New technologies for overactive bladder treatment. By Mohammed Belal, Consultant Urologist, Birmingham Prostate Clinic

Mr Mohammed Belal

The overactive bladder is a very common problem, affecting an estimated one in eight adults in the UK, particularly during later age. If we think of the bladder as effectively a bag of muscle, an overactive bladder occurs when those muscles contract suddenly without control, even when the bladder is not full. Urge incontinence is a term that is used interchangeably with ‘overactive bladder,’ although it has a specific meaning: urge incontinence means the sudden contractions of the bladder cause leaking of urine.

In this article, we consider how technological developments may be applied to overactive bladder devices used to help people with the most severe form of this problem.

What is the overactive bladder?

People with an overactive bladder experience a sudden and overwhelming urge to pass urine. This can occur when the bladder only contains a small amount of urine. Normally, the bladder starts to send signals to the brain from the stage when it is approximately half full. With an over activity, signals are sent from the bladder to the brain when there is very little urine in the bladder and often when there is a certain trigger, such as a person reaching their front door and putting keys in the lock.

Most common overactive bladder treatments

Treating the overactive bladder and urge incontinence always commences with the least invasive approach which may be effective. Usually, this means starting with your diet and drink intake and whether this can be modified. For example, reducing or cutting out alcohol and caffeine may be helpful and looking at times of day when you drink. It is very important, however, not to restrict fluid intake so much that you become dehydrated (this is something people often do and remember, dehydration presents its own risks). Bladder training is also commonly used as a first step for overactive bladder treatment, using techniques to help you last longer between visits to the toilet. Pelvic floor exercises can be very helpful. Medication to relax the muscles in the bladder is prescribed to people with urge incontinence if the first-line treatments are not success. Medication can be very effective, although some people are troubled by side-effects.

New technologies and devices

For some people who have tried all the different types of overactive bladder treatments discussed without success, an approach called sacral neuro stimulation may be considered. The principle is using electrical currents to reset the faulty signals the brain is sending to the bladder, telling it to empty immediately. During a short surgical procedure, a thin wire is implanted in the lower back (where the sacral nerves are located). The wire connects to a controller which sends electrical signals to the nerves, with the aim of interrupting the signals of the overactive bladder. When the overactive bladder device is first implanted, there is a process of adjusting the level of the electrical current, so it is effective. The current is painless are barely noticeable.

Currently, people using this sort of device wear a controller, usually in belt worn around the waist and additionally, there is a control unit which is used to set and change levels of the electrical signals. The rapid development of mobile phone technology has great potential in this area, with developers looking at how a smart phone could replace the control unit; a more convenient and discreet way of managing levels on the device. There are other advances in development using smart phone technology, such as the phone automatically recognising when a person is asleep and adjusting the level of the electrical current accordingly.

Find out more about bladder treatments

We provide a comprehensive service to precisely assess all types of incontinence and achieve the right solution for each person. Please contact us if you would like to see our bladder specialists.