Have you stopped taking your overactive bladder medication? You’re not alone! Medications for overactive bladder are often the first line of defense against urges. Still, many women stop taking them within a year. For some women, they just aren’t effective. Others experience uncomfortable side effects like constipation, dry eyes, and a dry mouth.

The decision to stop taking medications may not have been an easy one. You may find yourself back where you started, worried about urges or leaks and changing your schedule around bathroom locations. You’re probably wondering what to do now. Talking to your urologist is the first step. You may still have several options to explore.

Controlling Overactive Bladder When Medications Don’t Work

When medications are no longer an option for managing your overactive bladder, your doctor might recommend one of the following long-term options:

Botox (Onabotulinum toxinA)

Botox isn’t just for wrinkles! It has the same relaxing effect on bladder muscles as it does on facial muscles. Botox injected into bladder muscles helps relax the bladder and prevent those intense urges that come with overactive bladder (and sometimes urge incontinence). When the urges are calmed, you have time to get to the bathroom when you need to. Botox injections are usually only needed two or three times per year to maintain a calmer bladder.

Possible side effects include difficulty urinating and an increased chance of urinary tract infections.

Sacral neuromodulation

Sacral neuromodulation is a surgical procedure that implants a bladder pacemaker under the skin to send electrical signals to the roots of the sacral nerve. The sacral nerve controls bladder function and sends signals to your brain when your bladder needs to be emptied. Sacral neuromodulation sends electrical signals to the sacral nerve to help stop it from sending unwanted or incorrect signals to your brain. This helps stop those intense urges. Before committing to surgery, patients undergo a two-week trial period using temporary electrodes to ensure that symptoms will improve. If the trial is successful, a permanent bladder pacemaker can be implanted.

Side effects are rare, but any surgical procedure comes with a risk of pain and infection at the surgical site.

Percutaneous tibial nerve stimulation (PTNS)

PTNS also uses electrical stimulation of a nerve but does not require surgery. It’s a type of electroacupuncture used on a nerve root near the ankle. One very thin needle is used to deliver electrical signals to the nerve that helps regulate bladder function. PTNS treatments are given in the office weekly for about twelve weeks, and generally reduces symptoms for three to four months.

Side effects from PTNS are rare, and most women who try it have a significant improvement in their symptoms.

Talk to your urologist about your options

Starting treatment for overactive bladder was a big step. If medication is no longer the right treatment option for you (or never was), talk to your urologist about your other options. You don’t have to live with the uncomfortable symptoms of overactive bladder.