Urinary frequency is when one goes to the bathroom more frequently than usual. You can, you know, categorize this into daytime frequency, nighttime frequency. So what we’ll have someone do is we’ll have them fill out a frequency volume chart. And what we do this for is to really assess the quantity of times someone goes to the bathroom during the day and during the night and then the volume at each of these urinary events. And this gives us an idea as to how big the bladder is, how frequently it’s squeezing, so that we can more effectively decide what treatment option may be the best for you.

The sensation of bladder urgency is a topic that I talk about patients with. Urgency is really the urge that one gets, the sensation one gets when they need to urinate. So some people get urgency when they have a full bladder, which is normal. Sometimes people with very small bladder volumes get urgency at earlier times than the average person, and in this person, treating the overactive bladder symptoms of urgency can be useful. If you’re diagnosed with overactive bladder, a common pathway to treat someone with an overactive bladder is actually to look at someone’s lifestyle, see what they’re eating and drinking, how they live their lives, and how their bladder health and their symptoms in terms of their urgency and frequency is affecting their daily routine.

After maybe changing some behavioral modifications or looking at someone’s diet and making some changes, if the problem still persists, what we’ll often do is we’ll start some medications. And historically, those medications have been known as anticholinergic medications, but we found more recently that the medications have been linked to dementia and problems in older individuals. So they’ve actually developed newer medications, which are known as the beta-3 agonists known as Myrbetriq and Gemtesa. These medications can be good and relieve some of the symptoms of overactive bladder but sometimes can come at a high cost.

So what we like to do is evaluate them first with behavioral modifications, then move to medications to see if these alleviate symptoms of overactive bladder. If the first and second-line options aren’t successful at treating overactive bladder, there are third-line options. What we would talk about then, if I had a patient come in to see me, and they had symptoms that persisted despite being on some medications for an adequate trial of time, such as four to six weeks, we would talk about the third-line options which are a peripheral nerve stimulator testing or bladder Botox as being options for men and women with overactive bladder.

I’d like to talk a little bit about each of those briefly. The peripheral nerve testing can be done here in the clinic. It takes about 15 minutes where we would have someone laying on their stomach. We would use some numbing medication under the skin, and then we could stimulate the nerves that tell the bladder how to squeeze, and we could get an idea as to if that would be a successful solution to helping you with your overactive bladder. What we’ve found is that we can insert some electrodes alongside the nerves that stimulate the bladder to feel and to squeeze. And by manipulating the signals to the bladder, we can often help men and women with their overactive bladder symptoms very efficiently and very effectively.

Another option for a third-line treatment for overactive bladder would be bladder Botox. The role of using Botox in the bladder is to hopefully make the bladder squeeze less and alleviate the symptoms of having frequency and urgency. I’m Russell Libby with Northwoods Urology of Texas. You can visit us online at northwoodsurology.com or call us at 218-404-3000 to make an appointment. I’d be happy to help you with your bladder issues.