Products to Make Living With OAB Easier
Besides the medication to relax the bladder and bladder training techniques, there are several helpful products and devices that you can use to keep your bladder healthy and avoid OAB symptoms. Here is a review of them:
- Pessaries are small rubber devices that are inserted deep into vagina (to the point they touch the cervix). They support the urethra and bladder to better retain the urine and thus preventing incontinence. You can use this device when there is more stress on the bladder (i.e. during physical exercise ) or if comfortable, you can wear them all the time. A cheaper alternative (and with low risks too) are the regular tampons used during menstruation.
- Weighted vaginal cone are devices that also are inserted in the vagina, with the purpose of strengthening the muscles of the pelvic floor. As the name implies, they are coned shaped and are weighted , to better work your muscles to keep the device in the vagina.
- Urethral inserts are small thin tubes that are inserted in the urethra to prevent urine leakage. Unlike the catheters (that are hollow ), these inserts are solid, flexible plastic tubes . Alternatively, there are also self adhesive patches and caps that can be placed right where the urethra opens to prevent incontinence.
Advantages and Disadvantages
All these devices can help manage the symptoms of OAB, and are inexpensive. For this reason, they are recommended first before invasive procedures like surgery. They work better when combined with other techniques such as Kegel exercises.
Although they have a great safety profile, there are some risks associated with these devices- for example, and increased risk of developing infection of the urinary tract, a damage to the urethra and skin inflammation/irritation. Pessaries can also damage the vaginal wall.
Other Approaches to OAB Management
InterStim is the only FDA approved device that stimulates the sacral nerve (that controls the bladder) . Based on research studies, it is also effective long term (to improve the frequency of episodes, urine leakage and overall quality of life). During this treatment, there is an implanted lead that stimulates the S3 nerve root. This lead is attached to a small peacemaker which is placed under the skin in your buttock area. InterStim is recommended when other devices or medication fail to improve the symptoms, and the muscles of your pelvic floor don't function well. It is done in the operated room under anesthesia. The possible risks of InterStim include pain (where the device is implanted), skin irritation or infection , adverse changes in bowel or bladder function, numbness and other undesirable sensations.
Botox injections can also be used when other therapies fail and showed positive results in managing OAB . The most common side effects of botox injections include swelling and bruising at the site of injection , headaches or flu like symptoms. In very rare cases , one may experience botulism -like reactions (muscle weakness, vision problems , problems speaking, swallowing and loosing bladder control ) and should seek medical advise as soon as possible.
The best way to choose one device or therapy over another would be to consult your physician. Keep in mind that these devices don't replace the drugs or other treatments recommended by OAB.
