Overactive bladder (OAB) is not a disease, but a group of urinary symptoms. Up to 30% of men and 40% of women in the United States are affected by OAB symptoms.
The most common OAB symptoms are the sudden need or urge to urinate, and can include frequency and leaking urine or incontinence.
Urgency – when you have a strong feeling that you have to urinate because you are afraid that if you don’t get to the bathroom, urine may leak.
Leak urine – you leak urine after you feel the urgency. This may be only a few drops or a large amount of urine
Frequency– urinating greater than 8 times a day. Waking up from sleep to urinate more than once a night.
- Post-menopausal in women
- Prostate problems in men
- Underlying chronic infections of the urinary tract such as chronic cystitis, prostatitis, and/or urethritis.
- Obstructive diseases such as Benign Prostatic Hypertrophy (BPH) and urethral strictures.
- Diseases that affect the nervous system, such as multiple sclerosis, stroke, diabetes, Parkinson’s
- Drinks and foods may worsen your symptoms include caffeinated drinks
EVALUATION AND DIAGNOSTIC TESTING:
After discussing your history and doing a physical exam, your provider may order tests such as urinalysis and cultures or ultrasounds to further evaluate the cause of overactive bladder. Diagnosing OAB could include:
History and Physical: Bladder Diary to help learn about your day to day symptoms
Urine cultures to ensure the symptoms are not related to an infection
Bladder Scan: measures the amount of urine left in your bladder after you urinate to ensure you are not retaining urine
Urodynamic Study: a test to measures how well the urethra and bladder are doing their job of storing and releasing urine
Primarily, the cause of the condition is treated as an underlying infection, or the underlying disease. Some other treatments may be used such as:
Behavioral Therapy: Lifestyle changes in your daily routine that may help control your OAB symptoms. This may include limiting bladder irritating foods and drinks, keeping a bladder diary, exercises, and/or bladder training.
Medications to relax the Bladder Muscles: Oral medications or injections such as Botox
Biofeedback/Pelvic Floor Therapy: Where electrodes are placed on bladder/pelvic floor muscle and hooked up to a computer to show the activity in real time. A trainer/therapist then evaluates and guides you through exercises designed specifically to exercise the correct muscle.
Neuromodulation Therapy: a group of treatments that send electrical impulses to certain nerves to change how they work. This may include sacral nerve stimulation (SNS) or posterior tibial nerve stimulation (PTNS). For SNS, a device is placed under the skin and delivers electrical impulses to the bladder to stop of OAB symptoms. For PTNS, a needle electrode is placed near your ankle for thirty minutes. It sends mild impulses to the nerve that runs up your leg in order to help block the nerve signals that are not working correctly. Over time, repeating this procedure may help improve your symptoms.
Bladder Augmentation: A surgery performed to increase the capacity of the bladder by adding bowel segments or reducing the muscle-squeezing ability of the bladder (depending on the capacity of your bladder)