Description

Overactive bladder, also called the OAB, the causes of the sudden urination that may be difficult to control. There may be a need to urinate many times during the day and night. It could also be the loss of urine that is not the intention, called urgency incontinence.

People with overactive bladder may feel self-conscious. You can do that is to stay away from others, or limit your work and social life. The good news is that you can try.

Simple changes in behavior can manage the symptoms of overactive bladder. These can include changes in diet, urinating in a particular time and the use of the pelvic floor muscles for bladder control. There are also other treatments to treat.

Symptoms

If you have an overactive bladder, you can:

  • I feel a sudden need to urinate that is difficult to control.
  • Losing urine without meaning to after an urgent need to urinate, called urgency incontinence.
  • Urinate frequently. This can mean eight or more times in 24 hours.
  • Wake up more than two times per night to urinate is called nocturia.

Even if you can reach the bathroom in time when you feel an urge to urinate, frequent urination during the day and night can disrupt your life.

When to see a doctor

Although it is common among older adults, the overactive bladder is not a typical part of aging. It may not be easy to talk about your symptoms. But if symptoms of distress to you or to disrupt your life, talk to your health professional. There are treatments that can help.

Causes

How a healthy bladder works

The kidneys produce urine, which flows into the bladder. When urinating, urine passes from the bladder through a tube called the urethra (u-REE-thruh). A muscle in the urethra, called the sphincter opens to release the urine out of the body.

In people assigned female at birth, the opening of the urethra is just above the vaginal opening. In persons assigned male at birth, the opening of the urethra is at the tip of the penis.

As the bladder fills, nerve signals that are sent to the brain trigger the need to urinate. At the time of urination, these nerve signals cause the muscles of the pelvic floor and the muscles of the urethra, called the urinary sphincter muscles to relax. The muscles of the bladder contract, also called a contract, pushing the urine.

Involuntary contractions of the bladder

Overactive bladder occurs when the bladder muscles start to tighten on its own even when the amount of urine in the bladder is low. These are called involuntary contractions. That causes an urgent need to urinate.

Several conditions can be a part of the overactive bladder, including:

  • Conditions that affect the bladder, such as tumors or stones in the bladder.
  • Conditions that affect the brain and the spinal cord, such as stroke and multiple sclerosis.
  • Diabetes.
  • The factors that stand in the way of the urine out of the bladder, such as an enlarged prostate, constipation, or after you have had surgery to treat the lack of control over urination, it is called incontinence.
  • Hormonal changes during menopause.
  • Urinary tract infections, which can cause symptoms similar to those of an overactive bladder.

The symptoms of the overactive bladder can also be linked to:

  • The cognitive impairment due to age. This can make it more difficult for the bladder to the use of the signals received by the brain.
  • Drinking too much caffeine or alcohol.
  • The drugs that cause the body to produce a large amount of urine, or that need to be taken with plenty of fluids.
  • Not be able to get to the bathroom quickly.
  • Do not empty your bladder all the way. This leads to that there is not enough space in the bladder to urinate more.

Sometimes, the cause of overactive bladder is not known.

Risk factors

Aging increases the risk of overactive bladder. So does the fact of being a woman. Conditions such as enlarged prostate and diabetes may also increase the risk.

Many people with decrease in the ability of thinking, such as those who have had a stroke or have Alzheimer's disease, to obtain an overactive bladder. That is because they are less able to notice the symptoms of needing to urinate. Drink fluids on a calendar, sync and causing urination, absorbent garment, and bowel programs can help manage the condition.

Some people with an overactive bladder also have problems with bowel control. Tell your healthcare professional if you are having problems controlling your bowels.

Complications

Any type of incontinence that can affect the quality of life. If your symptoms of overactive bladder alter their life, you might also have:

  • Anxiety.
  • Of distress or depression.
  • Sexual problems.
  • Disorders of sleep and disrupted sleep cycles.

The people assigned female at birth who have an overactive bladder may also have a condition called mixed incontinence. This has both the urgency and stress urinary incontinence.

Stress urinary incontinence is the sudden loss of urine from the physical movement or activity that puts pressure on the bladder. Examples are coughing, sneezing, laughing, or exercise.

