Overactive Bladder After Surgery: Symptoms, Treatment, and Outlook

Overactive bladder (OAB) syndrome is a physical condition that can lead to physical and psychological symptoms. People with OAB experience urinary urgency and a need to urinate frequently. They also may feel anxious and depressed about it.

OAB has many causes, including nerve damage and some medications. In some cases, OAB may result from surgery. Here’s more about OAB after surgery, what the symptoms are, and what treatments may help.

For typical bladder function, the autonomic and nervous systems must work together. These systems send signals that cue filling and, when full, emptying the bladder by relaxing the urethral sphincter.

OAB happens when these nerve signals are interrupted. Symptoms like urgency with urination and frequent urination may occur during the day and night. Symptoms may interfere with a person’s daily life, leading to other health concerns like anxiety, depression, and sleep disturbances.

Risk factors include:

Some people may also develop OAB after having surgery, like pelvic, spinal, or back surgery.

Symptoms of OAB and OAB after surgery are the same. The difference is the onset. If you notice OAB symptoms that begin after surgery, discuss them with your doctor.

Symptoms of OAB after surgery include:

Your doctor may suggest lifestyle changes to help improve your symptoms. If symptoms do not improve, medical treatments may help.

Treatment options for OAB after surgery include:

Diet changes

Alcohol, coffee, or carbonated drinks may irritate the bladder. Instead, try drinking less irritating liquids, like milk, water, and herbal teas. Your doctor may also suggest reducing your liquid intake by as much as 25%. Drinking less liquid before bedtime may help relieve nighttime symptoms.

Bladder training

Holding your urine for progressively longer periods may help reduce your urgency.

Pelvic floor exercises

Kegel exercises can strengthen your pelvic floor and may help reduce OAB symptoms.

Medications

Drugs called anticholinergics or beta-3 agonists may help relax the bladder by blocking nerve signals. Medication is usually combined with other changes, like bladder training, for the best results.

Botox

Other options

Surgery may be an option for severe OAB that doesn’t respond to other treatments. Potential surgical options include:

Surgery may cause the nerve signals to and from the bladder to change. Many factors, such as anesthesia and pain medication, can affect the autonomic nervous system, causing urine retention, OAB, or other conditions.

Surgeries that are more likely to cause OAB include:

Between 38% and 60% of people may experience urinary dysfunction, specifically urinary retention (which can lead to OAB symptoms) after spine surgery. Also, 15-30% of people may experience OAB symptoms after mid-urethral sling surgery, and 39% of people may experience persistent OAB symptoms with prolapse surgery.

Numerous factors, such as the operating room table position or even postoperative narcotics usage, may contribute to the condition, researchers say. In many cases, older age and time in surgery may contribute to developing symptoms. A person’s BMI after surgery may also play a role.

Your doctor will likely ask you questions like how often you urinate during the day and night, whether you feel sudden urges to urinate, and if you leak urine before you can get to the toilet.

You will also have a physical exam to rule out other causes of your symptoms, including urinary tract infection (UTI).

Tools for diagnosis include:

How long OAB may last after surgery will depend on the individual, the underlying cause of OAB, and other risk factors. For some people, OAB may resolve on its own over time. In a study of 203 people who had prolapse repair, 61% reported that their symptoms went away with or without treatment.

Bladder training and pelvic floor exercises may help within 3 months. Medications may be taken for between 6 weeks and 6 months, at which point symptoms may return.

Why do I urinate frequently after surgery?

Changes in urination happen after surgery due to factors that impact the nervous system, such as anesthesia, medications, or pain.

Is bladder incontinence common after surgery?

It can be. For example, one survey on surgery for gynecological cancer noted that the rate of OAB before surgery was 4.1%. After surgery, it increased to 13.1%.

What calms an irritated bladder?

Staying hydrated may help. Alcohol and caffeine may irritate the bladder, so try drinking milk, water, or herbal tea.

If you experience symptoms of OAB after surgery, make an appointment with your doctor.

With only minimally invasive treatment, like bladder training, OAB goes away in time for most people. Even if OAB persists, many medications and surgical options may help.