A health condition in which a person experiences a sudden urge to urinate is called overactive bladder (OAB). It also can cause frequent urination either during the day or night. Moreover, a loss of urine can occur although it is not intended (urgency incontinence).
Those who experience this condition may feel self-conscious, which provokes them to avoid or limit contact with other people including at work. However, it is a treatable condition and sometimes certain behavioral changes can help to reduce the symptoms of OAB. The overactive bladder treatment usually includes dietary changes, urinating on schedule, training pelvic floor muscles that help to control the bladder, and others.
Symptoms
People with OAB usually experience the following symptoms. For example:
- Sudden urges to urinate that are often hard to control
- Urgency incontinence
- Frequent urination (such as 8-10 times during a day)
- Nocturia (it is when a person wakes up at least twice per night to urinate)
Some people may experience an urge to urinate although they get to the toilet in time. Furthermore, this condition usually occurs in older people and if it negatively affects your life, discuss it with a healthcare professional.
Causes
First, we need to understand how a healthy bladder works. In normal circumstances, the kidneys produce urine, which passes into the bladder. When a person urinates, the urine passes from the bladder through a tube called urethra out of the body. In the urethra is located a muscle (sphincter) that opens to release the urine.
In people assigned to females at birth, the urethral opening is located just above the vagina opening while in people assigned to males at birth, it is located at the tip of the penile.
When the bladder fills up, certain nerve signals are sent to the brain, which provoke the need to urinate.
Involuntary Bladder Contractions
This happens when the bladder begins to tighten despite a low amount of urine. These bladder contractions usually provoke a sudden urge to urinate. Check below some health problems associated usually with an overactive bladder:
- Tumors or bladder stones
- Brain and spinal cord conditions (including stroke, multiple sclerosis, and others)
- Diabetes
- Certain factors that affect urine leaving the bladder such as an enlarged prostate gland, constipation, surgery to treat urinary incontinence, and others
- Hormonal changes
- Urinary tract infections (UTIs)
In some cases, symptoms of OAB can be linked to the following factors. Examples include:
- Cognitive decline which is a part of aging
- People who drink increased amounts of caffeine or alcohol
- Certain medicines that make the body produce more urine
- Inability to get to the toilet quickly
- Not emptying completely the bladder can lead to enough space for more urine in the bladder
In some cases, determining the exact cause of OAB is not possible.
Risk Factors
Aging is a factor that could increase the risk of overactive bladder. Moreover, being a woman, having diabetes, or experiencing an enlarged prostate also elevates the risk of OAB.
Usually, people who suffer from a disease that declines thinking ability also have OAB. For example, those who experienced a stroke or have Alzheimer’s disease. It happens because the ability to notice an urge to urinate is reduced. However, consuming fluids on a schedule, bowel programs, and prompting urination can help to reduce the symptoms.
Some people with OAB also experience bowel control problems. Contact your healthcare professional if you experience bowel control issues.
What Are The Possible Overactive Bladder Complications?
This condition negatively affects everyone’s life and can lead to the following unpleasant complications. Examples include:
- Sleeping disturbances (insomnia)
- Sexual issues
- Emotional distress
- Depression
- Anxiety
Women and people assigned to females at birth in some cases can experience mixed incontinence (for example urgency and stress incontinence). Stress incontinence occurs when a loss of urine happens due to physical activity or movement. These include sneezing, coughing, laughing, or exercising.
How to Prevent OAB?
Check below some lifestyle changes that usually help others to reduce the risk of OAB:
- Perform the Kegel exercise to strengthen your pelvic floor muscles. These muscles help to control the bladder.
- Regular exercise and physical activity
- Limit alcohol and caffeine
- Try to get and maintain a healthy weight
- It is advised to get treatment for any existing health problems such as diabetes
- Quit smoking or never start
Diagnosis
Commonly, healthcare providers check patients for blood or infection in the urine if they experience OAB. They can also verify if the bladder is emptying completely during urination. Check below additional that your doctor may perform to diagnose overactive bladder:
- Your doctor may also ask you certain questions about the symptoms and medical history.
