Overactive Bladder

Suffering from an overactive bladder (OAB) can be distressing, frustrating as well as embarrassing. OAB refers to a problem in the bladder that causes to contract before it is full, causing a sudden urge to urinate, which could lead to the involuntarily loss of urine. With the correct diagnosis, OAB can be treated and the symptoms can be greatly reduced.

Causes of OAB

As urine is transported to the bladder from the kidneys, the bladder expands like a balloon in order to accommodate it. Once the bladder is a third of the way full, it sends signals to the brains informing it that it is getting full and you begin to sense that you need to urinate soon. The more the bladder fills, the greater the urge to urinate. When you begin urinating, the bladder muscles contract and force the urine out.

In the case of OAB, the muscles of the bladder contract involuntarily even though the bladder may not be full. This causes a sudden urge to urinate in the person. However, sometimes this urge is completely sensory and the bladder muscles are not really contracting. Still, the urge causes the person to have to rush to the restroom, often resulting in accidents.

There are several factors that may lead to OAB, including:

1) Excess fluid intake2) Excess caffeine or alcohol intake3) Urinary tract infections4) Certain medications can cause the bladder to become overly sensitive5) Enlarged prostate � often occurs in men over 406)Neurological disorders � such as Parkinson’s, strokes, or multiple sclerosis (MS)7) Bladder abnormalities, e.g. a tumor or bladder stones

Treatments for OAB

If one is diagnosed with OAB, the following are the steps that physicians usually follow for treatment:

1. Behavioral Therapy

The following behavioral therapies should first be used in order to treat the symptoms of OAB:

a) Reduction in Fluid Intake – Beverages such as tea and coffee can cause severe incontinence problems; therefore intake of such drinks should be minimized as a first option.

b) Double Voiding �After urinating, wait a few minutes and then try urinating again in order to empty the bladder.

c) Physical Exercise- Pelvic floor exercises, called kegels, are a great way to strengthen the weak muscles that can sometimes lead to incontinence. Kegels are performed by contracting the same muscles as one would use to stop urinating. Simply contract the muscles, hold for a few seconds and then relax. Repeat the same exercise ten times, a few seconds apart. Within 2-3 months OAB sufferers should begin to feel more control over their urinary flow and less incidences of leakage.

d) Catheterization � If the doctor recommends it, then OAB sufferers may need to perform self-catheterization in order to empty the bladder. Some popular catheters include the foley catheter and bard catheter.

e) Absorbent Pads � Another option to prevent accidents as a result of OAB is to wear absorbent pads such as depends or attends. One may also use a number of other incontinence products to control OAB.

2. Medication

If step 1 does not work, then medication may be necessary. There are a number of medical treatments available for OAB, including: anticholinegics such as imipramine (Tofranil), oxybutynin (Lyrinel), slifenacin (Vesicare)and tolterodine (Detrusitol). All of them work by relaxing the bladder muscles. Side effects of these treatments may include a dry mouth, constipation and drowsiness.

3. Surgery

As a last resort, people suffering from severe incontinence may need to undergo surgery.

Surgical methods are usually only performed on women who do not benefit from any of the above three methods and often have a deformity in their bladder. Some surgical options available for treating incontinence include:

a) Artificial urinary sphincterb) Bladder neck suspensionc) Collagen injectiond) Electrical Stimulatione) Tension-free vaginal tape (TVT)f) Urethral bulking agents or implantsg) Vaginal sling