HJAR Nov/Dec 2020

52 NOV / DEC 2020 I  HEALTHCARE JOURNAL OF ARKANSAS DIALOGUE COLUMN UROLOGY MORETHAN 30MILLIONAMERICANS each year suffer from overactive bladder (OAB). The sad fact is that many Americans think that they have to. They assume that it’s a normal part of aging and don’t think about this actually being a very treatable condition. Often, when we see patients, the condition has worsened and gone onmuch longer than it had to. We find that patients not only have the misconception that it is something they just have to live with but if they do decide to have any type of treatment, it will be very invasive and not worth it to them. We have found it’s important to communicate to patients early on that this is very treatable, and there are many treatment options available. This is an uncomfortable topic, and we’ve found it’s best to encourage patients to open up and let them know this is a common issue many people face. Patients also need to understand that OAB can be feeling a strong urge to go frequently, leaking urine, frequent urination and waking up at night frequently to urinate. One of the most frustrating parts of OAB is feeling this urge when there is no need to urinate. With a healthy bladder, there are signals in the brain to let a person know that the bladder is full or getting full, but there is still time to wait to go to the bathroom. With OAB, a person feels like they cannot wait. At Arkansas Urology, we take a compre- hensive approach to treating overactive bladder. We funnel patients through our nationally-recognized pathways to get the right treatment for them. The key we have found in treating OAB is to start with first- line therapies and then work to more ad- vanced therapies. The first course of treatment is lifestyle changes, also known as behavioral therapy. This includes encouraging patients to re- move all the “bladder irritating” foods out of their diet like caffeine, alcohol, soda, artifi- cial sweeteners and spicy food. We recom- mend patients keep a daily diary of trips to the bathroom and food consumed that helps everyone understand their symptoms better. We also find that this helps patients better see and understand triggers their body may experience, and it gives them a more active role in their healthcare. Bladder tricks like “double voiding” or “scheduled voiding” can also be helpful for patients. Other behavioral therapies in- clude pelvic floor exercises (Kegels) to help strengthen urine control. Biofeedback equip- ment is another tool that can be used to better identify the muscles that need to be exercised. Our second line therapies if behavioral and lifestyle changes do not work are medica- tions. This could include injections of BOTOX Comprehensive Treatment Approach for OVERACTIVE BLADDER