Prevention

These healthy lifestyle can reduce the risk of overactive bladder:

  • Exercises to make the muscles of your pelvic floor stronger. These are called Kegel exercises.
  • Get regular, daily physical activity and exercise.
  • Limit your consumption of caffeine and alcohol.
  • Maintain a healthy weight.
  • Manage, called chronic diseases, like diabetes, which you can add to the symptoms of overactive bladder.
  • Stop smoking.

Diagnosis

If you have an urgent need to urinate, your health care professional to look for an infection of the blood or in the urine. Your health care professional may also check to see if you are emptying your bladder completely when you urinate.

The appointment is likely to include:

  • History of medicine.
  • Neurological exam to look for problems, sensory or reflex of the problems.
  • Physical exam, which may include a rectal exam and a pelvic exam in women.
  • Urine sample to test for infection, traces of blood or other problems.

Testing the function of the bladder

Your health care professional may suggest tests to see how well the bladder works and if you can empty all of the way, he called urodynamic tests. A specialist of the majority of the times makes these tests. But the tests may not be necessary to make a diagnosis or start of treatment.

Urodynamic tests include:

  • The measurement of urine left in the bladder.This test is important if it can't be emptying the bladder completely when you urinate. Rest of the urine in the bladder, called postvoid residual urine, can cause symptoms similar to those of an overactive bladder. To measure residual urine after you cancel, your health care professional may want to get a ultrasound of the bladder. The ultrasound translates sound waves into an image. The image shows the amount of urine left in the bladder after urinating. Sometimes, a thin tube, called a catheter, is passed through the urethra into the bladder to drain the remaining urine. Then, the urine can be measured.
  • The measurement of urine flow. To measure how much and how fast you urinate, you may be asked to urinate into a device called a uroflowmeter. A uroflowmeter captures and measures the urine. We then used the data to create a graph of the changes in the flow rate.
  • The evidence of the bladder pressures.A test called the cystometry measures pressure in the bladder and in the area around it as your bladder fills. After emptying the bladder with a thin tube, called a catheter, your health care professional uses a catheter to fill the bladder slowly with the warm fluid. Another catheter with a sensor that measures the pressure is in the rectum or in the vagina. The sensor indicates the amount of pressure of the bladder is used to empty all the way. This procedure can show how full the bladder is when you start needing to urinate. You can also show whether the bladder contracts when it is not.

The measurement of urine left in the bladder. This test is important if it can't be emptying the bladder completely when you urinate. Rest of the urine in the bladder, called postvoid residual urine, can cause symptoms similar to those of an overactive bladder.

To measure residual urine after you cancel, your health care professional may want to get a ultrasound of the bladder. The ultrasound translates sound waves into an image. The image shows the amount of urine left in the bladder after urinating.

Sometimes, a thin tube, called a catheter, is passed through the urethra into the bladder to drain the remaining urine. Then, the urine can be measured.

The evidence of the bladder pressures. A test called the cystometry measures pressure in the bladder and in the area around it as your bladder fills. After emptying the bladder with a thin tube, called a catheter, your health care professional uses a catheter to fill the bladder slowly with the warm fluid.

Another catheter with a sensor that measures the pressure is in the rectum or in the vagina. The sensor indicates the amount of pressure of the bladder is used to empty all the way.

This procedure can show how full the bladder is when you start needing to urinate. You can also show whether the bladder contracts when it is not.

Your health care provider reviews the results of their tests and suggests a treatment plan.

Treatment

A combination of treatments can be better to relieve the symptoms of overactive bladder.

