An overactive bladder or OAB is where a person regularly gets a sudden and compelling need or desire to pass urine. This sensation is difficult to put off (defer) and this can happen at any time during the day or night, often without any warning.

With OAB, you feel you need to empty your bladder –even when it’s not full. You feel you need a bathroom quickly, right now. You can’t control or ignore this feeling and it happens much more than it should. Sometimes it may feel like your bladder muscle is squeezing to empty your bladder when you urinate, but the muscle may not really be squeezing.

What are the Symptoms of overactive bladder

1. Urgency: This is the main symptom of OAB. It is a strong (urgent) need to pass urine that can’t be ignored. This “gotta go” feeling makes people afraid they will leak urine if they don’t find a bathroom right away. People with OAB may also:
• Leak Urine: Sometimes OAB causes urine to leak out before getting to the bathroom. This is called urgency incontinence. Some people may leak just a few drops, while others can have a sudden gush.

2. Urinary frequency: If you have urinary urgency, this means that you need to pass urine often and more frequently than usual and in small volumes. The number of times people normally have to pass urine each day is very varied, but people with overactive bladders tend to pass urine more often than they would expect during the daytime.

3. Nocturia: Overactive bladder can also cause you to get up at night several times to pass urine. Sometimes disturbed nights can be the main problem. Urinary tract problems other than OAB can also cause nocturia, so this symptom may persist even if other OAB problems respond to treatment.

What is the cause of OAB?

OAB is common and can affect people of all ages, including children and the elderly. About 12% of the total adult population suffer from OAB. Usually the cause is unknown. Anxiety can make the problem worse. The type of fluid you drink can also influence your symptoms. People with neurological disease are at particular risk of OAB.

Diagnoses

The doctor will ask you questions about your problem and your general health. He may examine you and perform an internal examination. A urine test to check for infection will be done.

You will be asked to complete a 4-day frequency/volume chart to record the time of voiding and volumes of urine you pass.

You may also have a flow test which includes passing urine in a special machine to measure the strength of your flow and to check whether you empty your bladder completely. If your symptoms fail to respond to conservative and medical treatment, you may have an invasive urodynamic test, which is a special test to measure pressures inside the bladder.

Treatment

There are a number of things you can do to manage OAB. Everyone has a different experience with what works best. You may try one treatment alone, or several at the same time. You and your health care provider should talk about what you want from treatment and about each option. OAB treatments include:


1.Lifestyle Changes:Changing drinking habit: There are number of drinks that may irritate the bladder such as caffeinated drinks, carbonated drinks, drinks containing aspartame (artificial sweetener found in diet drinks), hot chocolate, green tea, alcohol, blackcurrant juice and citrus fruit juice. Drinks which are believed not to irritate the bladder are: water, herbal and fruit tea, milk and diluted fruit juice.

2. Keep a bladder diary: Writing down when you make trips to the bathroom for a few days can help you understand your body better. This diary may show you things that make symptoms worse. For example, are your symptoms worse after eating or drinking a certain kind of food? Are they worse when you don’t drink enough liquids?

3. Double voiding: This is when you empty your bladder twice. This may be helpful for people who have trouble fully emptying their bladder. After you go to the bathroom, you wait a few seconds and then try again.

4. Delayed voiding: This is when you practice waiting before you go to the bathroom, even when you have to go. At first, you wait just a few minutes. Gradually, you may be able to wait two to three hours at a time. Only try this if your health care provider tells you to. Some people feel worse or have urine leaks when they wait too long to go to the bathroom.

5. Timed urination: This means you follow a daily bathroom schedule. Instead of going when you feel the urge, you go at set times during the day. You and your health care provider will create a reasonable
schedule. You may try to go every two to four hours, whether you feel you have to or not. The goal is to prevent that urgent feeling and to regain control.

6. Exercises to relax your bladder muscle:You may be familiar with exercises to strengthen your pelvic floor muscles, also called Kegel exercises. A special exercise using those same pelvic floor muscles may help relax your bladder during those “gotta go” moments. “Quick flicks” are when you quickly squeeze and relax your pelvic floor muscles over and over again. So, when you feel the urge to go, a number of quick flicks may help control that “gotta go” feeling. It helps to be still, relax and focus on just the exercise. Your health care provider or a physical therapist can help you learn these exercises.


7. Biofeedback may also help you learn about your bladder: Biofeedback uses computer graphs and sounds to monitor muscle movement. It can help teach you how your pelvic muscles move and how strong they are.

8. Prescription Medications: When lifestyle changes aren’t enough, the next step may be to take medicine. Your health care provider can tell
you about special drugs for OAB. There are several drug types that can relax the bladder muscle. These drugs, like anti-muscarinics and beta-3
agonists, can help stop your bladder from squeezing when it’s not full.


9. Bladder Botox(botulinum toxin) Treatments: If lifestyle changes and medicine aren’t working, there are other options. A trained urologist or female pelvic medicine & reconstructive surgery (FPMRS) specialist can
help. They may offer bladder Botox. Botox works for the bladder by relaxing the muscle of the bladder wall reducing urinary urgency and urge
incontinence. It can help the bladder muscles from squeezing too much.


10. Nerve Stimulation (peripheral and central):Another treatment for people who need extra help is nerve stimulation, also called neuromodulation therapy. This type of treatment sends electrical pulses
to nerves that share the same path for the bladder. In OAB, the nerve signals between your bladder and brain do not communicate correctly. These electrical pulses help the brain and the nerves to the bladder
communicate so the bladder can function properly and improve OAB symptoms.


11. Surgery: Bladder Reconstruction/Urinary Diversion Surgery

Surgery is only used in very rare and serious cases. There are two types of surgery available. Augmentation cystoplasty enlarges the bladder. Urinary diversion re-routs the flow of urine. There are many risks to these surgeries, so it is offered only when no other option can help.


Together, you and your doctor can choose a treatment plan that’s best for you so you can start living your life again.

Should you require additional information or would like to make an appointment with our Consultant Dr. Noor Buchholz, please call us or e-mail us at info@westminsterclinic.ae

Reference

  • Bladder and Bowel Foundationhttp://www.bladderandbowelfoundation.org/
  • www.Nhs.uk
  • Continence Foundation:http://www.continence-foundation.org.uk/

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 of any damage done by the misuse or use of the information.