Choose the content to read

• Overactive Bladder
• What are the symptoms of OAB?
• When to see a doctor?
• What are the causes of OAB?
• How is OAB diagnosed?
• How is OAB treated?
• How to prevent OAB?

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Overactive Bladder

Overactive bladder occurs when the bladder muscles contract involuntarily, leading to a sudden and urgent need to urinate, which can result in urinary incontinence. It can lead to anxiety, stress, and loss of confidence. Overactive bladder can be due to aging, neurological disorders, diabetes, certain medications, caffeine, alcohol, and other factors. In the United States, approximately 10-30% of men and 10-40% of women are affected by this condition.

What are the symptoms of OAB?

• Frequent urination
• Urinary urgency is a sudden and intense urge that cannot be put off
• Urge incontinence
• Nocturia, urinate at least two times a night
• Strong urge to urinate but passing only a small amount of urine at a time

When to see a doctor?

An overactive bladder may come and go. Symptoms may wax and wane. Because similar symptoms can arise from other causes, such as infections, it is crucial to consult a physician for accurate diagnosis and appropriate treatment.

What are the causes of OAB?

• Pregnancy and childbirth can cause your pelvic muscles to weaken, making it more difficult to control the bladder.
• Nerve damage due to stroke, herniated discs, multiple sclerosis, Parkinson’s disease, pelvic or back surgery, or radiation therapy. Your brain and bladder may receive the wrong signal, causing an urge to urinate.
• If you are consuming certain medications, alcohol, and caffeine, your bladder may fill up quickly and overflow, leading to a leak.
• Urinary tract infection (UTI) causes bladder nerve irritation and contraction of your bladder.
• Overweight with excess pressure on the bladder and pelvis.
• Menopause leads to a decrease in estrogen levels, weakening the pelvic floor muscles and triggering overactive bladder symptoms.

How is OAB diagnosed?

• History and physical exam
• Urinalysis to evaluate if you have red blood cells, white blood cells, and bacteria in your urine. If you do, you may have an infection causing an overactive bladder. 
• Urodynamic testing simulates bladder function from storage to evacuation. Patients who do not respond to initial treatments may have this test to provide additional information that may aid in planning further treatment.
• Imaging tests, such as ultrasound, X-ray, and CT scan, identify any underlying pathology related to symptoms, such as stones or tumors in the urinary tract.
• Cystoscopy involves inserting a cystoscope through the urethra to examine the bladder. An anesthetic gel is applied to minimize discomfort during the procedure. In some cases, general anesthesia may be necessary, having the advantage of eliminating pain awareness during the procedure.

How is OAB treated?

Overactive bladder is treatable by lifestyle modification, medications, and nerve stimulation.

Lifestyle Modification

• Avoid food and drinks that cause overactive bladders. These include alcohol, coffee, tea, soft drinks, fruit juice, chocolate, tomatoes, tomato-based foods or beverages, spicy and sour foods, and artificial sweeteners.
• Eat more fiber, drink plenty of water, and exercise to prevent constipation, which can affect your bladder. Having regular bowel habits can minimize overactive bladder symptoms.
• Maintain a healthy weight to prevent pressure on your bladder.
• Quit smoking. Studies indicate smoking is associated with overactive bladder.

Training your bladder

Bladder training can help you to delay urination. You will learn how to resist the urge to go to the bathroom, urinate according to a schedule, and reset your overactive bladder.

Here are the steps you can follow to train your bladder.

• Take note of how often you urinate to evaluate your voiding interval.
• Once you know your current voiding interval, you can try to extend it a few minutes longer. For example, if you urinate every hour, you can try to wait for another 5 minutes before going to the bathroom and gradually increase the time. If you have a urinary urgency during the voiding intervals, relax by taking a deep breath in and out through your mouth until you don’t feel the urge. Urinate when the urge has subsided.
• When your body gets used to the new voiding interval with no leakage for at least a week, increase the voiding interval by 15 minutes and gradually increase it until your new voiding interval is 2 – 4 hours.
• Stick to your schedule as much as possible.

How to manage your urge during bladder training

• Sit or stand still and do the Kegels exercise to manage your urinary urge.
• Breathe deeply to relax your body, repress your urinary urge, and wait until you do not feel the rush to go to the bathroom.
• Keep squeezing your pelvic floor muscles while walking to the bathroom at the usual pace.

Bladder training takes around 6-8 weeks. You must be patient to achieve an improvement. If the result is unsatisfactory, consult your doctor, who may prescribe medications for the bladder training.

How to prevent OAB?

To prevent an overactive bladder, you should:

• Keep a healthy weight and exercise regularly, including Kegels or pelvic floor exercises.
• Drink enough fluids to prevent bladder irritation. However, your symptoms can aggravate if you have too much fluid intake.
• Limit your alcohol and caffeine consumption. Drink it in moderation.
• Keep your preexisting conditions, such as UTIs or diabetes, under control.
• If you wear incontinence pads, here are some tips you can follow to make you feel more comfortable and confident.
• Apply an emollient ointment or cream before using incontinence pads to prevent skin irritation.
• Change incontinence products such as adult diapers or pads right after a leak to reduce odors, and clean thoroughly before wearing a new one.
• Wear loose-fitting and dark-colored clothes to hide bulky incontinence products. Dark-colored outfits can also help hide stains or leaks.