Overactive Bladder Syndrome
What is Overactive Bladder Syndrome?
You normally use the bathroom throughout the day. However, it is scary when you always want to be near a bathroom or are worried about leaking urine if you don’t go in time. Overactive Bladder or OAB syndrome affects your normal daily activities such as work, going out with friends, exercising, and sleeping.
An overactive bladder syndrome is a group of bladder symptoms that may include a feeling to pass urine urgently, the need to pass urine often (day and night), and urine leaks with the “gotta go” feeling. The OAB syndrome is very common and having any of these symptoms can make it hard to get through the day without going to the bathroom many times.
OAB syndrome is more common in women than in men. It is sometimes also referred to as detrusor instability or an irritable bladder.
What Causes Overactive Bladder Syndrome?
In the case of a healthy bladder, when your bladder filters the water and is full of urine waste, your brain signals the bladder. The signals from the brain cause the bladder muscles to squeeze forcing the urine out through the urethra. The urine flows out when the sphincter in the urethra opens. The bladder is relaxed when your bladder is not full.
For a healthy bladder, you can wait to go to the bathroom when the brain signals that your bladder is getting full or is full. OAB syndrome results from an early, uncontrolled contraction or spasms of the bladder or detrusor muscle, resulting in an urge to urinate. This problem of the nerves and muscles of the bladder causes early contraction during the normal relaxation phase of bladder filling. The contraction of the bladder in response to filling with urine is part of the normal process of urination. Our nervous system regulates the contraction and relaxation of the detrusor muscles.
Numerous situations may result in signs and symptoms of overactive bladder, including:
Neurological disorders include stroke and multiple sclerosis.
Urinary tract infections have symptoms similar to overactive bladder.
Hormonal changes during menopause in women.
Abnormalities in the bladder like tumors or bladder stones.
Factors obstructing bladder outflow such as enlarged prostate, constipation, or previous operations to treat other forms of incontinence.
Some other factors may also result in symptoms including:
Medications cause a rapid increase in urine production.
Medications that require you to take lots of fluids with them.
Excess consumption of caffeine or alcohol.
Aging results in a decline in cognitive function that may impact the brain signals to reach the bladder.
Difficulty walking causes bladder urgency as you're unable to get to the bathroom quickly.
Incomplete bladder emptying causes symptoms of overactive bladder, as you have little urine storage space left.
Symptoms of Overactive Bladder Syndrome
Experiencing occasional incontinence is not always the symptom of an overactive bladder. Leakage of urine can be caused by other reasons, like laughing too hard or you’ve been fighting the urge to urinate for an extended time.
The doctor would confirm an overactive bladder if you have:
Urgency: If you have a sudden urgent desire to pass urine and you are not able to put off going to the toilet. This is sometimes also referred to as latch key urgency.
Frequency: You visit the toilet more often than normal - usually more than eight times a day. In severe cases, it may be more than eight times a day.
Nocturia: You may wake up more than once at night to go to the toilet.
Urge incontinence: This is a leaking of urine, sometimes in large amounts, before you can get to the toilet when you have a feeling of urgency.
Sometimes, even if you can get to the toilet in time as you sense an urge to urinate, unexpected frequent urination and nighttime urination can disrupt the quality of your life.
How do Doctors confirm Overactive Bladder Syndrome?
The doctor would perform a check history, physical examination, and urinalysis initially. Recommend urine culture or postvoid residual assessment, along with the use of bladder diaries or symptom questionnaires.
The physical examination for OAB syndrome includes:
Pulmonary and cardiovascular evaluation
Pelvic examination and rectal examination
Urine culture in case of infection
Postvoid residual testing
How can you Treat and Prevent Overactive Bladder Syndrome?
Overactive Bladder syndrome can be treated with various treatment options, such as:
Pelvic Floor Physical Therapy: Physical therapists work on the muscles of the pelvis through targeted muscle exercises and strengthening. This helps in managing a variety of urinary problems, including urgency, frequency, and nighttime symptoms.
Medication: The doctor will prescribe medicines that focus on two effects: relieving symptoms and reducing episodes of the urge as well as incontinence. The medicines will include tolterodine (Detrol, Detrol LA), trospium (Sanctura), and mirabegron (Myrbetriq).
Augmentation cystoplasty – This procedure involves a small piece of tissue from the intestine to be added to the wall of the bladder to increase the size of the bladder. Sometimes you may need to insert a catheter into your bladder to empty it after the surgery
Urinary diversion – This involves the tubes from the kidneys to the bladder (the ureters) routed directly to the outside of your body. After the surgery urine does not flow into the bladder. This procedure is opted when all other options have failed to treat your OAB syndrome.
Botox: Small dose of botox temporarily paralyze or weaken the bladder muscles. This helps in reducing the symptoms of OAB syndrome as it stops them from contracting too often. The effect of Botox may last six to eight months.
Nerve Stimulation: This procedure involves changing the electrical signal of the nerves that carry impulses to the bladder. The electrical stimulation is provided using a small wire that is inserted into the low back or a small needle through the skin of the lower leg. This procedure helps relieve the frequency and urgency of an overactive bladder.
Surgery: The surgery is recommended if the above treatments do not provide good results. Some of the surgery options include:
Changes in lifestyle helps in reducing as well as preventing the symptoms of OAB syndrome.
These healthy lifestyle choices may reduce your risk of overactive bladder:
Maintain a healthy weight.
Involve in regular, daily physical activity and exercise.
Limiting the consumption of caffeine and alcohol.
Managing chronic conditions, such as diabetes.
Strengthening the pelvic floor muscles by doing Kegel exercises.
OAB syndrome impacts the quality of life and might even lead to depression and anxiety. A combined approach of behavioral modifications and medications you help you significantly improve bladder urgency, and the quality of life.
If you or anyone you know is suffering from urinary problems, our expert providers at ASP cares will take care of your health and help you recover.
Call us on (210)-417-4567 to book an appointment with our specialists.