Overactive Bladder - More Common Than You Think

It is very common and characterized by the frequent and uncontrollable need to urinate. Researchers estimate up to 30% of men and 40% of women experience overactivity. It is important to remember an overactive bladder concerns the need and urge to urinate, not necessarily production. Incontinence or leaking may or may not occur in patients with an overactive bladder.

Changes in urination may indicate infection or another medical condition. You should discuss them with your doctor immediately. While an overactive bladder is not typically associated with pain or a danger to your health, it causes many patients stress, anxiety, and insecurity.

Signs & Symptoms

Despite the many causes of overactive bladder, the symptoms are consistent for most patients.

• A rapid and urgent need to urinate that cannot be suppressed or controlled
• Unintentional release or "leaking" of urine once you feel the need to urinate but before you make it to the bathroom
• Frequently urinating, generally 8 or more times in a twenty-four hour period
• Waking two or more times per night to urinate

Causes Of Overactive Bladder

A normally functioning bladder fills with urine and the brain receives a signal about the coming need to void. Once you're able to reach the bathroom, the brain signals the bladder muscles to tighten, forcing urine out of the bladder, down the urethra, and out of the body.

If the bladder is overactive, you feel a sudden and urgent need to urinate. The bladder may not even be full. This happens because the messages between the bladder and brain aren't transmitting correctly or bladder muscles are hyperactive. While an overactive bladder is common, it is not a normal or inevitable part of aging.

Possible contributing factors to overactive bladder include:

• An abdominal or pelvic injury that damaged the nerves between your brain and bladder
• Overconsumption of beverages like citrus juice, coffee, tea, and alcohol
• Hormonal changes, post-menopausal estrogen levels may affect bladder function
• Enlarged prostate that affects the urinary tract and bladder
• Unmanaged constipation that causes pressure in the abdomen
• Diabetes or kidney disease
• Bladder stones or tumors
• Pelvic muscle weakness or spasms
• Excess weight in the midsection that places abnormal pressure on the bladder
• An untreated urinary tract infection
• Side-effects from medication or over-the-counter supplements
• Neurologic disease or injury such as stroke, Parkinson's disease, and multiple sclerosis

Diagnosis

Medical consultation is necessary when you experience symptoms from an overactive bladder. The condition can be caused by anything from drinking too much coffee to a bladder tumor reducing capacity. Your doctor will perform a physical examination and may ask you to begin keeping a bladder diary. They'll want you to track your liquid consumption, the nature of your urge to urinate, the number of bathroom trips, and output.

The doctor may also order tests and diagnostic studies including:

• Urinalysis, a test to check for infection or blood
• An ultrasound, known as a bladder scan, measure how much urine is retained in the bladder after you void
• Urodynamic testing to measure the bladder's ability to store urine
• A cystoscopy to check for bladder abnormalities or tumors and to biopsy tissue

Managing an Overactive Bladder

Behavioral Changes

Sometimes an overactive bladder can be managed with lifestyle changes and preventative measures. These include:

• Maintaining a healthy weight with proper diet and exercise
• Limiting consumption of liquids that aggravate the bladder, like tea and alcohol
• Managing chronic conditions like diabetes
• Quitting smoking
• Strengthening the pelvic floor muscles with regular Kegel exercises. This involves tightening the muscles and holding the contraction. Over time, build up to performing 3 sets of 10 repetitions per day of holding the contraction for 10 seconds at a time.

Medical Treatment

Treatment depends on the cause of your overactive bladder. If the symptoms are caused by diabetes or neurologic disease, treating the underlying condition may resolve urinary issues. Other causes may be managed with:

• Medications to control overactive bladder muscles or spasms
• Nerve stimulation to ease overactivity by rewiring the signals sent to the brain
• Injections paralyze bladder nerves that incorrectly signal the brain about the bladder's capacity
• Surgery, usually as a last option, to increase the bladder's capacity

Conclusion

Frequent urination caused by an overactive bladder causes embarrassment, social withdrawal, trouble at work, and feelings of hopelessness. Consulting your doctor to determine the cause of overactivity is important for maintaining your overall health. Lifestyle modifications, controlling underlying conditions, and medical intervention are often enough to control urinary symptoms and return to normal bladder function.