Overactive Bladder at its best (is there really such a thing?) can be annoying. The constant running to the bathroom can be frustrating to say the least. But at its worst, OAB can be debilitating. Those with severe OAB make multiple trips to the bathroom a day and even night, and many times may have embarrassing accidents too. It can cause anxiety in social situations, limit interaction with friends and family, and can even negatively affect a person’s work. If you think you’ve tried everything and it hasn’t worked for you, surgery may be an option.
Surgery is typically a last resort for most people and should be considered only after more conservative options, such as behavioral modifications, medication or even advanced therapies like Sacral Neuromodulation have failed. The surgeries listed below are often done on women who no longer wish to have children, as childbirth can often remove many of the benefits of surgery.
What types of surgeries are available?
This procedure increases the size of the bladder, enabling the bladder to store more urine. A small amount of tissue is typically taken from the intestine and added to the wall of the bladder to make it bigger. In some cases, a catheter may be needed after this surgery has been performed.
This procedure takes the tubes that lead from the kidneys to the bladder, and reroutes them through the abdominal wall to the outside of the body. Urine is then collected in an ostomy bag – a specially designed bag to be worn on the abdomen. While this option does require maintenance (emptying the bag, keeping the area clean and safe from infection) it does allow an active life post surgery.
Vaginal sling procedures are surgeries that help control stress urinary incontinence, which happens when you leak urine upon coughing, laughing, sneezing, lifting or exercising. The basic concept of a sling is to place a strong piece of material beneath the urethra as a supporting “hammock”. During the procedure, physicians use a sling placed around the urethra to lift it, or the bladder, back into a normal position.
There are many different types of sling procedures, as well as a number of different sling materials available, so talk to your doctor about your options, as well as the pros and cons for each one.
Is surgery for me?
The decision to have surgery can be difficult, as there are pros and cons with each procedure. But, if your OAB symptoms are severe, and you have tried all other options, surgery may be right for you. Be sure to talk with your doctor about all of your options, including what the procedure is like, the materials used, the pros and cons of different surgical options, and the recovery times for each. It’s also important to talk with your doctor about what you can expect after surgery, as not everyone is completely cured from incontinence after these procedures. A frank discussion with your doctor, and your own research on surgical options can help you decide if this is a path you would like to consider.
Learn more about surgery options for OAB in our 6th and final video of our series on managing Overactive Bladder.