibiting involuntary bladder contractions.

Recently, FDA approved Myrbetriq (mirabegron), a medication that improves the bladder’s ability to store urine by relaxing the bladder muscle during filling. (Side effects of Myrbetriq include increased blood pressure and urinary tract infection. In certain situations, Myrbetriq may increase your chances of not being able to empty your bladder on your own, for example, if you are also taking other medicines to treat your overactive bladder.)

For women 18 and older, there’s also a patch, called Oxytrol for Women, that is applied to the skin every four days. This over-the-counter patch is available without a prescription and delivers oxybutynin. For men, an oxybutynin patch is available by prescription only and is called Oxytrol. (Side effects of the Oxytrol patch include skin irritation, sleepiness, dizziness and blurry vision.)

For adults who cannot use or do not adequately respond to anticholinergics, there are Botox (onabotulinumtoxinA) injections. Botox is injected directly into the bladder muscle under local or general anesthesia in a doctor’s office using a small camera that enables the urologist to see the inside wall of the bladder.

Botox causes the bladder to relax, increasing its ability to store urine and reduce urinary incontinence. When the effects of Botox wear off, more injections can be given, but no sooner than three months from the last set of injections.

(Botox may cause serious side effects that can be life-threatening, including problems breathing or swallowing, and spread of toxin effects. These problems can happen hours, days, to weeks after an injection. Call your doctor or get medical help right away if you have any of these problems after treatment with Botox. Less serious side effects of Botox include urinary tract infections and inability to empty your bladder on your own.)

“There are many treatment options for patients with overactive bladder. Not every drug is right for every patient. Patients need to take the first step of seeking help from a health care professional to determine whether the symptoms they are experiencing are due to overactive bladder or another condition, and to decide which treatment is the best,” Easley adds.

Reprinted with permission of FDA Consumer Health Information. This article appears on FDA’s Consumer Updates page, which features the latest on all FDA-regulated products. Click here for more updates.