Overactive bladder treatment in Johns Creek and Cumming

What overactive bladder feels like

Overactive bladder is a pattern: a sudden, hard-to-hold urge, trips that come too close together, waking more than once most nights, and, for some people, a leak if a bathroom is not close enough. The urge can be set off by running water, arriving at the door, or simply standing up. It is not the same thing as a urine infection, though an infection can look similar and is one of the first things we check.

Men and women both come in for this. In men we also look for an enlarged prostate that may be part of the picture. Our overactive bladder care page covers the evaluation — history, a urine test, and, when it would change the plan, a look at emptying or a bladder diary — in more detail.

The treatment ladder we actually use

We usually start with how much and when you drink, bathroom habits, and, when it fits, a medicine aimed at calming the urge. We will tell you what a given medicine is for and what to watch for. If pills are not enough, or you cannot take them, we talk about the next rungs we actually offer.

Bladder Botox is an injection into the bladder muscle that can quiet the unplanned contractions that drive urgency and urge leaks. InterStim is a sacral neuromodulation device that helps the nerves controlling the bladder fire in a more useful pattern. Altaviva is an implantable tibial-nerve stimulator we offer for overactive bladder, urgency, frequency, and urge incontinence; it is not a series of needle PTNS office sessions. If you searched for PTNS, that is the honest distinction: we can talk about the search term, and the treatment we provide in that family is Altaviva, not needle PTNS.

Rezum is not part of our practice, and we will not present it as a treatment you can get here. If an enlarged prostate is part of the story, we point you to the enlarged prostate treatments we do provide, on our enlarged prostate treatment page.

What happens at the visit, and where procedures are done

You do not have to finish a bladder diary before we will see you, though a few days of notes can help. Bring medicines you already take, including ones for blood pressure or mood that can affect the bladder, and any urine tests or urodynamic studies already done. We may recommend urodynamic testing later if the pattern is unclear or if we are choosing between Botox, InterStim, and Altaviva.

Clinic visits run at Johns Creek and at Cumming. Office procedures and any implant or operating-room date are planned from that visit; implant procedures and work that needs the operating room are scheduled at the Johns Creek Clinic & Surgery Center. We will tell you which door to use and how long a trial step, such as a temporary InterStim lead, lasts when that is the path.

When this is an emergency, and when it can wait for a clinic slot

A sudden inability to urinate, heavy bleeding, or fever with pain belongs in a hospital emergency department. Everyday urgency, frequent urination, or leaking on the way to the bathroom, without those signs, is clinic work, even when it has taken over your schedule. We would rather see you while the history is clear than wait until pads are a constant.

An official video on InterStim for overactive bladder

An official Advanced Urology video on this topic.

Playing: #003 - Rewiring Bladder Control: How InterStim Transforms Overactive Bladder

Watch on YouTube

Overactive-bladder visits in Johns Creek are with Dr. Neal Patel, Dr. T. Casey McCullough, and Dr. Nicholas Farber. In Cumming they are with Dr. Neal Patel, Dr. Herman Bagga, Dr. Rut Patel, and Dr. Kushan Radadia, with physician assistants as part of the same team.

Questions we are often asked