Behavioral therapies

Behavioral therapies are the first choice in helping to manage an overactive bladder. Often work and have no side effects. Behavioral therapies may include:

  • Biofeedback. During biofeedback, a decision to put the patch on the skin over the bladder is connected to a cable that is linked to a screen. This allows you to see when the muscles of the bladder contract. This may help you to know what it feels like when your muscles contract so that you can learn to control them.
  • The training of the bladder. The training of the bladder is to go to the bathroom at set times. The use of a bladder diary to see how often you go. Then, add 15 minutes at a time between trips to the bathroom. To urinate, even if you don't feel the need. This can train your bladder to hold more urine before you feel the need to urinate.
  • Healthy weight. If you are overweight, losing weight may ease the symptoms. Weight loss may help if you also have stress incontinence.
  • Intermittent catheterization. If you are not able to empty your bladder, using a tube called a catheter times to empty the bladder completely helps your bladder, do what you can't do by itself. Ask your health care professional if this approach is right for you.
  • Exercises for the pelvic muscles.Kegel exercises strengthen the pelvic floor muscles and urinary sphincter. Stronger muscles can help stop the bladder from contracting on its own. Your health care provider or a physical therapist can help you learn how to do Kegel exercises. Kegel exercises are like other types of exercise. How well they work depends on your to do regularly. It may take six weeks before you start to work.

Exercises for the pelvic muscles. Kegel exercises strengthen the pelvic floor muscles and urinary sphincter. Stronger muscles can help stop the bladder from contracting on its own.

Your health care provider or a physical therapist can help you learn how to do Kegel exercises. Kegel exercises are like other types of exercise. How well they work depends on your to do regularly. It may take six weeks before you start to work.

Drugs

After menopause, estrogen therapy can help strengthen the muscles and tissues of the urethra and the vaginal area. Vaginal estrogen comes in creams, suppositories, tablets, or rings. It can improve the symptoms of overactive bladder.

Medications that relax the bladder may help to relieve the symptoms of overactive bladder and reduce the episodes of urge incontinence. These medications include:

  • Fesoterodine (Toviaz).
  • Mirabegron (Myrbetriq).
  • Oxybutynin, which can be taken as a pill (Ditropan XL) or is used as a skin patch (Oxytrol) or gel (Gelnique).
  • Solifenacin (Vesicare).
  • Tolterodine (Detrol).
  • Trospium.
  • Vibegron (Gemtesa).

The common side effects of most of these drugs include dry eyes and dry mouth. But drink water for the thirst can make the symptoms of overactive bladder worse. Constipation is another possible side effect that can cause bladder symptoms worse. Extended-release forms of these drugs, including the skin patch or gel, may cause fewer side effects.

Your health care professional may suggest that you take small sips of water or sucking on a piece of sugarless candy or chew sugarless gum to relieve dry mouth. You can use eye drops to keep the eyes moist.

Medications available without a prescription, such mouthwashes designed to relieve the dryness of the mouth, may be useful for the long-term, dryness in the mouth. Eating a diet rich in fiber, or the use of stool softeners might help to prevent constipation.

The bladder injections

OnabotulinumtoxinA (IN-ah-boch-yoo-lih-num-tox-in-One), also known as Botox, is a protein from the bacteria that causes botulism, a disease. Small doses of vaccine in the tissues of the bladder can relax the muscles and increase the amount of urine the bladder can hold.

Studies show that Botox can help in severe urge incontinence. The effects often last for six months or more. When the effects wear off, you need another chance.

The side effects of these vaccines include infections of the urinary tract and urine retention. If you are thinking of Botox treatments, you must be willing to put a catheter in yourself if you start the retention of urine.

Nerve stimulation

Mild electrical pulses to the nerves of the bladder may improve symptoms of overactive bladder.

A procedure that uses a thin wire is placed near the sacral nerves which pass near the tailbone. The sacral nerves carry signals to the bladder.

This minimally invasive procedure that is often done with a trial of a wire is put under the skin in the lower part of his back. Your health care professional, then use a handheld device connected to the cable to send electrical impulses to the bladder. This is like a pacemaker for the heart.

If the test helps your symptoms, a battery, pulse generator is put in with the surgery. The device remains in your body to help control the nerves.

Percutaneous tibial nerve stimulation (PTNS)

This procedure uses a thin needle that is placed through the skin near the ankle. Sends the electrical stimulation of a nerve of the leg, called the tibial nerve, the vertebral column. There it connects with the nerves that control the bladder.

PTNS treatments are given once a week for 12 weeks to treat the symptoms of overactive bladder. After that, the treatments every 3 to 4 weeks to help keep the symptoms under control.

Surgery

The surgery to treat overactive bladder is only for people with severe symptoms that do not respond to other treatments. The goal is to improve the ability of the bladder to store urine and reduce the pressure in the bladder.

