“I suddenly feel the urge to urinate and can’t hold it…”

“I’ve tried all the medications for overactive bladder, but nothing works…”

A woman in her late 60s had been struggling with this issue for over 10 years.

Despite trying every available medication for overactive bladder (OAB), she saw little improvement. There were times when her symptoms settled down, but they never truly went away.

So, was her bladder really the problem?

A closer examination revealed some surprising findings.

Three Key Issues Identified

1️⃣ Vaginal pH 8.0 (Normal: ≤4.5) → GSM (Genitourinary Syndrome of Menopause)

🔹 After menopause, hormonal changes cause vaginal mucosal atrophy, making the bladder and urethra more sensitive to irritation.

2️⃣ Mild Urethrocele → Urethral Laxity

🔹 Weakened support structures can alter urethral shape, leading to discomfort and urgency.

3️⃣ Tenderness in the Left Obturator Internus Muscle → “Vaginal Tightness” (MPPS – Myofascial Pelvic Pain Syndrome)

🔹 Hypertonic pelvic floor muscles can trigger bladder irritation, resulting in urgency and frequency.

The Real Cause Wasn’t the Bladder!

What seemed like overactive bladder (OAB) was actually a combination of:

✅ Pelvic floor muscle tightness (MPPS)

✅ Hormonal decline causing mucosal thinning (GSM)

Since the bladder itself wasn’t overactive, it’s no wonder that standard OAB medications didn’t work.

How Can This Be Treated?

To address the root causes, a targeted treatment plan is necessary.

1️⃣ Pelvic Floor Rehabilitation (“Releasing Vaginal Tension”)

✅ Helps relax hypertonic pelvic floor muscles, reducing unnecessary bladder stimulation.

2️⃣ Local Hormone Therapy (for GSM)

✅ Restores vaginal mucosa, reducing irritation in the bladder and urethra.

3️⃣ Advanced Treatment Options

💡 Magnetic Stimulation Therapy → Relaxes pelvic floor tension

💡 Extracorporeal Shockwave Therapy (ESWT) → Improves blood flow and relieves muscle tightness

💡 Vaginal Laser Therapy → Regenerates atrophic vaginal mucosa and reduces urethral discomfort

Key Takeaways

✅ The issue wasn’t OAB, but rather “Vaginal Tightness” (MPPS) and Hormonal Changes (GSM).

✅ Pelvic floor rehabilitation + local hormone therapy can significantly improve symptoms.

✅ Cutting-edge treatments offer additional support for long-term relief.

If OAB medications haven’t worked, it might not be a bladder issue at all.

Instead of just managing symptoms, addressing the underlying causes could be the key to lasting relief!