WHAT IS OVERACTIVE BLADDER (OAB)?
An estimated 33 million people in the USA alone are dealing with an Overactive Bladder (OAB) - that urgent and frequent need to pass urine. And half of the people with Overactive Bladder are struggling with Urgency Urinary Incontinence (UUI), when leakage actually occurs.
Typical symptoms of Overactive Bladder include urinating more than 8 times per day or more than once at night (urinary frequency) as well as a strong and sudden desire to urinate (urinary urgency).
To understand the cause of Overactive Bladder, a basic understanding of how the urinary system operates is needed.
The kidneys produce the urine and send it to the bladder. The bladder expands to holds the urine while the sphincter muscle acts as a spiget and controls the flow of urine. Basically on or off. As soon as your bladder gets approximately half full—most people can handle about 2 cups of urine—your brain is signaled that you need to empty it. The bladder muscles contract while the sphincter relaxes. When there is a coordination problem along this system, incontinence occurs.
With Overactive Bladder, a person may be suddenly aware of the urgency sensation but is unable to get to the toilet before losing control of his or her urine. Urine loss can be in large amounts that soak underwear and even outer clothing.
Common triggers like hearing running water or simply the anticipation of urinating can cause a bladder spasm. In some cases, people who have physical limitations may not be able to reach the toilet in time, causing an accident.
Research indicates that most people believe the symptoms of an overactive bladder (urgency, frequency, and/or urgency incontinence) are an inevitable and normal part of growing older, rather than a treatable medical problem.
In fact, fewer than half of individuals with incontinence actually consult a healthcare provider about their problem. This is unfortunate, since there are many treatments available to combat symptoms of OAB.
Many people find the use of a Care Pathway useful when determining the treatment steps for Overactive Bladder. A Care Pathway is a roadmap that helps patients know the appropriate steps to take when treating their symptoms.
With the increased attention on incontinence issues, incredible progress and innovation has been made in the arena of products for everyday use.
The first step toward treatment is to visit your doctor. Your doctor will conduct an evaluation and ask you many questions in order to provide an accurate diagnosis. In order to prepare for your visit, take a look at these tips, and visit our resource center for tools you can use to help your doctor determine the best treatment for you.
Those who take charge of their condition will discover a variety of treatment options to eliminate, reduce, and manage their condition. Your physician can help prescribe options best suited to the specifics of your condition. This might include:
- Dietary changes
- Fluid management. With supervision from your physician, reducing the amount of dietary irritants (e.g., coffee, colas etc) as well as limiting fluid intake while maintaining 6-8 8oz. glasses of water a day may help with OAB symptoms.
- Bladder retraining
- Pelvic Floor Muscle Exercises
- Injection Therapy
- Sacral nerve stimulation - This is an implant that sends electrical stimulation to the nerves that reach the bladder and modulates how the bladder functions.
Surgery is rarely used to treat urgency incontinence. However, if it is severe and refractory, augmentation cystoplasty, or bladder enlargement, can be considered. You will want to consult your physician as well as a urologist to learn more about this treatment option.
In some cases, medication has proven to be effective. Your physician may prescribe Ditropan®, Detrol®, Enablex®, or other drugs designed to calm bladder nerves.
Botox® or botulinum toxin, is a new tool for bladder control. Injecting Botox® into the bladder and the bladder’s sensory pathways may help to strengthen bladder control. The dose of Botox® is not set but ranges from 50 to 300 units. The result may be relief of urgency, but it may lead to urinary retention, which may require self-catheterization. Repeat injections may have to be performed as the bladder recovers from the toxin. This may be 3 to 9 months later.
Antimuscarinics and alpha-blockers are also used. These drugs may affect the brain, so there can be side effects, such as memory loss, reddening of the skin, loss of sight, decreased secretions causing individuals to feel extremely hot, and constipation.