The procedures include:

  • The surgery to increase the amount of the bladder can hold. This procedure uses the parts of the intestine to replace a part of the bladder. People who have this surgery may require the use of a catheter sometimes for the rest of their lives to empty your bladder.
  • Bladder removal. This procedure is used as a last resort. It involves the removal of the bladder and surgically to do a bladder to replace it, is called a neobladder. Or it may involve making an opening in the body, called a stoma, in order to set a bag on the skin to collect the urine.

Lifestyle and home remedies

The following may reduce symptoms of overactive bladder:

  • Don't drink too much or too little. Ask your healthcare professional how much to take daily. Drinking too much liquid can make your symptoms worse. However, not drinking enough can irritate the lining of the bladder and increase the need to urinate.
  • Limit foods and drinks that can bother your bladder. These include caffeine, alcohol, tea, carbonated beverages, citrus juices, and fruit, chocolate, spicy foods, and tomatoes. Try not to eat or drink these to see if it helps.
  • Maintain a healthy weight. If you are overweight, losing weight may help relieve your symptoms. Heavier people are also at higher risk of stress urinary incontinence. That it can be improved with weight loss.
  • Manage constipation. Constipation can make urinary incontinence worse. Your health care professional may suggest that you add more fiber to your diet. You can add fiber by eating more fiber-rich foods or by taking a fiber supplement.
  • Stop smoking. Smoking can make urinary incontinence worse. If you smoke, talk with your healthcare provider to help you quit smoking.
  • Wear absorbent pads or underwear. These are designed to take in liquids, control odor and protect your clothes when urine leaks.

Alternative medicine

There is No complementary or alternative therapies have been tested for the treatment of overactive bladder.

Some research suggests that acupuncture can help to relieve the symptoms of overactive bladder. Acupuncture involves the use of very thin needles that are disposed of after the procedure. More studies are needed.

Complementary treatments may not be covered by the insurance. So check with your insurance company if you want to try one.

Coping and support

Living with overactive bladder can be difficult. Consumer education and advocacy support groups, such as the National Association for Continence can provide you with the online resources and information. These groups connect with other people who have overactive bladder and urge incontinence. Support groups offer the opportunity to talk about their concerns and to learn new ways to cope.

Teach your family and friends about overactive bladder and how it affects that can help you to create your own support network and reduce feelings of shame. Once you start talking about it, you may be surprised to learn how common this condition is in reality.

Preparing for your appointment

For overactive bladder, start by seeing your primary healthcare professional. You could then be sent to a specialist in diseases of urinary tract in men and women, called a urologist, a specialist in urinary diseases in women, called a urogynecologist, or a specialist in physical therapy.

Here's some information to help you prepare for your appointment.

What you can do

  • Keep a journal of the bladder for a couple of days. Make a note of when, how much and what type of fluid you drink; when you urinate; if you feel the need to urinate; and if you have incontinence.
  • Tell your health care professional how long you have had your symptoms and how they affect your day-to-day activities.
  • Note other symptoms you may have, especially those related to how their insides work.
  • Let your healthcare professional know if you have diabetes or a neurological disease, or if you have had pelvic surgery or radiation treatments.
  • Make a list of all medications, vitamins or supplements that you take, including over-dose.
  • Write questions to ask their health professional.

For overactive bladder, the questions may include:

  • What are the possible causes of the symptoms?
  • Is my urine clear?
  • I can empty my bladder well?
  • Do you recommend other tests? For what?
  • What treatments are there? Which do you suggest for me?
  • What side effects can I expect from treatment?
  • Are there changes in the diet might help?
  • How to make my other health problems that affect my bladder symptoms?
  • Are there brochures or other printed material I can have? What websites do you suggest?

What to expect from your doctor

Your health care professional may use an overactive bladder questionnaire to assess their symptoms. The questions may include:

  • How long have you had these symptoms?
  • Do you leak urine? What's the frequency?
  • What are the symptoms prevent you from doing?
  • Makes movement such as walking, coughing, or bending over cause you to lose urine?
Symptoms and treatment of the Overactive bladder