Over active Bladder

—Specialisation

Quick Answer

Quick Answer: Overactive Bladder (OAB)

What is overactive bladder?+

Overactive bladder (OAB) is a condition in which the bladder muscle contracts involuntarily, causing a sudden, hard-to-control urge to urinate. It often leads to frequency, nocturia, and sometimes urge urinary incontinence.

What causes overactive bladder?+

OAB can result from neurological conditions, ageing, bladder muscle changes, obesity, caffeine or alcohol intake, constipation, and pelvic-floor weakness. In many people no single cause is found.

How is OAB diagnosed?+

Diagnosis is largely clinical — a careful history, voiding diary, and physical examination. Urinalysis rules out infection; in selected cases, urodynamic testing and cystoscopy provide further information.

How is overactive bladder treated?+

A stepwise approach: bladder training and pelvic-floor exercises first, then oral medication (anticholinergics, mirabegron), then advanced options such as intra-detrusor Botox injections or sacral neuromodulation.

Overactive Bladder (OAB) is a condition where the bladder muscle contracts involuntarily, causing a sudden, hard-to-control urge to urinate that can sometimes lead to leakage (urge incontinence). It is common, manageable, and rarely dangerous – though it can significantly affect quality of life. The problem of overactive bladder affects roughly 40% of adults at some point in their lives. The problems, like urine incontinence is caused because of the overactive bladder for about 40% to 70%. This problem is not life-threatening and people live with this condition for many years together.

OAB can be embarrassing and may lead patients to limit their social activities – but effective treatment is available, and there is no need to suffer in silence.

Causes

The exact cause of OAB is often unclear. Contributing factors include constipation, caffeine and alcohol intake, obesity, diabetes, chronic pelvic pain, and reduced mobility.

Symptoms

After the overactive bladder problem gets started, the symptoms that are experienced by the patient, are the following.

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Urine urge incontinence

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Frequent urination that usually goes beyond 8 times per day

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Sudden urge to urinate and inability to control it completely

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Frequent urination for more than 2 times during the nights

Diagnosis

Diagnosis is done to understand the specific cause by simple and brief evaluation. It is important to understand the signs and symptoms clearly to confirm the problem. Diagnosis is basically done to exclude the possible conditions like neurological conditions or urinary tract infections. It is because these symptoms are similar to the symptoms of bladder cancer, urinary tract infection, benign prostatic hyperplasia, etc.

Treatments Available

Treatment of overactive bladder is always started with the behavioural strategies, like timed voiding, techniques to hold the bladder and fluid schedules. After the management starts with this, the later treatment methods are continued if the problem is not controlled by the behavioural changes. Bladder holding techniques are done with the help of pelvic floor. The home based practices needed are the following.

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Bladder training

Bladder training is the most common and most effective treatment recommended for the overactive bladder. It does not need any kind of medication. The training includes changes done with the usage of the bathroom. The key point here is scheduled voiding, which means fixing certain times all the day and night to urinate. The schedules are more frequent during the initial stages and the interval between the visits to the bathrooms will be increased in the later stages.

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Pelvic floor exercises

Pelvic floor exercise is an exercise done to strengthen the muscles that could control the urination, just like the exercises performed to strengthen the muscles of the arms, ribs, etc. of the body. The exercise is done by tightening, holding and then relaxing the muscles, which are function, while starting and stopping the flow of urine, while urination. Start it with sets of three and increase to the sets of 10.

Other kinds of activities are the following.

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Activities for weight loss, for the people, who are obese

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Decreased consumption of the caffeine

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Consuming fluids moderately

To avoid the embarrassing movements, while spending more time out, one can wear the absorbent pads so that the leakage from the bladder can be controlled. Such arrangements can be done until the overactive bladder comes into control.

When the treatments like behavioural therapies do not help to relieve from the symptoms, medication has to be started. Injection of certain specific toxins is also given as a part of the treatment. This kind of medication is treated as second line treatment. There are a few people get relief from the medication, however they are effective moderately. Treatment for overactive bladder also includes certain procedures. There are many of the devices used to treat this condition. Devices like urgent PC neuromodulation system can be used. Intra-detrusor injections of Botulinum Toxin A (Botox) suppress involuntary bladder contractions and typically provide symptom relief for 6–9 months per treatment. For the overactive bladder condition, complex treatments like surgery or urinary catheters are not recommended.