If lifestyle changes and prescription drugs don’t work for you, or the drug side effects are serious, then botulinum toxin, better known as Botox®, is injected into your bladder muscle by way of a small flexible camera in the office. This works well for overactive bladder or urge incontinence. The drug can paralyze muscles to keep it from contracting too often. It may need to be repeated in 3 to 6 to 8 months. Risks include infection and retention of urine.
Stimulating Nerves (Neuromodulation Therapy)
Sacral neuromodulation (SNS)
This treatment will work by stimulating the sacral nerve (near the base of the spine) that goes to the bladder. SNS therapy basically uses a “bladder pacemaker” to interrupt these signals from the bladder to the brain, which can improve OAB symptoms like urgency and frequency. This device delivers electrical impulses to the bladder to essentially stop the signals from the spinal cord that cause OAB. Risk can include site infection, neuron damage, spinal cord bleeding, and rarely infection.
Percutaneous tibial nerve stimulation (PTNS)
This in office minimally invasive therapy stimulates the tibial nerve. PTNS is performed during an office visit that takes about 30 minutes but requires 12 treatments. A small acupuncture needle electrode is placed in your ankle. Gentle electrical pulses are sent to the tibial nerve which runs up your knee to the sacral nerves. The electrical pulses help block the nerve signals that aren’t working correctly.