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The link between (treating) overactive bladder and longevity

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While it can be uncomfortable to talk about it out loud, an overactive bladder is a condition that needs to be addressed. Recently, one of our readers responded to an article where we mentioned that a drug that treats the condition called Overactive Bladder (sometimes called OAB or Nocturia) is one of our top-ten-selling products. He told us of his own experience and how he had suffered many of the secondary effects of OAB. These included breaking a toe while trying to navigate his way to the toilet in the dark, and having to disguise from friends and family why he was leaving the room so frequently and was declining invitations to spend time with them if it would mean he was too far away from a bathroom. Finally, he looked for help from his family doctor, and now he copes with his condition far better since beginning treatment with Myrbetriq.

We are pleased to be able to add to his positive feedback with breaking news that research has now found that treating OAB with the appropriate drugs not only relieves the discomforts but can even go one step further and contribute towards improved life expectancy.

Good news for folks who suffer from overactive bladder.

At the beginning of October 2023, the American Urological Society’s journal published the results of a study under the title The reduction of male Lower Urinary Tract symptoms is associated with a decreased risk of death

The study researched whether treating men for lower urinary tract symptoms (LUTS) had any secondary benefits besides managing the symptoms. The study subjects were all males aged fifty and over suffering moderate to severe lower urinary tract symptoms. The finding was a direct relationship between the relief of the symptoms coming from treatment and life expectancy.  On average, the men who received the appropriate medication lived longer, and the greater the benefit they experienced, the more pronounced their life expectancy improved.

What are the current options for treating OAB?

There is a wide range of possible treatments for OAB, which include lifestyle changes, exercises, medication, or even going as far as surgery in more extreme cases.

  • Lifestyle changes
    • Controlling the volume and timing of liquid intake, especially later in the day, and ruling out drinks like caffeine and beer or wine that are natural diuretics. This is a delicate line to tread because inadequate hydration can cause more severe problems than OAB.
    • Bladder retraining is a technique for controlling and lengthening the gaps between each visit to the bathroom by resisting as much as possible the urge to urinate outside of scheduled visits to the toilet. A “bladder diary” must be maintained to monitor liquid intake and other relevant information.
      In consultation with a healthcare provider, a plan is developed to visit the bathroom at fixed intervals that are generally slightly longer than what the person recorded as the baseline of the average time between needing to urinate. Over time, the intervals are gradually extended, usually by 15 to 30 minutes each week, to reach a more normal frequency of urination—about every three to four hours during waking hours.

Bladder training is often recommended as a first-line treatment in guidelines from healthcare organizations like the American Urological Association. Still, this approach requires dedication and commitment since it usually takes several weeks to see meaningful improvement. People must be prepared to endure some initial discomfort as they may experience increased urgency or even some episodes of incontinence initially as their bladder adjusts to the new schedule.

  • Kegel exercises are often part of a comprehensive treatment plan for OAB that may include medications, behavioral techniques, and even surgical options. The underlying principle of Kegel exercises is strengthening the pelvic floor muscles to improve urinary control. What sets Kegel exercises apart as a significant aspect of OAB treatment is the minimal risk and side effects and absence of interaction with other medications. There may be a cost of getting skilled training and oversight from a healthcare professional.
  • Surgical inventions may be required in extreme cases where other techniques are not producing the needed benefits or as adjuncts to the alternatives.
    • Sacral Nerve Stimulation (SNS) involves implanting a small device near the sacral nerve to modulate its activity. This technique has received FDA approval and has been shown to reduce symptoms of OAB significantly.
    • Augmentation cystoplasty procedure is taken in extreme cases. This surgical procedure enlarges the bladder using tissue from the intestines. However, it risks complications like urinary tract infections and cancer.
  • Medication
    • Anticholinergic drugs like Ditropan (oxybutynin) and Detrol LA (tolterodine) inhibit the action of acetylcholine, a neurotransmitter that contributes to bladder muscle contractions. However, they can cause side effects like dry mouth and constipation.
    • Beta-3 agonists such as Myrbetriq (mirabegron) relax the bladder, allowing it to hold more urine. 
    • Botox injections into the bladder muscle relax it, thus increasing its storage capacity and reducing urgency. This is generally considered a last resort option due to potential complications like urinary retention.

What are the new drugs recommended to treat Overactive Bladder?

Myrbetriq (generic name: mirabegron) is prescribed to treat the symptoms of an overactive bladder, including incontinence and a strong need to urinate immediately or more frequently than normal. Mirbagron acts on beta-3 adrenergic receptors in the bladder, which leads to the relaxation of the bladder.

Myrbetriq is one of the most frequently ordered drugs in our range of products. This is probably because of the increasing prevalence of OAB as the population ages and the growing awareness that OAB can be a treatable condition. IsraelPharm supplies Myrbetriq at steeply discounted prices compared to retail US pharmacies. The table below indicates the savings you can expect. 

Dose US Retail price per tablet IsraelPharm price per tablet
25mg x 30 tablets

50mg x 30 tablets

$13

$13

$3.50

$2.75

Frequently asked questions

Is OAB related to kidney disease?

The need to urinate more often, especially at night, can be a sign of underlying kidney disease. Damage to the kidney filters can cause an increase in the urge to urinate. In other cases, the more frequent need to urinate can be a sign of a urinary tract infection (UTI) or an enlarged prostate in men.

What is the best way to treat OAB?

Medications that relax the bladder can help relieve overactive bladder symptoms and reduce urge incontinence episodes.

Can kidney problems cause Overactive Bladder?

This additional volume of fluid and waste causes increased urinary frequency, so urinating more often than usual is one of the first symptoms of CKD in some people.

What is Nocturia?

Nocturia is the clinical term for the interruption of sleep to void the bladder, and it is a fairly common condition. It is associated with a wide variety of diseases, including some specifically urologic conditions, prostate cancer, and urinary tract infections (UTI). In addition, it can be associated with systemic conditions such as cardiovascular disease (more specifically, heart failure) and diabetes. As well, medications such as diuretics will contribute to the symptoms. 

Nocturia is also associated with poor sleep and sleep disorders, such as sleep apnea and restless legs syndrome. Studies have raised the possibility that accident morbidities, such as falls and hip fractures, could be causally related to nocturia as people navigate the dark to find the bathroom. There’s also an association between nocturia and perceived lower quality of life and depressed mood that appear to be directly related to the number of disturbances reported at night. In self-assessment studies, people who report three or more visits to the bathroom during sleep also report lower quality of life (QOL). 

What is Overactive Bladder (OAB)?

OAB and Nocturia share many features, with the main difference being that Nocturia mainly presents as disturbed sleep patterns caused by the need to void the bladder. Overactive Bladder can result in frequent needs to empty the bladder throughout the day and at night. Sometimes, it is associated with an inability to control urine flow fully, wherein incontinence (leakage) may occur. There’s also a more specific form of leakage called Stress Incontinence when urine leaks when a person sneezes, coughs, or performs strenuous activities.

There is a strong relationship between age and the occurrence of Nocturia and OAB. Additionally, women who have given birth naturally may have weakened their pelvic floor during pregnancy and childbirth, affecting their bladder control.

Overactive bladder is not a disease but can be a symptom of another problem. It’s important to report persistent symptoms to your physician so that further investigation and appropriate treatment can be undertaken. Many people suffering from OAB may feel embarrassed and don’t ask for help. Some people simply don’t know how to address such a sensitive issue, or they think that it’s just a natural part of aging and that no treatments can help. 

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