The Women's Journal

Don’t Let an Overactive Bladder Keep You From Enjoying Life

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Dr. Saks

By Dr. Emily Saks

Emily K. Saks, M.D., MSCE, is a urogyne-cologist with the Christiana Care Center for Urogyne-cology and Pelvic Surgery. Dr. Saks completed a residency in Obstetrics and Gynecology at Pennsylvania Hospital in Philadelphia and has completed a fellowship in Female Pelvic Medicine and Reconstructive Surgery at the Hospital of the University of Pennsylvania.

Do you sometimes feel a strong urge to urinate but can’t make it to the bathroom? When you go to a new place do you find yourself looking for the nearest restroom? Are you familiar with every public bathroom in Delaware?

If so, you might have a combination of conditions of the bladder known as urge urinary incontinence/overactive bladder. Urge urinary incontinence is the sudden and strong urge to urinate accompanied by the inability to make it to the bathroom, resulting in urine leakage.  Overactive bladder is the increased sensation of urgency with an increased need to urinate throughout the day and possibly the night – minus the leaking urine.

Urinary incontinence is a very common problem that affects approximately 50 percent of women over the age of 50.  Incontinence is a more common condition than breast cancer, depression or diabetes.

To understand urge urinary incontinence/overactive bladder, you must first understand how the normal bladder functions. Urine is produced 24 hours a day in the kidneys, travelling down tubes to the bladder, where it is stored until you urinate. The bladder wall senses how much urine the bladder is holding and transmits this information to the brain. The brain collects this information and when the bladder becomes full – a signal triggers the urge to urinate.

Once you feel the urge to urinate, you must decide whether you are going to do so or put it off until a more convenient time. If you decide to put it off, the urge will stop, but the bladder will continue to fill as the kidneys produce urine. Later you will feel another, more intense urge. This cycle will continue until eventually you go to the bathroom or the urine begins to leak out.

In the case of urge urinary incontinence/overactive bladder, this cycle is malfunctioning. Your bladder senses that it is holding more urine than it really is and is sending premature signals to the brain. This results in a variety of complaints all centered around needing to get to the bathroom and being unable to defer that urge.

Urge urinary incontinence/overactive bladder is evaluated by a detailed history and a comprehensive physical exam. At times, further office testing may be necessary.

The Christiana Care Center for Urogynecology and Pelvic Surgery offers state-of-the-art treatment options for urge urinary incontinence/overactive bladder, including behavioral modifications, medications and individual exercise programs for the pelvic floor muscles.  If these more conservative options do not achieve the desired effect, we also offer minimally invasive nerve stimulation for the bladder that will correct the signaling in the bladder so that the right message is transmitted to the brain.  Other non-traditional options also exist.

Feel free to make an appointment at the Christiana Care Center for Urogynecology and Pelvic Surgery; you will be evaluated by the only three fellowship-trained physicians in the state of Delaware. We specialize in treating women with urge urinary incontinence/overactive bladder and other pelvic floor problems.

The Christiana Care Center for Urogynecology and Pelvic Surgery is located in Suite 1208 of Medical Arts Pavilion 2, on the campus of Christiana Hospital in Newark. Appointments are also available at the Christiana Care Center for Women’s Health, 3706 Kennett Pike in Greenville, or 100 S. Main Street, Suite 215 in Smyrna. For more information or to schedule an  appointment, call 302-623-4055 or visit

Dr. Vakili CMYKBabak Vakili, M.D., is the director of the Center for Uro-gynecology and Pelvic Surgery. Dr. Vakili is a fellow of the American College of Obstetrics and Gynecology. He completed a fellowship in Female Pelvic Medicine and Reconstructive Surgery at the Louisiana State University Health Science Center in New Orleans, LA.

Dr. Goldstein CMYK

Howard B. Goldstein, D.O., MPH, is a fellow of the American College of Obstetrics and Gyne-cology. He

completed a fellowship in Female Pelvic Medicine and Recon-structive Surgery at Cooper University Hospital in Camden, NJ. He currently serves as the Director of Research and Education for the Division of Urogynecology.

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