What is the treatment for bladder spasms?

From the Guidelines

Treatment for Bladder Spasms

The first line of management for bladder spasms is often with anticholinergic medications such as oxybutynin (5-10 mg orally, 2-3 times a day) or tolterodine (2-4 mg orally, 2 times a day) 1.

• In some cases, medications like flavoxate (100-200 mg orally, 3-4 times a day) or phenazopyridine (100-200 mg orally, 3 times a day) may also be used.
• Additionally, bladder training and pelvic floor physical therapy can be beneficial 1.
• It's essential to consult a healthcare provider for proper diagnosis and personalized treatment, as the underlying cause of the bladder spasms may need to be addressed.
• In severe cases, other interventions such as botulinum toxin injections into the bladder muscle or nerve stimulation therapies may be considered under medical supervision 1. Key considerations include:
• Pharmacologic therapies are effective but may have adverse effects, and patient adherence can be poor 1.
• Non-pharmacologic treatments like pelvic floor muscle training (PFMT) and bladder training can be effective and have fewer side effects 1.
• The choice of treatment should be based on the individual patient's symptoms, medical history, and preferences.

From the FDA Drug Label

Oxybutynin chloride exerts a direct antispasmodic effect on smooth muscle and inhibits the muscarinic action of acetylcholine on smooth muscle. Oxybutynin chloride relaxes bladder smooth muscle In patients with conditions characterized by involuntary bladder contractions, cystometric studies have demonstrated that oxybutynin chloride increases bladder (vesical) capacity, diminishes the frequency of uninhibited contractions of the detrusor muscle, and delays the initial desire to void Oxybutynin chloride thus decreases urgency and the frequency of both incontinent episodes and voluntary urination. Oxybutynin chloride is indicated for the relief of symptoms of bladder instability associated with voiding in patients with uninhibited neurogenic or reflex neurogenic bladder (i.e., urgency, frequency, urinary leakage, urge incontinence, dysuria). Flavoxate hydrochloride counteracts smooth muscle spasm of the urinary tract and exerts its effect directly on the muscle.

The treatment for bladder spasms is oxybutynin or flavoxate, which are medications that exert a direct antispasmodic effect on smooth muscle and counteract smooth muscle spasm of the urinary tract, respectively 2, 2, 3.

• Oxybutynin relaxes bladder smooth muscle and decreases urgency and the frequency of both incontinent episodes and voluntary urination.
• Flavoxate exerts its effect directly on the muscle and counteracts smooth muscle spasm of the urinary tract.

From the Research

Treatment Options for Bladder Spasms

• Anticholinergic agents, such as oxybutynin and tolterodine, are commonly used to treat overactive bladder syndrome, which can cause bladder spasms 4, 5, 6
• Other treatment options include bladder training, pelvic floor muscle training, and electrical stimulation 5, 7, 8
• Combination therapy, such as using anticholinergic agents with bladder training or electrical stimulation, may be effective for some patients 5, 7, 6

Pharmacological Treatments

• Anticholinergic agents, such as darifenacin, solifenacin, and trospium, have been shown to be effective in treating overactive bladder syndrome 4, 6
• Beta-3 adrenoceptor agonists, such as mirabegron, may also be used to treat overactive bladder syndrome 6
• Vaginal estrogen therapy may be used to treat overactive bladder syndrome in women, especially those with vaginal atrophy 6

Non-Pharmacological Treatments

• Bladder training involves gradually increasing the time between voiding to help the bladder hold more urine and reduce symptoms of overactive bladder syndrome 5, 8
• Pelvic floor muscle training, also known as Kegel exercises, can help strengthen the muscles that control urination and reduce symptoms of overactive bladder syndrome 5, 8
• Electrical stimulation, such as transcutaneous electrical nerve stimulation (TENS) or percutaneous posterior tibial nerve stimulation (PTNS), may be used to treat overactive bladder syndrome 5, 7