Leaky? Drippy?
No, these aren’t the names of cute characters from an animated Disney film.
Rather, these are some of the complaints I hear from my patients with urinary problems. As a urologist in private practice since 2001, I’ve managed thousands of patients who complain that they have to run to the bathroom … all day long … all night long … and often don’t make it in time.
They can’t go to the movies, live shows or sporting events because they have to be right near a bathroom or else they’ll have an accident. When they go to a restaurant, they immediately look for the restrooms. Airline travel can be a nightmare, especially if they are stuck with a window seat.
The condition is called overactive bladder and the key symptom is urgency. Urgency is defined as “a sudden compelling desire to void, which is difficult to defer.” Other symptoms include frequency, getting up at night more than twice to void, and a sudden leakage of urine not related to laughing, coughing or sneezing.
If you have these symptoms and you think you’re all alone, think again. Studies show that one in three adults over the age of 40 have reported symptoms of OAB at least sometimes. It does become more common as one gets older and by age 75, it is almost equally prevalent in both men and women.
The first line treatment is behavioral therapy, such as eliminating or reducing caffeine and alcohol. The second line treatment includes medications either taken orally or used as a skin patch, which can increase the capacity of the bladder and reduce bladder spasms.
If these are not effective, then third line therapies are used. One option that has been used for several years is a sacral nerve stimulation device by Medtronic. This technique involves placing a small thin wire from the lower back onto the nerve that stimulates the bladder. Although it requires a minimally invasive surgical procedure, the results are immediately effective. My patients have reported going from eight pads per day down to just two pads in less than 24 hours.
Another option is percutaneous tibial nerve stimulation, also known as Urgent PC, which is a low-risk, nonsurgical treatment creating excellent results. Here’s a story by a patient who was treated very successfully with Urgent PC:
Back in 2012, Laurie (not her real name), then age 55, started noticing that she was making more and more trips to the bathroom. An avid traveler, she and her husband would take frequent car trips, including trips around Europe with friends. Laurie remembers how they’d always have to pull over so she could go to the bathroom.
“I didn’t realize anything was wrong at first. I just thought these Brits have large bladders!” Three years later, she had enough of her urinary symptoms. Her frequent bathroom visits made her feel like a nuisance when she was out with family and friends. She was tired of rushing to the bathroom again and again. It reached the point where every 10 minutes Laurie was running to the bathroom.
“I can tell you where all the restrooms are,” joked Laurie. “I would go before I left the house, drive to the grocery store and go there, do my shopping, go again before I left the store, then drive home and immediately go again. I knew things had to change.”
A urologist diagnosed her with overactive bladder and put her on medications. The medication helped, minimally. Instead of a bathroom trip every 10 minutes, she was now going every half hour.
That’s when fate stepped in. Laurie took a trip to Southern California to visit a friend, who was also a retired nurse. After hearing Laurie’s story, her friend made some calls and got Laurie information about Urgent PC. She started using it in California and soon came to Urology Specialists of Nevada for treatment.
Urgent PC is a minimally invasive procedure that improves bladder control in men and women by stimulation under the skin of the tibial nerve, the large nerve that runs the length of the leg. This ultimately leads to the adjustment of bladder control.
This therapy is provided through a series of 30-minute treatments. During each session, the patient sits with their foot elevated. This allows stimulation of the tibial nerve using a very thin needle temporarily placed in the ankle. This stimulation travels up the leg to the sacral nerve plexus, which is the group of nerves at the base of the spine that are responsible for bladder function.
Urgent PC offers many different levels of stimulation, so we can adjust treatment to suit an individual patient’s needs, as well as address any discomfort that might be experienced during treatment.
“I never felt any pain during the treatments,” said Laurie. “It just felt like a vibration.”
Urgent PC therapies require a bit of patience as Urgent PC treatments gently and gradually work to retrain the bladder system. Most patients typically start to see results after six treatments but the full effect of treatment may not occur until the patient receives the 12 initial treatments. After the 12 treatments, successful patients usually need a monthly maintenance treatment.
Urgent PC is an option for most overactive bladder patients and is often used for patients who are not satisfied with the results from drug therapy because they do not respond or only experience a small benefit. This therapy is so low-risk, it is usually an option even for patients who cannot take overactive bladder drugs or are unable to have other treatments.
Most patients do not experience side effects but if they do occur, they are typically temporary and include mild pain and skin inflammation at or near where the needle is placed. Clinical studies show that up to 80 percent of patients get good results.
“It has changed my life,” said Laurie. She’s currently planning her next car trip in April and knows that this time there won’t have to be frequent stops.
For more information about treatments for overactive bladder, call the office of Dr. Jason Zommick of Urology Specialists of Nevada at 702-877-0814 to schedule an initial appointment.
Dr. Jason Zommick is a urologist with Urology Specialists of Nevada.