Overactive Bladder Treatment in Gurgaon

Overactive bladder (OAB) is a syndrome characterised by urgency - a sudden, compelling need to pass urine that is difficult to defer - with or without urge incontinence (leaking before reaching the toilet), usually accompanied by frequency (passing urine more than 8 times in 24 hours) and nocturia (waking to pass urine more than once per night). OAB affects approximately 11–16% of adults. It is not a normal part of ageing and is highly treatable. The underlying cause is detrusor (bladder muscle) overactivity - involuntary contractions of the bladder wall before it is full.

OAB dry: urgency and frequency without leakage. OAB wet (urge urinary incontinence): urgency accompanied by involuntary urine leakage before reaching the toilet. Both are part of the same OAB syndrome and are treated similarly. OAB wet typically has more impact on quality of life - pad use, restriction of activities, and social withdrawal are common. Women are more commonly affected by OAB wet due to shorter urethra and pelvic floor factors. Both forms respond well to bladder training, anticholinergic medications, or mirabegron.

In many cases OAB is idiopathic (no identifiable cause). Known contributing factors include: neurological conditions (multiple sclerosis, Parkinson's disease, stroke - neurogenic OAB); bladder outflow obstruction (enlarged prostate in men causing secondary detrusor overactivity); bladder irritants (caffeine, alcohol, carbonated drinks, artificial sweeteners); UTI or bladder inflammation (always exclude before treating OAB); bladder stones or tumours (haematuria or refractory OAB always investigated); medications (diuretics, some antidepressants). A thorough history and urine test before starting treatment is essential.

No - but the symptoms (urgency, frequency, burning) overlap significantly. The key distinguishing features: OAB typically has no burning on urination (dysuria), no fever, and urine culture is negative. UTI has a positive urine culture, often with dysuria, and sometimes fever. However, OAB can be triggered or worsened by a UTI, and some women with recurrent UTI-like symptoms actually have OAB with sterile urine. This distinction is important because treating OAB with antibiotics (when the culture is negative) is ineffective and drives antibiotic resistance.

Intravesical botulinum toxin (Botox) injection into the detrusor muscle is an effective second-line treatment when antimuscarinic medications have failed or are not tolerated. Botox temporarily paralyses overactive detrusor muscle fibres, increasing bladder capacity and reducing urgency. Performed as a day-case cystoscopic procedure under local or light general anaesthesia - 20–30 injections across the detrusor wall. Effect lasts 6–9 months on average, after which repeat injection is required. Continence rates of 60–70%. Main risk: temporary urinary retention (inability to pass urine) requiring self-catheterisation in ~5–10% of patients.

Sacral neuromodulation (InterStim) is an implantable device that delivers mild electrical impulses to the sacral nerves controlling bladder function - modulating the neural circuits driving bladder overactivity. It is used for refractory OAB that has not responded to medications and Botox. A test stimulator is placed first (percutaneous nerve evaluation stage); if symptoms improve >50%, a permanent device is implanted under the skin of the buttock. Unlike Botox, SNM avoids retention risk and provides continuous therapy. Battery lasts 5–10 years. Highly effective in carefully selected patients.