Bladder Control

Overactive Bladder - Symptoms, Causes, And Treatments

An overactive bladder is not a normal part of aging. It is one of many types of urinary incontinence (UI) and more than 33 million people in the US have this condition. Overactive bladder causes a frequent and urgent need to empty the bladder. It may cause anxiety for those that have urinary incontinence as well.

Along with anxiety comes depression and embarrassment or shame. Treatments are available to help. OAB can alter your work life, social life, exercise, and fitness, as well as sleep. The symptoms make it difficult to get through the day without making many trips to the bathroom. Some don’t want to leave the house. If they do, they never travel far from a bathroom and seldom go out with friends for fear of accidents. Sadly, OAB can result in loneliness and isolation.

Overactive Bladder Symptoms

• Urinary urgency causes a sudden urge to urinate. Sometimes this occurs shortly after emptying your bladder
• Urge incontinence is the loss of urine from the bladder unintentionally after experiencing the urge to void
• Frequent urination. This is more than eight times in 24 hours
• Nocturia - waking up during the night to urinate more than once

Causes of OAB

When the bladder fills or is getting full, the brain sends a signal (the feeling you get when you need to void) that it’s time to empty the bladder. If you have OAB, the signal occurs when the bladder is not full. The need to empty the bladder is so strong and urgent that you need to find a bathroom right away. For some with OAB, the muscles in the bladder are too active and that feeling occurs too frequently, again it is sudden and urgent.

Risk factors

• A urinary tract infection (UTI)
• Side effects from medication
• Pelvic muscle weakness
• Hormone changes
• Neurologic disorders or damage to the signal between the brain and the bladder
• Conditions that affect the spinal cord or brain (a stroke, multiple sclerosis)

Seeking help

The first step in seeking treatment of OAB is to talk with your doctor. Many feel embarrassed to bring up the subject. Remember, your doctor is there to help and has experience with this type of problem. Be prepared with a list of questions for your doctor. The questions should include lifestyle changes you can make to improve your symptoms, medications used to treat OAB, and the side effects they cause.

Keep a bladder diary. Track the incontinent episodes you have (and how much urine you leak), how many times you need to use the bathroom a day, and how many times you wake at night to empty your bladder.

Include how often you have that “gotta go right now” feeling. You should also include the foods you ate and what you drank before your incontinent episodes. Also, include how much fluid you drink each day. Another tracker is any activity you do that causes UI. By keeping a diary, you may start to see patterns in what worsens your symptoms. Bring the diary with you to your appointment.

Once you are with your doctor, be totally honest. Don’t make the problem seem insignificant when it is impacting your life in so many ways. Talk about the physical feelings you’re experiencing and include the emotional ones this problem is causing. Let your doctor know you are ready to take action to improve your situation. They may suggest a consultation with a urology specialist.

Diagnosis

A diagnosis of Overactive Bladder Syndrome is determined after an evaluation is completed. The evaluation includes:

• A detailed medical history, including medications you take, over the counter supplements, and a surgical history
• Physical exam, including an abdominal exam and assessment of your pelvic organs and rectum
• Review of your bladder diary

Treatment

• The first and easiest treatment is lifestyle changes or behavioral therapy
• These include food, drinking habits, and planned trips to the bathroom
• Limit food and drinks that bother your bladder – such as coffee, caffeine, tea, alcohol & carbonated beverages
• Acidic foods like citrus or tomato-based foods
• Chocolate
• Spicy food

Double voiding

When you are void, you may not completely empty your bladder Once done, sit for a minute then try to void again.

Urination schedule

• Planned times to void whether you need to empty your bladder or not. For example, every 2 hours, increasing to every three, then four hours.

Medications & treatments

Medications & specific treatments can be prescribed to relax the bladder muscles and include:

• Anticholinergics (Detrol La, Oxybutynin)
• Beta-3 agonist (Myrbetriq, Gemtesa)
• Botox injected into the bladder muscle lasts about 6 months
• Kegel exercises for pelvic floor strengthening
• Nerve stimulation (neuromodulation therapy) With this type of treatment, an electrode is placed internally, and electrical impulses are sent through nerve channels to the bladder and the brain
• Sacral neuromodulation (SNS) carries signals through the spinal cord to the bladder. This is a 2-part, outpatient surgical process. A temporary external unit is used for 1-2 weeks. If it is successful, a permanent device like a pacemaker is implanted in the lower back
• Percutaneous tibial nerve stimulator (PTNS) sends the impulses from the ankle up the tibial nerve to the lower back. The treatment is 12 months long.

HPFY carries many quality products that can help you feel a little less anxious when you need to leave the house.

• Bladder control pads such as Poise, Attends, Always, or Tena
• Adult diapers or briefs such as Depends, Prevail, Attends, or Medline
• Pull-up Underwear by Prevail, Attends, or Tena
• Washable absorbent panties for those with light leakage
• Personal cleansing wipes such as Medline Fit Right or Tranquility

If you have spoken with your doctor, you’ve taken the first step toward an improved quality of life. Be sure to follow up with the doctor to be sure your planning is working optimally.

 

Author Profile: Christine Kijek, Registered Colorectal Nurse

 

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