Overactive Bladder Specialist
Dr. Daniel Stone, MD FACOG
Urogynecologist located in Phoenix, AZ
Dr. Daniel Stone, MD is an expert in the surgical and non-surgical management of overactive bladder and urge urinary incontinence. Dr. Stone can diagnosis and provides management options for overactive bladder and urge urinary incontinence to patients in the Phoenix, Scottsdale and surrounding Arizona areas.
Overactive Bladder and Urge Urinary Incontinence Q & A
What is Overactive Bladder and Urge Urinary Incontinence?
Women with Overactive Bladder (OAB) often have a sudden urge to urinate (urgency), frequent urges to urinate (frequency) and wake up frequently at night (nocturia). Some women leak urine on the way to the bathroom and this is referred to as Urge Urinary Incontinence. This is in contrast to Stress Urinary Incontinence which is leakage of urine with coughing, laughing or sneezing.
This condition is primarily due to problems with the detrusor muscle, which surrounds the bladder. The detrusor muscle should be relaxed as the bladder fills and should contract when our bladder empties. In women with Overactive Bladder, this muscle becomes overactive and squeezes too often and without adequate warning.
How common is Overactive Bladder?
Overactive Bladder is extremely common. Over 33 million people in the United States suffer from Overactive Bladder. 40% of women will suffer from Overactive Bladder in their lifetime.
How is Urge Urinary Incontinence different than other types of incontinence?
Urge Urinary Incontinence is leakage associated with a sense of urgency. In other words, it occurs when you are rushing to make it the restroom. The other type of leakage occurs with cough, laugh, sneeze, or exercise and is called Stress Urinary Incontinence.
Isn't Overactive Bladder a normal part of aging?
Overactive Bladder is very common and becomes more common as we age. However, it should not be considered "normal". It can negatively affect your quality of life and should be treated if it bothers you.
What are the risk factors for Overactive Bladder?
There are several risk factors that make Overactive Bladder worse.
- Diet (coffee, tea, caffeinated beverages, carbonated beverages, artificial sweeteners, juices, and alcohol)
- Bladder and kidney stones
- Urinary Tract Infections
- Prior Anti-Incontinence procedures
- Bladder Prolapse or a Cystocele
- Other chronic conditions such as Diabetes, Parkinson’s, Multiple Sclerosis
How can Overactive Bladder or Urge Urinary Incontinence be diagnosed?
The key steps in diagnosing Overactive Bladder are ruling out common conditions that can mimic, or exacerbate Overactive Bladder symptoms, such as urinary tract infections, incomplete bladder emptying, and pelvic organ prolapse.
Depending on your history, Dr. Stone may recommend some additional testing which may include:
- Urinalysis to check for a urinary tract infection
- Ultrasound to check for how much urine is left in the bladder
- Urodynamic testing to get more information on the bladder
- Bladder diary which requires you to measure the amount and how often you drink and the frequency and the amount of urination.
What are the conservative treatments for Overactive Bladder and Urge Urinary Incontinence?
Dietary Changes: There are certain types of foods and drinks that can make symptoms worse. Some common food and drinks that make symptoms worse include coffee, tea, caffeinated beverages, carbonated beverages, artificial sweeteners, juices, and alcohol.
Bladder Training: People can train their bladder to hold more urine for longer periods of time. Bladder training involves using your pelvic floor muscle and "mind over bladder" techniques to gradually increase the time between bathroom visits. These techniques can be very difficult to do. Ask Dr. Stone if you're interested in learning more and he can refer you to a pelvic floor physical therapist to learn more about these techniques.
What are the medical treatments for Overactive Bladder and Urge Urinary Incontinence?
Overactive Bladder medications help calm the bladder down and help you hold more urine, go less frequently, have more time to get to the bathroom, get up less at night and have less urinary leakage. There are two main groups of medications.
One group of medications is called anticholinergic or antimuscarinic medications. There are six of these medications on the market and they work well, however, they all have common side effects which include dry mouth, dry eyes, and constipation. This group of medications has also recently been found to increase the risk of developing dementia.
The newest medication class is called a Beta-3 agonist and there are two medications currently on the market. These medications work well and are much more tolerable in terms of side effects.
If you're interested in these medications, Dr. Stone with discuss them with you and will find one that fits your goals and values.
What are the advanced therapies for Overactive Bladder and Urge Urinary Incontinence?
There are 3 advanced therapies for Overactive Bladder and Urge Urinary Incontinence and each one has pros and cons.
Sacral Nerve Stimulation: This is an implantable device that stimulate the nerves that innervate the bladder reducing the need to urinate as often and giving more bladder control. There are two devices on the market, both of which Dr. Stone regularly implants. The advantage of this technique is the long duration that this therapy can remain effective. The disadvantage of this technique is that it may involve 2 procedures for the full implant to take place.
Percutaneous Tibial Nerve Stimulation (PTNS): This is done with a small needle (similar to an acupuncture needle) that is painlessly placed by the ankle and connected to an external device that delivers small amounts of electrical stimulation. This treatment is done during a series of office visits. The advantage of this technique is it is minimally invasive and painless. The disadvantage is it is time-consuming as one has to frequently return to the clinic for treatments.
Bladder Botulinum toxin (Botox) injection: Botox relaxes muscles and if injected into the bladder it will relax the bladder muscle. This allows the bladder to hold more urine and allows more time to get to the restroom. Dr. Stone routinely does this in his office under local anesthesia. A small camera (cystoscope) is placed in the bladder and a needle is used to inject the botox into the bladder wall. This treatment tends to last about 6-9 months and will need to be repeated. It works well but can cause temporary urinary retention in 5% of patients.
Major Insurance Providers Accepted
We accept most insurance policies for your convenience. Please contact your insurance carrier to verify your individual benefits and any copays or coinsurance that are part of your plan. Patients are responsible for notifying our office if a specific plan requires precertification, preauthorization, or a referral (especially HMOs). Please call the phone number on the back of your insurance card to verify your provider network participation as insurance carriers change policies often.
Phoenix, Arizona 85016-1302
Office Hours: Monday-Friday from 8 AM – 5 PM
Main: (602) 788-1521
Fax: (602) 688-5420
Conveniently located just off Highway 51 on Maryland Avenue just East of 16TH Street between East Bethany Home Road and East Glendale Avenue.