Medicine or Surgery for Overactive Bladders (OAB) or Just Planning When To Pee?

Women just run to the bathroom to pee too often have bladders that do not react normally to the signals of full and empty. Most women can't stand this life intrusion and want it fixed which is why they find themselves at their gyno office discussing whether they should begin medicine or get a surgery.  This is called the "overactive bladder" or OAB. Medically we say that overactive bladders have a "SUDDEN, COMPELLING DESIRE TO PASS URINE THAT IS DIFFICULT TO DEFER"
. Physicians might also term term this urgency. Women say that it's not a sensation that can be avoided, when they experience this sensation they have to go to the bathroom very quickly, or they may not be able to hold their pee. Some women leak and drip (urinary urge incontinence or UUI) when they don't even realize this is happening, and this is an entirely different problem and may be due to nerve damage, diabetes, too much caffeine or other issues. Some women manage to make it to the bathroom although they have these strong urge sensations, and are not particularly bothered by actual leaking into their pants or on to a pad. So not all OAB has incontinence. It's important that we all  have some sensation that our bladder is filling, otherwise we'd never know when to actually go to the bathroom to pee. The sensation should come on gradually, and be something we can work with if we are watching a good movie or on the phone, and not have to go running to the bathroom over and over during the day.  It has always been thought that this whole problem of the overactive urge sensations is completely different from SUI or STRESS INCONTINENCE WHICH IS LEAKING WHEN YOU STRAIN. Leaking when you cough or line dance was thought to be a structural problem vs OAB which was thought to be due to damage in the way our bladder nerves function. And the traditional fix has been medication for OAB,and treatment with surgery or pessaries for SUI. But now the physician researchers are not so sure if perhaps the causes are not more closely linked after all. So a new study in the March 09 issue of Obstetrics and Gynecology looked into how women did with their OAB symptoms after sling operations primarily designed to correct stress incontinence. And actually almost half of all OAB patients had complete resolution of their urge symptoms and another third had most of their symptoms treated. So in addition to fixing the problem of stress leakage, the bladder sling surgery helped fix the problem of OAB as well. An exciting discovery for those who take care of women with this bothersome problem. Other gynos will just tell you to time when you pee. Emphasizing that it's getting in the right habbit that is what will calm an overactive bladder, but the best review of this strategy did not show effectiveness in the 2004 Cochrane review.

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