Overactive Bladder: Symptoms and Treatment

Overview

Overactive bladder (OAB), is a common condition with bladder-storage function. It causes a sudden urge to urinate. The urge may be difficult to stop, and overactive bladder may lead to the involuntary loss of urine, known as urge incontinence.

Overactive bladder affects about 33 million Americans. An estimated 40 percent of American women and 30 percent of American men are thought to experience OAB symptoms.

Causes

There are a number of reasons why OAB may occur:

  • Weak pelvic muscles
  • Drugs 
  • Aging and menopause
  • Overweight and obesity
  • Nerve Damage and Nervous System Disorders
  • Urinary Tract Infections
  • Bladder Abnormalities

Symptoms

Symptoms of overactive bladder can change. The main symptoms of OAB include these signs:

  • Urinary urgency

Urgency is considered as the defining symptom of overactive bladder.

  • Urinary frequency

Frequent urination is often defined as eight or more times within 24 hours.

  • Urge incontinence

This means you are leaking urine uncontrollably, or leaking urine after getting the urge to urinate.

  • Nocturia

It is defined as waking up twice or more times during the night to urinate.

The physical symptoms of OAB can also lead to emotional symptoms:

  • Avoiding social activities

Fear of an accident, or being far from a bathroom, can cause social anxiety in those with OAB. In more severe cases, people with OAB may avoid social situations.

  • Emotional distress

Many people with OAB suffer a loss of self-esteem and have the desire for intimacy.

Diagnosis

The diagnosis of overactive bladder is mainly based on the presence of symptoms. Normally, the diagnosis includes:

  • A thorough medical history

The diagnosis of overactive bladder can be
suspected based on the history and presenting complaints of an individual.

  • A general physical examination

This allows your doctor to feel for tenderness around your abdomen and kidneys or check for an enlarged prostate.

  • Urine sample
    (Urinalysis)

A urinalysis can help identify a urinary tract infection or other urinary tract problems.

  • Urodynamic testing

This assortment of tests can assess the bladder’s
ability to hold and store urine.

  • Cystoscopy

A cystoscopy, sometimes taken along with biopsies, helps to determine if your symptoms are caused by any abnormalities within your bladder, such as bladder stones or tumors.

  • A post-void
    residual (PVR).

This entails measuring the amount of urine in the bladder after urination
using an ultrasound or by placing a catheter in the bladder through the
urethra.

  • Further tests for women and men respectively

A pelvic exam in women and prostate exam in men
are important in the assessment of an individual with overactive bladder.

Treatment

There are a number of treatments to help manage OAB. Doctors may prescribe treatment to help you manage your symptoms.

Overactive bladder surgery

  • Sacral nerve
    stimulation

During this procedure, your doctor can place a small electrode under the skin of your buttocks or lower abdomen. This electrode will send pulses that help regulate signals that tell your body when you need to urinate.

  • Urinary diversion

Rerouting
your ureters (the tubes that carry urine from your kidneys to your
bladder) can reduce the frequency and urge to urinate.

  • Cystoplasty

If your doctor
thinks your OAB symptoms are the result of a bladder that is too small, they
may suggest enlarging it during this procedure.

  • Bladder removal

Rarely, your doctor may decide removing your bladder entirely is the only option to eliminate OAB symptoms and complications. These surgeries are often highly effective, but they carry a number of risks and possible lifelong complications.

Overactive bladder exercises

  • Pelvic floor
    exercises

These exercises, also known as Kegels, can help you strengthen the muscles in and around your pelvis.

  • Vaginal cones

If imagining using those muscles seems too abstract or difficult, you can use a device called a vaginal cone to help you isolate your pelvic floor muscles.

  • Bladder training

Bladder training helps you lengthen the time between an urge to urinate and when you actually urinate.

Overactive bladder medications

Medications used to treat overactive bladder include antimuscarinics and newer drugs:

Botox

In this treatment, a series of Botox injections are administered directly into the bladder using cystoscopy. Botox can help relax the bladder and increase its storage capacity, reducing OAB symptoms.

Keywords: Overactive Bladder (OAB).

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