- Neurological examination to check for sensory or reflexes problems.
- Physical examination (including pelvic examination in females, rectal examination, and others).
- Urine tests to check for blood, infections, and other problems
Bladder Function Tests
The following tests (urodynamic tests) are often performed by doctors to determine how well your bladder works. These tests include:
- Measuring urine that is left in the bladder – Physicians usually perform an ultrasound test to determine if urine remains in the bladder after urination. They also use a special catheter (a thin tube) to drain the urine that remains in the bladder.
- Urine flow rate measurement – Physicians also can use an uroflowmeter to determine how fast urinate.
- Bladder pressure tests – To determine the pressure in the bladder physicians usually perform a test known as cystometry. It helps doctors understand how full is the bladder when you begin to need to urinate and when it tightens.
According to the outcomes of the previous tests and questions, physicians often prescribe the treatment.
Treatment
Healthcare providers usually prescribe a combination of treatments to reduce the symptoms and treat OAB. Check below some OAB treatment options:
Behavioral Therapies
The following therapies usually help to lessen the symptoms without adverse reactions. For example:
- Biofeedback – It involves an electrical patch on the skin over the bladder. It helps to learn how to control bladder muscles.
- Bladder training – This therapy helps to train the bladder to hold more urine before feeling the urge to urinate.
- Healthy weight – It is recommended to lose weight because it helps to reduce the symptoms and manage stress urinary incontinence.
- Intermittent catheterization – Doctors usually recommend this therapy when you are not able to empty the bladder. It involves a thin tube that helps to drain the urine from the bladder.
- Pelvic floor muscle exercises – One of the most used exercises to train pelvic floor muscles is the Kegel exercises.
Medicines
Vaginal Estrogen therapy can help to strengthen tissues and muscles in the urethra and vaginal area in women after menopause. It comes in suppositories, creams, rings, or tablets. Therefore, it can improve an overactive bladder. Check below some medications that help to relax the bladder and reduce the symptoms:
- Oxybutynin
- Mirabegron
- Tolterodine
- Trospium
- Solifenacin
- Fesoterodine
The most common adverse reactions that people experience when using previous medications include constipation, dry eyes, and dry mouth.
Injections
In some cases, doctors recommend OnabotulinumtoxinA (botox) to relax the bladder muscles and help it to hold more urine. As per studies, this medication can help to treat severe urge incontinence. On the other hand, this injection can provoke serious adverse reactions including urinary tract infections.
Nerve Stimulation
This treatment involves mild electrical impulses to the bladder nerves. It helps to improve the symptoms and control the bladder.
Percutaneous Tibial Nerve Stimulation (PTNS)
This treatment option involves a thin needle that is inserted into the skin near the ankle. Thus, it sends electrical signals to the nerves in the leg (tibial nerve) and then to the spine. As a result, the electrical signals reach the nerves that control the bladder. PTNS helps to reduce the symptoms of OAB. The treatment usually lasts 12 weeks and then once every 3-4 weeks.
Surgery
There are two surgery types that help to get rid of OAB but doctors recommend surgery when other treatment options are not effective and for people with severe symptoms. It helps the bladder to store urine and reduce pressure. For example:
- Bladder removal – This is a surgery in which the surgeon removes the bladder and replaces it with a new one (neobladder).
- Surgery to increase the amount of urine the bladder can hold – It involves a catheter that in severe cases can remain for the rest of the patient’s life to empty the bladder.
Frequently Asked Questions
Is it possible to get rid of OAB without treatment?
No, this condition does not go away on its own and requires treatment. If you suspect you have OAB, you should discuss it with a doctor.
What is the primary cause of overactive bladder?
Commonly, a malfunction of the detrusor muscle provokes OAB. It happens due to abdominal trauma, nerve damage, pelvic trauma, surgery, and others.
What are the potential complications of OAB?
If you ignore the symptoms and do not get treatment, it may lead to some complications. These include sleeping issues (insomnia), sexual problems, infections, skin problems, depression, anxiety, and others. Ask your healthcare professional if you have additional questions.
