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What is Overactive Bladder?

Thursday 20 August 2020
Urology

Table of Contents


I. What is Overactive Bladder?

II. Overactive Bladder Symptoms

III. What Causes Overactive Bladder?

a. How Does Overactive Bladder Occur?

b. Risk Factors for Overactive Bladder

IV. How is Overactive Bladder Treated?

a. Diagnosis

b. Medications

c. Medical Treatments

d. Lifestyle Changes


What is Overactive Bladder?

Everybody knows the stress and anxiety you feel when you have a sudden urge to urinate and cannot find a bathroom. For people that have overactive bladder (OAB), this can be a regular occurrence.

Overactive bladder affects around 33 million people in the United States and can negatively affect a person’s quality of life. [1] OAB is slightly more common in women than in men. Around 40 percent of women in the US show symptoms of overactive bladder. For men, it is around 30 percent. [2] Overactive bladder is also more common in people over the age of 40. [3] However, OAB is not simply a normal part of getting older and can affect people of any age.

Unfortunately, overactive bladder can be an unpredictable condition. This can make it difficult for people to plan social activities, trips, long travel, and outdoor activities. Sometimes, people with OAB avoid social gatherings or visiting new places, for fear of being too far away from a bathroom. This condition can also prevent a person from getting enough sleep regularly.  Thankfully, overactive bladder can be treated with antispasmodic medications such as Myrbetriq (mirabegron), Detrol LA (tolterodine), and Vesicare (solifenacin).

OAB is not the same as having occasional incontinence or the occasional urgent need to urinate after heavy drinking. Overactive bladder is not a disease, but a collection of symptoms that affect urination. Keep reading to learn more about overactive bladder, including the symptoms, causes, and how it can be treated.

Overactive Bladder Symptoms

There are several symptoms of having an overactive bladder. Many of these symptoms may resemble similar symptoms of conditions such as an enlarged prostate. The symptoms and severity of overactive bladder can vary between patients. Overactive bladder can be treated. If any of these symptoms seem familiar, then you should speak to a doctor.

The most obvious of OAB symptoms are frequent and urgent urination. The urge to urinate may appear and worsen rapidly. Some OAB patients may slightly leak urine when this urge occurs. [2] The frequency and urgency of these needs determine whether or not you are suffering from overactive bladder. [1] If you frequently need to urinate eight or more times within a 24-hour day, then you may have OAB. [4]

A man getting out of bed

Many people with overactive bladder also suffer from nocturia. This is the frequent need to wake up multiple times during the night in order to urinate.

Incontinence is another common symptom of an overactive bladder. This can be caused when an urgent need to urinate arrives suddenly. Even when you are able to reach the toilet in time and unintentional urination does not occur, the fear of this symptom can disrupt your life.

What Causes Overactive Bladder?

a. How Does Overactive Bladder Occur?

For most people, when their bladder is full, signals in the brain let them know that they need to go to the bathroom. Once the brain is ready, the muscles in the bladder contract, forcing urine out of the body through the urethra. Usually, these signals begin before the bladder is full so that people have plenty of warning and can visit the bathroom when it is convenient. [5]

Overactive bladder occurs when the nerve signals connecting the brain and the bladder do not function correctly. This may be caused by nerve damage to the muscles surrounding the bladder, uterus, pelvic floor, or anus. When the nerves surrounding the bladder become damaged, the bladder muscles can spasm. This can result in the brain incorrectly thinking that the bladder is full and needs to be emptied, which causes sudden, powerful urges to urinate. [6]

b. Risk Factors for Overactive Bladder

There are several risk factors that can increase the chance of developing an overactive bladder.

Childbirth: Childbirth can be a common cause of developing this condition. It is believed that this is one reason why OAB is more common in women over 40 than men. [3] While pregnant, the weight of the fetus can cause stress to the pelvic floor. During childbirth, damage to the nerves in the pelvic area may occur.  Often overactive bladder in women may be the result of nerve damage caused by a C-section. [6]

A pregnant woman holding her stomach

Neurological Disorders: There are several neurological disorders that may increase the risk of developing overactive bladder. Conditions such as stroke, Parkinson’s disease, and multiple sclerosis can affect the nervous system, causing OAB.

Surgery: As well as C-section childbirths, other surgeries may also contribute to developing OAB. This is especially true for any surgeries on or around the pelvis, which may damage nerves in the pelvis or bladder. [6]

Other Bladder Issues: Other medical conditions that affect the bladder may also lead to OAB. This includes tumors, bladder stones, or an enlarged prostate [4]

Other Risk Factors: There are several other possible causes of OAB. This includes hormone changes, medications that increase the production of urine, walking difficulties, and diabetes. [4]

How is Overactive Bladder Treated?

a. Diagnosis

In order to diagnose overactive bladder, your doctor may initially study your medical history and perform physical tests such as rectal or pelvic exams. Additionally, you may need to provide a urine sample to test for signs of infections or blood in the urine. Your doctor may also refer you to a specialist in order to assess your bladder function.

b. Medications

There are several medications that may be prescribed to help treat overactive bladder. Antispasmodic medications work by relaxing the smooth muscles of the bladder, which helps to decrease the need for urgent urination. Common antispasmodic medications include Myrbetriq (mirabegron), Detrol LA (tolterodine), and Vesicare (solifenacin). [7]

c. Medical Treatments

As well as taking medications, there are other treatments that may help to improve OAB. Small amounts of Botox injected every six to eight months can weaken the bladder muscles, preventing them from frequently contracting. [1]

Nerve stimulation is another treatment that may be effective. A small wire inserted into the lower back can regulate the nerve signals to the bladder. For people that have severe OAB symptoms that are not controlled by medications or other treatments, then surgery may also be an option.

Blister packets of medication

d. Lifestyle Changes

The symptoms of OAB can often be treated with lifestyle changes. There are many exercises that you can do to strengthen your pelvic muscles. Effective exercises include Kegels, vaginal cones, and bladder training. [1]

Changing your diet may also improve overactive bladder symptoms. The amount of liquids consumed during the day has an obvious effect on the frequency and quantity of your urination. However, there are many other substances that may increase your symptoms. For people that have an overactive bladder, it may be best to avoid caffeine, gluten, citrus fruits, spicy foods, alcohol, and artificial flavorings. [1]

The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis or treatment.