To those who experience it, an overactive bladder can be very frustrating. In fact, it is a disability to feel that you need to find a restroom constantly throughout the day. Frequent and, sometimes, uncontrollable urination is embarrassing and complicates an already complicated world. The impact it can have socially, mentally, and physically can be stressful and exhausting. It is more prevalent in women and affects 15-18% of women. Women who have an overactive bladder can need a restroom eight or more times a day. This also includes waking up several times at night. Luckily, there are ways to help treat the symptoms and keep that uncomfortable feeling at bay.

When the bladder is full, a signal is sent to your brain to inform you that it needs to be emptied. To urinate, you simply contract the bladder and the urine is released. In the overactive bladder, the muscles contract without any warning; even when the bladder isn’t full. There are different theories as to the cause of this disorder, but generally its presence seems to increase with age. Parkinson’s disease, dementia, and Alzheimer’s are also thought to be contributing factors; as well as spinal cord injuries and strokes.

The constant anxiety that comes with having an overactive bladder is caused by the uncertainty of unexpected leakage. This in turn can affect a sufferer’s social life, home life, and work options. One of the less talked about complications involves the patient’s sex life. Discussing this condition with others can be difficult; let alone, how it may impact intimacy. Incontinence can leave a woman ashamed and worried about sexual encounters. Having an open conversation with your significant other can be difficult at first, but is necessary to maintain a healthy relationship.

Obviously, it is important to look at all of your options and surgery should be the last resort. Bladder exercises can be an effective way to decrease symptoms. Training that helps strengthen your core and pelvic muscles like “kegels” are a great start. Begin slowly and then build up the amount of time devoted to these exercises.

Many find that there are improvements in bladder control after only three to six weeks.  Avoiding diuretics like caffeine is imperative; it might be time to start drinking decaf coffee or tea. Try to stay away from spicy foods, alcohol intake, and citric juices.

When it comes to Botox, you might think of the television show Real Housewives of Atlanta or Nicole Kidman’s forehead; however, one of its lesser known uses is to help control an overactive bladder. It is actually very effective and has been approved by the FDA to control urinary incontinence. Botox is injected into the bladder and works by relaxing and limiting its ability to contract uncontrollably. One small injection can last up to 12 months. This newer method for controlling Urinary Incontinence is growing in popularity and proving to be quite successful in treating urinary frequency, urgency and bladder pain also.

Another treatment for an overactive bladder is something called the Axonics, the latest technology for a treatment involving the sacral nerves that innervate the bladder. This technology send electrical impulses to the bladder and bowel nerve, and just like a pacemaker for the heart, it tells the muscle to work harder or softer, longer or shorter, etc. It is intended to help people control their annoying urinary frequency, urgency, urge incontinence, and even urinary retention. It has an amazing effectiveness of >94% in the people who try it. 

Joseph Gauta M.D.
Board Certified Urogynecologist

Dr. Gauta is now the first physician in S.W. Florida dual board certified in Urogynecology and Obstetrics and Gynecology. Dr. Gauta’s practice, The Florida Bladder Institute, is  solely  dedicated  to Urogynecology.

One out of every six women suffers from overactive bladder and half of all women will suffer from pelvic organ prolapse. A challenge for women seeking treatment is that they would go to a urologist for one problem, a gynecologist for another and a gastroenterologist for another. Dr. Gauta explains “A Urogynecologist has the skill and experience to assess the entire pelvic region including the uterus, bladder, vagina, rectum as well as the muscles, ligaments, connective tissue and nerves that support those systems. Evaluating your pelvic system as a whole ensures the best treatment and outcome”. Some of the newer treatment options include biofeedback, electrical stimulation, Botox, and minimally invasive outpatient surgery. In addition to providing the most advanced medical care for his patients, Dr. Gauta was a preceptor for Boston Scientific, Medtronic and Olympus and trains other physicians from around the world on how to do the most advanced Urogynecology procedures. He nows trains other highly-skilled surgeons on advanced procedures for companies like Laborie and Coloplast. He is the recipient of the prestigious Castle Connolly’s Top Doctors award, and is amongst the top 1% of physicians in the country who are honored with the Patient’s Choice Award for 5 years in a row. Dr. Gauta received his training at Tulane University in New Orleans mentored by world renowned Urogynecologists David Herbert M.D. and Thomas Elkins M.D.

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