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Overactive Bladder: Symptoms, Causes, and Treatment
Overactive Bladder: Symptoms, Causes, and Treatment

Overactive Bladder (OAB)

Overactive Bladder (OAB) : Symptoms, Causes, and Treatment

Overactive bladder (OAB) is characterized by frequent and sudden urges to urinate, often leading to involuntary leakage. Symptoms include a strong, sudden need to urinate that may be difficult to control, frequent urination (typically more than eight times in 24 hours), waking up more than once during the night to urinate (nocturia), and sometimes urinary incontinence. OAB in men or women can significantly disrupt daily life, causing embarrassment, and anxiety. This symptom also hampers social life and work performance. It can result from various factors such as nerve damage, bladder abnormalities, or certain medications. Treatment options range from lifestyle changes and pelvic floor exercises to medications and, in severe cases, surgery may also be considered.

Overactive bladder (OAB) (bladder hyperactivity) affects millions worldwide, with prevalence increasing with age. Approximately 16% of adults over 40 experience OAB symptoms, with women being more affected than men. Among those affected, about 33% report urinary incontinence as a significant symptom. OAB can significantly impair quality of life, with studies indicating that up to 45% of individuals with OAB experience limitations in daily activities, work productivity, and social interactions.

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What are the Symptoms of an Overactive Bladder?

Overactive bladder symptoms such as frequent urination, urgency, or incontinence significantly disrupt daily life, persist for more than a few weeks, worsen, or are accompanied by blood in the urine or severe pain, seek medical evaluation to determine underlying causes and appropriate management strategies.

 

The main symptom of overactive bladder is an urge to urinate that you may not be able to control. This can lead to urine leakage (loss of bladder control).

Some of the major symptoms associated with OAB

  • Urgency: You suddenly feel like you really need to pee and can't wait.

  • Frequency: You need to pee more often than usual.

  • Nocturia: Waking up at night to pee.

  • Urge incontinence (bladder hyperactivity): Leaking urine when you feel a strong urge to pee and can't hold it in.

  • Urinary urgency incontinence: Leaking urine because you can't control the sudden urge to pee.

  • Hesitancy: Trouble starting to pee even when you feel the urge.

  • Intermittency: Your pee starts and stops unexpectedly.

  • Weak urine stream: Your pee doesn't come out with much force.

  • Straining: You have to push hard to start peeing.

  • Incomplete emptying: Feeling like you haven't fully emptied your bladder after peeing.

What Causes OAB?

Here are the overactive bladder causes affecting females and males: 

  • Neurological Disorders

Conditions such as Parkinson's disease or multiple sclerosis can disrupt nerve signals controlling bladder function and cause overactive bladder syndrome. 

  • Bladder Irritants

Certain foods, drinks (e.g., caffeine), medications, and bladder irritants can trigger OAB symptoms by irritating the bladder.

  • Bladder Abnormalities

Conditions like bladder stones, tumours, or urinary tract infections can irritate the bladder and lead to nocturia symptoms.

  • Hormonal Changes

Menopause-related hormonal changes can weaken pelvic floor muscles and affect bladder control, contributing to OAB symptoms.

  • Idiopathic OAB

OAB can sometimes occur without a specific underlying cause, termed idiopathic OAB, often related to ageing.

How is an Overactive Bladder Diagnosed?

  • Urinalysis

Analysis of urine samples to check for infection, blood, or other abnormalities indicating underlying conditions.

  • Bladder Diary

Recording voiding patterns, fluid intake, and symptoms over a period to assess frequency, urgency, and incontinence.

  • Post-Void Residual Measurement

Ultrasound or catheterization is used to measure urine remaining in the bladder after voiding to assess emptying efficiency.

  • Urodynamic Testing

Various tests to evaluate bladder and urethral function, including bladder pressure measurement, to assess storage and emptying capabilities.

  • Cystoscopy

Visual examination of the bladder using a thin tube with a camera to identify bladder abnormalities or other potential causes of OAB.

What are the Treatments Available?

If you are looking for the best treatment for overactive bladder, then you can choose the following options: 

  • Behavioural Therapy

Pelvic floor exercises, bladder training, and fluid management to improve bladder control and reduce symptoms naturally.

  • Medications

Medications that relax bladder muscles, reducing urgency and frequency of urination by blocking nerve signals.

  • Sacral Neuromodulation

Implantation of a device that stimulates sacral nerves, regulating bladder function and reducing OAB symptoms.

  • Percutaneous Tibial Nerve Stimulation (PTNS)

A non-invasive procedure involving stimulating nerves in the lower leg to regulate bladder function and reduce symptoms.

  • Bladder Augmentation Surgery

Surgical procedure to increase bladder capacity, reducing urgency and frequency of urination by enlarging the bladder.

What are the Home Remedies?

Here are some home remedies to treat OAB:

  • Bladder Training

Gradually increasing intervals between bathroom visits to train the bladder to hold urine longer and reduce urgency.

  • Fluid Management

Limiting caffeine, alcohol, and acidic drinks while ensuring adequate hydration to minimize bladder irritation can help in managing OAB

  • Pelvic Floor Exercises (Kegels)

Strengthening pelvic floor muscles to improve bladder control and reduce urgency and leakage episodes.

  • Dietary Modifications

Avoid bladder irritants like spicy foods, artificial sweeteners, and acidic fruits to minimize OAB symptoms and discomfort.

  • Scheduled Voiding

Establish a regular bathroom schedule to empty the bladder at set times to reduce urgency and frequency of urination.

When to see a Doctor?

Overactive bladder or OAB, characterized by urgency, frequency, and incontinence, can stem from various factors including neurological conditions, irritants, and hormonal changes. Treatment options range from lifestyle modifications to surgical interventions, with behavioural therapies and medications often proving effective. It's crucial to consult urologists if experiencing persistent symptoms impacting daily life. Early intervention can prevent complications and improve quality of life. Therefore, seeking medical advice promptly ensures proper diagnosis and tailored treatment to manage an overactive bladder effectively and enhance overall well-being.

FAQs

1. What are the common symptoms of OAB?

Urgency, frequency, nocturia, and urinary incontinence are typical symptoms, often disrupting daily activities and affecting quality of life.

2. What causes OAB?

Factors such as neurological conditions, bladder irritants, hormonal changes, and ageing can contribute to overactive bladder symptoms.

3. How is OAB diagnosed?

Diagnosis involves a medical history review, physical examination, urine tests, bladder diary, urodynamic tests, and sometimes cystoscopy.

4. What treatments are available for OAB?

Treatments for OAB include behavioural therapies, medications, Botox injections, neuromodulation, and sometimes bladder augmentation surgery.

5. When should I see a doctor for OAB?

Seek medical advice if experiencing persistent urinary urgency, frequency, or incontinence that disrupts daily life or affects well-being.

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