Overactive bladder (OAB) results in frequent, unexpected bathroom urges that can be challenging to control. You can experience frequent urges to pee during the day and at night, as well as involuntary urination (urgency incontinence).
OAB is also called “spastic bladder” or “irritable bladder” that affects many individuals across the globe.
It can be physically and emotionally taxing to have a bladder condition, affecting your daily activities. It can be annoying; at worst, it can be crippling. when urine incontinence is involved, it can also lead to anxiety, embarrassment, and even despair.
OAB may also have an impact on your relationships with your friends and family. In addition, your sleeping pattern may be disturbed due to frequent urination,. Moreover, if there is a leak of urine, you could be more prone to infections, like urinary tract infections (UTIs).
What causes overactive bladder (OAB)
The signals involved in emptying a bladder are complex. Normally, urine from the kidneys flows into the bladder. The sphincter muscle functions as a faucet and regulates urine flow while the bladder expands to hold the urine. As the bladder fills, nerve signals are sent to the brain that prompts the urge to urinate. The brain sends the signal to the bladder to hold on until a person consciously decides to go. Urine is emptied out of the bladder through conscious contraction of the bladder muscle.
With OAB, nerve signals between the brain, spinal cord, and bladder are not functioning well. There may be abnormalities with the urethra, bladder, or urinary sphincter. The bladder may contract without voluntary control, or the urethral sphincter may not be closing properly or resisting the flow of urine from the bladder, leading to leakage.
Possible causes of overactive bladder include:
- Brain or spinal cord problems (e.g., stroke or multiple sclerosis)
- Diabetes mellitus
- Urinary tract infections (UTI)
- Bladder tumors, polyps, or stones
- Hormone changes in women going through menopause
- Drinking excessive amounts of caffeine or alcohol
- Side effects of certain medications (e.g., water pills)
- Decreased cognitive functioning due to aging
- Inadequate emptying of the bladder
What are the symptoms of overactive bladder (OAB)
The overactive bladder symptoms are as follows:
- You have the sudden desire to urinate that is hard to control
- Involuntary loss of urine right after an urgent need to urinate (urgency incontinence)
- Urinating more often, typically eight or more times in 24 hours
- Getting up in the middle of the night during sleeping hours more than two times to urinate (nocturia)
How do you diagnose an overactive bladder (OAB)
When you have consulted your symptoms with your healthcare provider, they will typically do an assessment immediately. They could also suggest a specialist, like a urologist, who specializes in diagnosing and treating patients with OAB.
Most of the time, OAB can be confirmed with the following to rule out any underlying conditions:
- Medical history
- Physical examination (e.g., rectal exam and pelvic exam)
- Urine study to screen for an infection, blood traces, or other problems
- Comprehensive neurological assessment that may detect sensory or reflex problems
Additional testing may be performed in more complicated cases. These tests will help healthcare providers gain more knowledge of the lower urinary tract’s structure and function. These tests could consist of the following:
- Urodynamic tests evaluate how well your bladder is working and whether it can consistently empty fully.
- Ultrasound (bladder scan) to assess how much urine is left in your bladder after you urinate or if the bladder is emptying well
- Uroflowmeter to monitor voiding volume and rate
- Cystometry to check how well the bladder is functioning. It is indicated to check for problems with the filling and emptying of the bladder. Also, it is used to identify if you have uncontrollable muscular spasms or a rigid bladder that cannot hold urine under low pressure.
How to treat overactive bladder (OAB)
Once you have been diagnosed with OAB, patients can explore potential treatments with their doctor. Discussing will aid in your understanding of the root of your issue and the possible benefits of various therapies. In addition, your doctor will discuss any potential side effects associated with a given course of treatment.
The following are the overactive bladder treatments or strategies:
Behavioral Therapies are the most effective method for controlling OAB and have no harmful side effects.
- Pelvic floor muscle rehabilitation (Kegel’s exercise) helps strengthen the pelvic floor muscles and urinary sphincter, preventing the involuntary contractions of the bladder.
- Biofeedback, a mechanism in which sensors are attached to your body to help you receive information about your body and make subtle changes
- Weight loss
- Schedule urination, which helps you develop a regular routine to urinate, and does not rely on the urge
- Intermittent catheterization, in which a device is inserted in the urethra to help you empty your bladder if the bladder cannot do so by itself
- Absorbent pads, which helps protect you and your clothing from leakage
- Bladder training, which helps you hold in the urine until you are ready
Medications
Numerous pharmacological therapies are effective in treating OAB. Your doctors can provide you with advice on what medications might be best for you depending on your symptoms, your other medical problems, the prescriptions you are currently taking, and the adverse effect profile of medicines.
- Vaginal estrogen therapy to help strengthen the muscles and tissues in the urethra and vaginal area
The symptoms of an overactive bladder can sometimes be relieved by taking medications that relax the bladder like:
- Tolterodine (Detrol)
- Oxybutynin (Ditropan XL), (Oxytrol), or (Gelnique)
- Trospium
- Solifenacin (Vesicare)
- Fesoterodine (Toviaz)
- Mirabegron (Myrbetriq)
- Bladder injections
- OnabotulinumtoxinA helps relax the muscles
Nerve stimulation
The symptoms of OAB can be improved by controlling the nerve impulses to your bladder.
- Percutaneous tibial nerve stimulation (PTNS)
This procedure transmits electrical impulses from the tibial nerve to your spine, where it connects to control the bladder.
Surgery
Surgery is only used to treat OAB in cases where the symptoms are severe and other treatments are ineffective. The intention is to lessen bladder pressure and increase the capacity of the bladder to hold urine.
- Bladder removal
Conclusion
Overactive bladder is characterized by a sudden, intense urge to urinate that is challenging to put off, including frequent urination, nocturia, and urinary incontinence.
With OAB, some individuals can have a profound effect on their quality of life. OAB disrupts the ability to accomplish daily tasks and curtails social functions such as work, travel, physical activity, sleep, and sexual function.
However, it is essential to be aware that symptoms of OAB can be effectively treated. These treatments can range from behavioral therapies, medications, minimally invasive procedures, and surgery.
Although it may seem odd to discuss something so personal with your doctor about bladder problems, seeking medical assistance is the first stage of treatment to overcome this medical condition.
