Overactive Bladder

Overactive bladder (OAB) is a common condition that affects approximately 33 million Americans have overactive bladder. Thirty percent of all men and 40 percent of all women in the United States live with OAB symptoms.

The number of people suffering from OAB is most likely much larger. That’s because many people living with OAB don’t ask for help. Some are embarrassed. They don’t know how to talk to their healthcare professional about their symptoms. Others don’t ask for help because they think there aren’t any treatments for OAB.

If you think you have a problem, don't wait. OAB can get in the way of your work, social life, relationships, exercise and sleep. But you don't have to allow OAB symptoms to limit your life—there are treatments available to help. If you think you have OAB, please see your urologist.

Symptoms:

The major symptom of OAB is a “gotta go” feeling—the sudden, strong urge to urinate that you can’t control. You may also worry that you will not be able to get to a bathroom in time. You may or may not leak urine after feeling this urge.

If you live with OAB, you may also experience:

  • Leaking urine (incontinence): Sometimes people with OAB also have "urgency incontinence." This means that urine leaks after they feel the sudden urge to go. This isn’t the same as "stress urinary incontinence" or "SUI.” Women with SUI leak urine while sneezing, laughing or doing other physical activity. You can learn more about SUI at our It’s Time to Talk about SUI campaign web pages.
  • Frequent urination: You may also need to go to the bathroom many times during the day. The number of times someone urinates varies from person to person. But many experts agree that going to the bathroom more than eight times in 24 hours is “frequency."
  • Waking at night to urinate: Having to wake from sleep to go to the bathroom more than once a night is another symptom of OAB.

Risk Factors:

As you grow older, the risk for OAB symptoms increases. Both men and women are at risk for OAB. Women who have gone through menopause and men who have had prostate problems seem to be at greater risk for OAB. Also, people with neurological diseases, such as stroke and multiple sclerosis (MS), have a high risk of OAB.

Eating a diet that is rich in "bladder irritating" food and drinks (such as caffeine, alcohol and highly spiced foods) can increase OAB symptoms.

Causes:

The bladder and kidneys are part of the urinary tract—the organs in our bodies that produce, store and pass urine. You have two kidneys that produce urine. Then urine is stored in the bladder. The muscles in the lower part of your abdomen hold your bladder in place.

When it isn’t full of urine, the bladder is relaxed. When nerve signals in your brain let you know that your bladder is becoming full, you feel that you need to urinate. Then the bladder muscles squeeze and push urine out through the urethra, the tube that carries urine from your body. The urethra has muscles called sphincters. They help keep the urethra closed so urine doesn't leak before you're ready to go to the bathroom.

OAB can happen when the nerve signals between your bladder and brain tell your bladder to empty even when it isn’t full. OAB can also happen when your bladder muscles are too active. Then, your bladder muscles “contract” to pass urine before your bladder is full, and that causes a sudden, strong need to urinate, called “urgency.

Diagnosis:

In order to diagnose OAB, your health care professional will first gather facts about your past and current health problems, the symptoms you’re having and how long you've had them, what medicines you take, and how much liquid you drink during the day.

Your health care professional may also conduct a physical exam to look for something that may be causing your symptoms, including examining your abdomen, as well as the organs in your pelvis and your rectum (for women), or prostate and rectum (for men).

He or she may collect a sample of your urine to check for infection or blood and, in some cases, conduct other tests, such as a urine culture or ultrasound.

Your health care professional may also ask you to keep a “bladder diary” to learn more about your day-to-day symptoms.

Treatments:

Behavioral therapy: Lifestyle changes—known as “behavioral techniques”—are often the first treatments used to manage OAB. In behavioral therapy, you make some changes in the way you live day-to-day.

This may include changing your diet to determine if less caffeine, alcohol, and spicy foods will reduce your symptoms. Behavioral changes may include going to the bathroom at scheduled times during the day, and doing “quick flick” Kegel exercises to relax your bladder muscle. Most patients don’t get rid of their symptoms completely with lifestyle changes, but many do have fewer symptoms using this type of treatment.

Medications: There are several drugs available to relax the bladder muscle and stop it from contracting at the wrong times. You take some of these medications by mouth, while others may use a gel or adhesive patch to deliver the drug through the skin. You may take the drug alone or along with behavioral therapy.

Neuromodulation therapy: These treatments deliver harmless electrical impulses to nerves that can change how the nerves work. Specialists use this type of therapy only for some patients when medications or behavioral therapies don’t work, or when patients have serious side effects from medications.

Botox injections: Some experts think that injections of botulinum toxin, better known as Botox®, can help patients who don’t respond to other treatments. The injections into the bladder muscle may help keep it from contracting too often.

Citations:

OVERACTIVE BLADDER (OAB. (2013, March). Retrieved October 25, 2013, from Urology Care Foundation website: http://www.urologyhealth.org/urology/index.cfm?article=112&display=1


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