Overactive bladder

Overview

Overactive bladder, medically known as OAB, leads to frequent and sudden urges to urinate, often difficult to control. This condition can make you feel like you need to urinate frequently throughout the day and night, sometimes resulting in unintentional urine leakage, known as urgency incontinence.

Living with an overactive bladder can be challenging, potentially causing embarrassment, social isolation, or limitations in your work and social life. The encouraging news is that a brief evaluation can help identify any specific causes of your overactive bladder symptoms.

Managing overactive bladder symptoms may be possible through straightforward behavioral strategies. These may include making dietary adjustments, following a schedule for urination (timed voiding), and practicing bladder control techniques using your pelvic floor muscles. If these initial approaches do not provide sufficient relief for your overactive bladder symptoms, there are additional treatment options available.

Symptoms

Overactive bladder is characterized by a cluster of symptoms, including:

• Urinary urgency: This entails an abrupt and uncontrollable urge to urinate, often requiring a swift dash to the restroom once the sensation arises.
• Frequent urination: A frequent need to urinate, surpassing one’s usual restroom visits.
• Urge incontinence: This manifests as an abrupt, uncontrollable urge to urinate, occasionally resulting in involuntary urine leakage.
• Nocturia: Nocturia refers to the necessity of waking up at least twice during the night to urinate.

It’s crucial to note that while overactive bladder is more prevalent in older adults, it should not be regarded as a natural aspect of the aging process. Though discussing these symptoms with a healthcare provider may not be easy, if they are causing distress or interfering with your life, it is advisable to seek medical attention. Various treatments are available that may offer relief and enhance your overall well-being.

Causes

Overactive bladder can be attributed to various conditions and injuries that impact the detrusor muscle, a group of smooth muscle fibers within the bladder wall. These contributing factors include:

• Nerve damage: Dysfunction in the signaling between the brain and bladder, resulting in untimely urges to urinate, may be caused by certain diseases or injuries that lead to nerve damage. These include pelvic or back surgeries, herniated discs, radiation therapy, Parkinson’s disease, multiple sclerosis, or a stroke.
• Abdominal trauma: Traumatic incidents, including pregnancy and childbirth, have the potential to stretch and weaken pelvic muscles, responsible for supporting the organs in the lower abdomen. Consequently, weakened pelvic muscles can lead to the displacement of the bladder from its normal position.
• Substances and medications: Consuming substances such as alcohol, caffeine, and specific medications can dull the nerves responsible for regulating bladder signals, potentially causing the bladder to involuntarily release urine. Diuretics and caffeine can prompt the bladder to fill rapidly, increasing the likelihood of leakage.
• Infections: Bladder irritations due to infections, such as urinary tract infections (UTIs), can lead to the overstimulation of bladder nerves, causing spontaneous contractions of the bladder.
• Excess weight: Being overweight places additional pressure on the bladder, which can contribute to the development of urge incontinence.
• Estrogen deficiency post-menopause: Hormonal shifts experienced during menopause can lead to urge incontinence. Vaginal-only estrogen therapy has been identified as a potential remedy to address this hormonal imbalance.

Risk factors

Overactive bladder is prevalent among individuals aged 65 and above, with women potentially experiencing it at a younger age, typically around 45 years old. Other risk factors that may contribute to an overactive bladder include:

• Certain medical conditions: Higher susceptibility to diseases and disorders, including enlarged prostate and diabetes, can contribute to additional bladder function issues.
• Cognitive decline: Individuals experiencing cognitive deterioration, such as those who have had a stroke or are affected by Alzheimer’s disease, are more prone to developing an overactive bladder.
• Bowel Control Issues: Some individuals with overactive bladder may also experience problems with bowel control.