Treatment

OAB Surgery Options

Erica Sanderson Jul 16th, 2014 (updated Nov 24th, 2014)
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Overactive bladder (OAB), also known as urge incontinence, occurs when the destrusor muscle surrounding the bladder begins to improperly contract as the bladder fills, causing frequent urination and urinary leakage. Surgery is usually performed only if other treatment options fail. Here are some available OAB surgery options, if you and your doctor agree that it’s suitable for you.  

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Sacral nerve stimulation
Sacral nerve stimulation

A neurotransmitter is placed under the skin in the upper buttock, near the base of the spine, which sends slight electrical jolts to the sacral nerve. The sacral nerve is located in the spine and sends brain signals to the bladder and pelvic floor muscles. The impulses from the device can help control voiding of the bladder.  While this implantation is not a cure, it may reduce frequent urination.

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Sling procedure
Sling procedure

Usually used for stress incontinence, slings can also treat OAB. There are several sling surgeries, but the more common is suburethral. This requires manipulating a patient’s tissue, animal tissue, or synthetic material to create a “hammock” around the bladder neck and urethra, securing it to the abdominal wall and pelvic bone. This sling supports the urethra so it’s in the correct position.

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Augmentation cystoplasty
Augmentation cystoplasty

This surgery is considered a major operation. The goal is to increase bladder capacity by making the bladder larger. How? A surgeon cuts open the bladder and grafts parts of the patient’s intestines—small or large—creating a reconstructed patchwork for the now bigger bladder. The surgery has reported a high success rate.

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Urinary diversion
Urinary diversion

A rarer surgery, urinary diversion is most commonly performed for people with malfunctioning or damaged bladders. However, it can be used for some severe cases of OAB. Surgeons reroute the flow of urine by connecting ureters to a passageway made out of intestines. Urine is then directly released into an external pouch from an opening in the abdomen called a stoma.

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Risks
Risks

Incontinence surgery should never be considered without a full examination and analysis from an urologist. It is usually the last line of treatment. Surgery is always serious and you need to be educated and aware of the risks. These include bleeding, blood clots, infection, increased incontinence, inability to urinate and fistulas. Surgery will most likely only improve your OAB, not cure it.