Overactive Bladder

Overactive bladder is the name given to a group of symptoms affecting the urinary system. These symptoms include:

• Uncontrollable urge to urinate
• Leakage of urine along with urge to urinate, also called as incontinence
• Having to go to the washroom many times during the day and night

According to statistics, 30% of all men and 40% of all women in the United States suffer from overactive bladder. It roughly affects 33 million Americans as per hospital estimates. But the number could be much more as many people suffering from an overactive bladder are too embarrassed to seek help.

Symptoms of Overactive Bladder

• Urgency: This is the most important symptom of an overactive bladder. There is this sudden strong urge to urinate. You feel that if you do not relieve yourself immediately, you may leak urine.

• Incontinence: Along with the sudden urge to urinate, some patients may actually leak a few drops of urine before they can go to the washroom.

• Increased Frequency of Urination: Passing urine more than eight times in a day is called as increased frequency of urination. In patients suffering from an overactive bladder, the frequency of urination is increased.

• Nocturnal Micturia: Patients with an overactive bladder have to get up several times in the night to void urine.

Causes of Overactive Bladder

Normally, when the bladder gets full, nerve impulses from the brain direct the muscles of the bladder to contract and empty the bladder. However, at times, the brain may signal the bladder to empty even when it is not full. This is seen in patients with an overactive bladder. Similarly, if the bladder muscles are too active, they undergo contractions even when the bladder is not full. This leads to urgency in patients suffering from an overactive bladder.

Risk Factors For an Overactive Bladder

Some of the risk factors for an overactive bladder include:

• Old age
• Men suffering from prostate problems
• Women after menopause
• People suffering from conditions affecting the brain and spinal cord like Multiple sclerosis and stroke

Diagnosis of Overactive Bladder

Patients suspected to be suffering from an overactive bladder are asked by their doctors to maintain a bladder diary in which they note the number of times they have to go to the washroom in a day.Certain tests are also performed. These include:

• Urine Culture: This is done to rule out urinary infection or blood.
• Bladder Scan: This is done to find out the amount of urine remaining in the bladder even after emptying it.
• Cystoscopy: The interior of the bladder is visualized with the help of a cystoscope to rule out any other cause of urgency.
• Urodynamic Studies: They reveal the way the bladder is storing urine before releasing it.

Treatment of an Overactive Bladder

Treating an overactive bladder includes:

• Lifestyle changes
• Medical and surgical treatments

Lifestyle Changes: These include reducing the intake of food and beverages that are more likely to irritate the bladder. Some of them are tea, coffee, alcohol, soda, fizzy drinks, chocolate, citrus fruits and spicy foods. Patients are also advised to try delayed voiding i.e. holding back urination for some time even when they feel the urge; and double voiding i.e. trying to pass the urine a second time after passing it once so that the bladder empties properly. Patients are also taught exercises to strengthen the bladder muscles.Medical and Surgical Treatments: These include drugs to relax the bladder muscles and giving Botox injections into the bladder muscles to prevent them from contracting too often. Surgical treatment modalities include sacral neuro-modulation (SNS) and percutaneous tibial nerve stimulation (PTNS).Reference:http://www.urologyhealth.org/urologic-conditions/overactive-bladder-(oab)