Experiencing an overactive bladder (OAB) is common after undergoing prostate surgery. Various treatment options exist to help manage the condition and reduce the frequent urge to urinate.
OAB refers to a urinary condition that can cause a variety of symptoms. The most common symptom is the uncontrollable urge to urinate, which may lead to accidents or leaks.
The prostate is a gland located in the male pelvis below the bladder. Urine leaves the bladder through the prostatic urethra on its way to the penis.
Various conditions can affect the prostate, and the treatment of these conditions may involve surgical removal of the prostate. As with any surgery, there is the potential risk of side effects, which may include damage to nearby organs, such as the bladder.
In this article, we will discuss the relationship between OAB and prostate surgery, including what causes OAB and how to treat it.
A radical prostatectomy is when a surgeon removes the complete prostate along with surrounding structures, such as the pelvic lymph nodes and semen-storing seminal vesicles.
OAB is common after a prostatectomy, affecting 15.2 to 37.8% of people who have a radical prostatectomy. The rates are even
Many variables may contribute to OAB after prostate surgery. However, in most cases, a person may experience these symptoms due to postoperative problems such as nerve damage of the bladder, stress urinary incontinence, or a bladder outlet obstruction.
Typically, when someone’s bladder is full, it
This can result in the signals between the bladder and the brain working incorrectly, telling the brain that the bladder is full when it is not. It can also cause the muscles of the bladder to become overactive, squeezing the bladder when it is not full. Health experts may refer to this as neurogenic bladder. It can lead to urinary problems such as OAB.
In addition to neurologic damage, other risk factors for OAB include:
- hormone changes
- pelvic muscle weakness or spasms
- urinary tract infection (UTI)
- side effects from certain medications
- conditions that affect the brain or spinal cord, such as stroke and multiple sclerosis
There are several options to help treat frequent urination and other OAB symptoms after prostate surgery.
For some people, making small lifestyle changes is sufficient to treat OAB. This can involve avoiding foods and drinks that may bother the bladder, such as caffeine, alcohol, and soda. It may also be beneficial to keep a bladder diary to identify patterns.
A person may also consider preplanning toilet visits and being aware of where the nearest available restrooms are.
Bladder retraining is another way of treating OAB. There are several types of bladder retraining:
- Double voiding: This is when, after someone has finished urinating, they wait for a while and then try to urinate again to ensure their bladder is empty.
- Delayed voiding: This involves someone waiting a while to visit the toilet after they feel the urge to urinate. The delay can be a few minutes at first and build up to a few hours over time, gradually helping to regain control over the urge.
- Timed urination: This is when someone establishes a schedule for when they can visit the toilet. As with delayed urination, this can help take control of the urge over time.
Kegel exercises, which strengthen the pelvic floor muscles, can also lessen OAB symptoms. Quickly tensing and then releasing the pelvic floor muscles a few times can help let go of the urge to urinate.
If lifestyle changes and retraining are not working on their own, a doctor can prescribe several types of medication that may help relieve OAB symptoms.
These drugs can help relax the bladder muscles and allow the bladder to store and empty more urine. They are available in various forms, including pills, gels, and patches. A doctor may prescribe them on their own or in combination with one another.
Another treatment option is bladder botox treatment. This treatment aims to relax the muscles of the bladder by injecting them with small amounts of botox. A doctor can perform this procedure in their office while a person is under local anesthesia. The effects of the botox should last around 6 months.
A doctor may offer several surgical options. One option is nerve stimulation, which uses electrical pulses to assist or correct the nerves involved in bladder control. There are two forms of nerve stimulation used for OAB treatment:
PTNS attempts to correct the nerves in the bladder by sending pulses to the tibial nerve. For this procedure, a surgeon places a small electrode in the lower leg, near the ankle.
SNS uses a pacemaker to change the functioning of the sacral nerve, which helps control the holding and releasing of urine. There are two stages to this surgery. First, a surgeon inserts an electrical wire into the skin of the lower back, which links to a handheld pacemaker. If the treatment is helping, a surgeon will insert a permanent pacemaker to regulate the nerve rhythm.
In rare cases, there are two other forms of surgery that a doctor may suggest: augmentation cystoplasty and
For most people, OAB symptoms will last roughly 3–6 months. For some, they may persist up to a year or 2. In very rare cases, symptoms can be permanent.
OAB is a common experience after prostate surgery. It may occur due to nerve damage as a potential complication of the prostatectomy.
A number of treatment options are available, such as lifestyle changes, bladder retraining, and medication. When symptoms are persistent or more severe than usual, a doctor may recommend more invasive treatment options, such as surgery.