Can overactive bladder in women be cured?

The bladder is a very important urinary organ in the human body. This part is also prone to lesions. Overactive bladder is a typical one. After suffering from overactive bladder, patients will show symptoms such as frequent urination, urgency, and frequent urination at night, which has a great impact on the patient's normal life. So, can overactive bladder in women be cured? Let’s take a closer look below.

Overactive bladder refers to a series of symptoms such as reduced bladder stability due to various reasons, which leads to frequent urination, urgency, and even lower abdominal pain. Overactive bladder in women is treatable, mainly by treating the cause and combining it with symptomatic treatment to address both the symptoms and the root cause. Whether it can be cured cannot be generalized. The causes of overactive bladder in some female patients are more complicated, and often the primary cause cannot be eliminated, resulting in persistent symptoms. For some patients, the primary disease has been cured, but the symptoms of overactive bladder, such as frequent urination and painful urination, still persist. At this time, the treatment is mainly targeted at the symptoms.

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1. Behavioral therapy

(1) Bladder training Bladder training is effective in treating OAB. Through bladder training, bladder contractions are inhibited and bladder capacity is increased. The key points of training are to drink more water during the day, hold urine as much as possible, and extend the interval between urination; stop drinking water after nightfall, and do not drink irritating or excitatory beverages. You can take sedatives and sleeping pills in moderation at night to fall asleep peacefully. Keep a urination diary during treatment to increase confidence in recovery.

(2) Biofeedback therapy People consciously urinate and control urination because of certain biological information in the body. Biofeedback therapy is the use of biofeedback therapy equipment to amplify the information in the body and use it for patients, so that they can learn to bring this information that they usually don't pay attention to under conscious control and actively urinate or control urination. The feedback therapy device inserted into the anus or vagina records bladder activity in the form of sound, light, and images. When the patient has uninhibited or unstable detrusor contraction, the instrument will emit specific sound, light, image and other information, allowing the patient to directly perceive bladder activity and consciously learn self-control gradually, thereby achieving the purpose of inhibiting bladder contraction.

(3) Pelvic floor muscle training Through biofeedback or other guidance methods, patients can learn to inhibit bladder contraction by contracting the pelvic floor muscles and other strategies to suppress urinary urgency.

(4) Other behavioral therapies such as hypnotherapy.

2. Medication

(1) M receptor antagonist drug therapy is easily accepted by most OAB patients and is therefore the most important and basic treatment for OAB. The contraction of the detrusor muscle is mediated by the stimulation of choleretic (M receptors). M receptor antagonists can inhibit the contraction of the detrusor muscle, improve bladder sensory function, and inhibit the possibility of unstable detrusor contraction by antagonizing M receptors. Therefore, they are widely used in the treatment of OAB. First-line drugs include tolterodine, trospium, solifenacin, etc. Other drugs include oxybutynin, propivine, propantheline, etc.

(2) Sedatives and anxiolytics Multiple areas of the central nervous system are involved in urination control, such as the cortex and diencephalon as well as the midbrain, medulla oblongata and spinal cord. Neurotransmitters related to these neural pathways may be selected, such as gamma-aminobutyric acid, 5-hydroxytryptamine, dopamine and glutamate. Among the drugs used to treat OAB, the most commonly used is imipramine, which not only has anticholine and sympathomimetic effects, but may also have a central inhibitory effect on the urination reflex. It is recommended for the treatment of mixed urge and stress urinary incontinence. However, imipramine takes a long time to work and may not be effective until several weeks have passed. Adverse reactions include orthostatic hypotension and arrhythmia. Another antidepressant, duloxetine, increases the tone of the external urinary sphincter by inhibiting the central reuptake of serotonin and norepinephrine.

(3) Experiments on calcium channel blockers have shown that calcium antagonists such as verapamil and nifedipine can inhibit the contraction of the bladder detrusor muscle by blocking the influx of extracellular calcium ions; potassium channel openers increase the outflow of potassium ions, causing cell membrane hyperpolarization and relaxation of smooth muscle.

(4) Other drugs include prostaglandin synthesis inhibitors (indomethacin), flavopiridol, etc.

3. Traditional Chinese Medicine Treatment

In recent years, traditional Chinese medicine has been tried for the treatment and auxiliary treatment of OAB. It has definite efficacy and few adverse reactions. It is increasingly valued by doctors and accepted by patients. Including traditional Chinese medicine therapy, acupuncture therapy, massage therapy, bladder irrigation therapy, rectal medication, external treatment, aromatherapy, etc.

4. Surgical treatment

Surgical treatment is only used for patients with severely low-compliant bladder, small bladder capacity, damage to upper urinary tract function, and other treatments that have failed to respond. Including detrusor transection, autologous bladder augmentation, intestinal bladder augmentation, and urinary diversion.

5. Other treatments

This includes multiple injections of botulinum toxin type A into the bladder detrusor muscle, which is effective for severe detrusor instability. You can also instill hyaluronidase or capsaicin into the bladder. These substances can participate in bladder sensory afferents and reduce bladder sensory afferents after instillation. This can be tried for people with severe bladder sensory hypersensitivity. Neuromodulation, sacral nerve electrical modulation therapy is effective for some patients with stubborn urinary frequency, urgency and urge incontinence.

In short, OAB patients often use a combination of behavioral therapy and drug therapy. M receptor antagonists are the main means of treating OAB today, with an efficacy of up to 75%.