Overactive bladder (OAB) is the name for a group of urinary symptoms. It is not a disease. The most common symptom is a sudden, uncontrolled need or urge to urinate. Some people will leak urine when they feel this urge. Another symptom is the need to pass urine many times during the day and night. 

What causes overactive bladder?

Several conditions may contribute to signs and symptoms of overactive bladder, including:

  • Neurological disorders, such as stroke and multiple sclerosis
  • Diabetes
  • Urinary tract infections that can cause symptoms similar to those of an overactive bladder
  • Hormonal changes during menopause in women
  • Conditions affecting the bladder, such as tumors or bladder stones
  • Factors that get in the way of urine leaving the bladder, such as enlarged prostate, constipation or previous surgery to treat incontinence

Overactive bladder symptoms may also be associated with:

  • Medications that cause your body to make a lot of urine or require that you take them with lots of fluids
  • Drinking too much caffeine or alcohol
  • Declining cognitive function due to aging, which may make it more difficult for your bladder to understand the signals it receives from your brain
  • Difficulty walking, which can lead to bladder urgency if you’re unable to get to the bathroom quickly
  • Incomplete bladder emptying, which may lead to symptoms of overactive bladder, as you have little urine storage space left

Symptoms

If you have an overactive bladder, you may:

  • Feel a sudden urge to urinate that’s difficult to control
  • Experience unintentional loss of urine immediately after an urgent need to urinate (urgency incontinence)
  • Urinate frequently, usually eight or more times in 24 hours
  • Wake up more than two times in the night to urinate (nocturia)

Diagnosis

Medical History: The doctor will take a detailed  medical history about the symptoms present how long, and how they’re changing the life. A medical history will include questions about the past and current health problems. Also, about the diet and how much and what kinds of liquids drink during the day and night.

Physical Exam: Doctor will examine to look for something that may be causing the  symptoms. Doctors will often feel the abdomen, the organs in the pelvis, and the rectum.

Bladder Diary: patient may be asked to keep a Bladder Diary for a few weeks. With this, he will note how often he go to the bathroom and any time leak urine. This will help the health care provider learn more about  day-to-day symptoms. 

Having a Bladder Diary during first visit can be helpful because it describes the daily habits, urinary symptoms, and shows how they affect the patient’s life. 

Other Tests

Urine test: to test for infection or blood.

Bladder scan: This type of ultrasound shows how much urine is still in the bladder after going to the bathroom.

cystoscopy or urodynamic testing: Usually not needed but may be used if the doctor  thinks something else is going on.

Treatment

Behavioral therapies

Pelvic floor muscle exercises: Kegel exercises strengthen the pelvic floor muscles and urinary sphincter.

Biofeedback: During biofeedback, patient connected to electrical sensors that help to  measure and receive information about the body. The biofeedback sensors teach the patient how to make subtle changes in the body, such as strengthening pelvic muscles so that when patient have feelings of urgency, they are better able to suppress them

Healthy weight: If you’re overweight, losing weight may ease symptoms.

Scheduled toilet trips: Setting a schedule for toileting — for example, every two to four hours — gets patient on track to urinate at the same times every day rather than waiting until they feel the urge to urinate.

Intermittent catheterization. If patient is not able to empty the bladder well, using a catheter periodically to empty  bladder completely helps the bladder do what it can’t do by itself.

Absorbent pads. Wearing absorbent pads or undergarments can protect the clothing and help to avoid embarrassing incidents.

Bladder training. Bladder training involves training self to delay voiding when feel an urge to urinate. 

Medications

After menopause, vaginal estrogen therapy can help strengthen the muscles and tissues in the urethra and vaginal area. Vaginal estrogen comes in the form of cream, suppository, tablet, or ring, and can significantly improve symptoms of overactive bladder. Medications that relax the bladder can be helpful for relieving symptoms of overactive bladder and reducing episodes of urge incontinence.(Example: Tolterodine (Detrol),Oxybutynin).

Bladder injections

Botox is a protein from the bacteria that cause botulism illness. Used in small doses directly injected into bladder tissues, this protein relaxes the muscles

Nerve stimulation

Regulating the nerve impulses to the bladder can improve overactive bladder symptoms.

Percutaneous tibial nerve stimulation (PTNS)

This procedure uses a thin needle that is placed through the skin near your ankle to send electrical stimulation from a nerve in your leg (tibial nerve) to your spine, where it connects with the nerves that control the bladder

Surgery

Surgery to increase bladder capacity: This procedure uses pieces of bowel to replace a portion of bladder. This surgery is used only in cases of severe urge incontinence that doesn’t respond to any other.

Bladder removal. This procedure is used as a last resort and involves removing the bladder and surgically constructing a replacement bladder (neobladder) or an opening in the body (stoma) to attach a bag on the skin to collect urine

Lifestyle and home remedies

These lifestyle strategies may reduce overactive bladder symptoms:

  • Maintain a healthy weight : If you’re overweight, losing weight may ease your symptoms. Heavier people are also at greater risk of stress urinary incontinence, which may improve with weight loss.
  • Drink adequate amounts of fluid : Ask your doctor how much fluid you need daily. Drinking too much fluid can worsen your symptoms, but not drinking enough can make your urine become concentrated and can irritate the lining of your bladder. This increases the urge to urinate.
  • Limit foods and drinks that might irritate your bladder : Some foods and drinks that may irritate the bladder include caffeine, alcohol, tea, carbonated drinks, citrus juice and fruit, chocolate, spicy foods, and tomatoes. If any of these worsen your symptoms, it might be wise to avoid them.

Disclaimer: All contents on this site are for general information and in no circumstances, information be substituted for professional advice from the relevant healthcare professional, Writer does not take responsibility for any damage done by the misuse or use of the information.

References:

https://www.bsuh.nhs.uk/   (Brighton and Sussex University Hospitals NHS trust)

https://www.mayoclinic.org/(Myoclinic)

https://www.urologyhealth.org/ (Urology care foundation)