Rockledge, Florida

Marja Sprock, M.D., FACOG, FPMRS Board Certified
Fellowship Trained Urogynecologist

Now Accepting New Patients      Phone:  321-806-3929

Recently Published

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new  Laser and the Vagina

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new  Overactive Bladder

new  Painful Bladder Syndrome / Interstitial Cystitis

new  Stress Urinary Incontinence

new  The Thrill is Gone

new  Chronic Constipation

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Have You Had Your Pap Smear?

Resources for Pelvic Floor Disorders

The Uterine Fibroid Dilemma

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New Treatment Option for Stress Urinary Incontinence

Non-hormonal Vaginal Atrophy Treatment -- Non-painful Sex Without Estrogen

In-Office Painless Laser Vaginal Tightening

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Nerve Stimulation to Treat Urinary and Fecal Problems

Is UTI a Major Health Problem?

It Appeared to be an Overactive Bladder

Pessary Treatment of Prolapse

Overactive Bladder Evaluation Chart

Accidental Bowel Loss or Fecal Incontinence

Overactive Bladder Guidelines

Vaginoplasty and the “Designer Vagina”

Surgical Treatment of Stress Urinary Incontinence

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Pads are "Out of Style"

Stool or Bowel Incontinence

Pain with Sex

Nightime Urination

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Health and Feeling Good About Yourself

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Treatments for Fecal Incontinence

Third Generation i-Lipo Xcell now available!  FIRST IN U.S.A.

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InTone Home Device to Treat Urinary Incontinence

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Sexy Meshes ???

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A Happy Patient Testimonial - Swimming Again After Bladder Procedure  <external>

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Nocturia, Nighttime Voiding

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Previously Published by Category








Technical & Educational Info

All Published Articles

Overactive Bladder
by: Marja Sprock, M.D., F.A.C.O.G., F.P.M.R.S board certified

Overactive Bladder (OAB) or the “got to go” bladder is a quality of life interfering condition and can be quite frustrating. Women as well as men can be bothered by OAB. The prevalence increases with age, and 1 in 6 people over age 40 have “got to go bladders”

The initial treatment should focus on making the muscles of the pelvis stronger (Kegels) and lifestyle factors like treating constipation and monitoring your diet. Alcohol, caffeine and soda may irritate the bladder. Excess weight is definitely a factor to address, however contributes more to stress incontinence than OAB. Smoking increases your chance of urine incontinence and there are plenty of good reasons to quit that habit.

Overactive bladder medications get advertised on TV quite often and help a lot of people. Options are anticholinergics which help to stop some of the bladder contractions contributing to OAB and beta 3 mimetics, mostly allowing more volume in the bladder. Drugs can potentially have side effects and constipation is common with the anticholinergics.

When we get older our nerves are not as reliable in transferring the info from our bladder to our brain and we get the urge sign at the last minute or too late. To get an urge when the bladder is really ready to go or already starting to empty is a recipe for leaking urine. This means if you wait for an urge in this situation, you will be too late. Adjustments are: timed voiding and during the day you should empty your bladder at least every 3 hours, urge or no urge. Also be aware of what your bladder can hold, and that is less when we get older. Could we easily hold 10 oz. at age 35, at 70 that may be 6 oz. Remember when you sit down in a restaurant or in front of the TV, you do not notice your urge as well. That large glass of water, may give you a nasty surprise when you get up after 2 hours. Monitor your volume intake as well as the time between voids.

You wear glasses if your eyes do not register all those tiny letters, so why would you expect your bladder to remain perfect without any help? Be smarter than your bladder. There are ways to work with your bladder or even rejuvenate it. We have no stem cell treatment yet for OAB, but nerve stimulation helps quite well.

There are several FDA approved treatments for overactive bladder, varying from pelvic floor training and biofeedback to medications and neuromodulation. Neuromodulation can be achieved by a permanent implanted electrode or by a temporary one. Pessaries or the newer modified tampon Impressa are supposed to stop leaks by compression, their success rate is modest and mostly for stress urinary incontinence (SUI)

Percutaneous tibial nerve stimulation (PTNS) is a minimally invasive temporary nerve stimulation. It is easily applicable and well tolerated to treat overactive bladder and urinary retention. It was FDA approved in 2000 and continues to be used successfully.

PTNS is a covered benefit for most insurances and more or less rejuvenates the bladder nerve. It helps with OAB and also improves emptying of the bladder.

It is performed via a stick-on electrode and a minute needle that will get inserted above the ankle. The treatment session will continue for about 30 minutes and it will take up to 6 sessions before it can be judged if the treatment is helpful. After 10-12 sessions, results will be more noticeable. For the first 6 sessions, the frequency will be weekly, then it will be slowly spaced out to maintain the achieved benefit. There are very few successful treatments like PTNS, while sitting in a chair, watching TV or reading a book, your bladder nerve gets its energy boost and OAB gets better. You will still have to get up to empty your bladder though!

Neurostimulation helps for overactive bladder, be it permanent like the Interstim® or temporary like PTNS.

Stimulation of the nerves connected with our pelvic organs like bladder and rectum has proven to be very beneficial for lower urinary tract problems as well as fecal problems.

Pelvic floor muscle training and lifestyle changes should be the start of OAB treatment. Remember, like a biceps muscle needs training, so does the pelvic floor. Proper use of the pelvic floor muscles can bring enormous improvement. Also be smarter than your bladder, use your watch or a timer on your phone to remind yourself to go during the day at least once every 3 hours.

Medications with lifestyle changes help a lot of people. OAB is not the same for everyone. Some people have a normal looking bladder, others a scarred bladder. Some bladders never stop contracting, others only will if you challenge them to the max. People, bladders and severity are different, that is why there are many treatments available.

No need to suffer or be insecure, Central Florida UroGynecology has ample experience to help you to conquer your OAB. 

Katrina Davis MD and Marja Sprock MD are female physicians, board certified in OB/GYN and board certified in Female Pelvic Medicine and Reconstructive Surgery (FPMRS) and more than able to help you put an end to your OAB.

Call for an appointment 321-806-3929 or

"Central Florida UroGynecology where high tech and common sense meet"

Central Florida Urogynecology

101 Eyster Boulevard, Rockledge, FL 32955

Phone 321-806-3929

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updated:  January 11, 2016