What You Need to Know About Overactive Bladder

What You Need to Know About Overactive Bladder

An estimated 33 million Americans have an overactive bladder (OAB). The Urology Care
Foundation estimates around 30 percent of men and 40 percent of women live with symptoms of
OAB. Often, they are too embarrassed to talk to their health care providers about what they’re
experiencing, and they don’t realize help is available. Symptoms such as a need for frequent
urination may cause a person to feel isolated and create problems in social situations. However,
overactive bladder symptoms don’t have to interfere with every aspect of your day. Find out
what you need to know about the causes, symptoms, and treatments.

What is Overactive Bladder?

Overactive bladder isn’t a disease. It’s a group of symptoms influenced by physical conditions
and everyday habits. Sometimes several factors contribute, so physicians have a hard time
isolating one cause. People with OAB often feel a sudden, urgent need to urinate and may
experience involuntary urine loss.

What Causes Overactive Bladder?

When muscles in the bladder wall are overactive, it creates the need for frequent urination.
Alcohol and caffeine can cause muscles to be overactive, but there is a range of other
contributors.

The urinary system works in conjunction with the skin, intestines, and respiratory system to
balance bodily fluids. The National Institutes of Health say for most adults, the urinary system
removes between 27 and 68 ounces of fluid daily. Kidneys remove waste products from the
blood in the form of urea. Urea mixes with water and other waste as it travels to the bladder
through thin tubes called ureters.

The ureters feed tiny amounts of urine into the bladder every 10 to 15 seconds. The bladder
slowly fills like an expanding balloon. A normal bladder stores up to 16 ounces of urine for
between two and five hours without feeling strained.

When individuals urinate, their urethra allows urine to exit the bladder. Sphincters regulate the
opening between the bladder and the urethra to keep urine in until the individual is ready for it to
drain.

The detrusor muscle exists in the bladder wall to help with urine evacuation. With a healthy
bladder, it stays relaxed and allows the bladder to fill until it’s at least halfway full. At that point,
the brain starts to send signals that cause the detrusor to contract.

With OAB, the detrusor muscle malfunctions. It may contract even when there’s very little urine
in the bladder, making the individual feel an unavoidable urge to go even when their bladder
contains very little fluid. Sudden contraction may also cause incontinence. These conditions may
cause an overactive bladder:

  • Biological factors such as an enlarged prostate, constipation, or other incontinence
    treatments
  • Urinary tract infections
  • Neurological conditions including nerve damage, Parkinson’s disease, multiple sclerosis,
    or stroke
  • Catheter use
  • Urinary system changes after vaginal delivery
  • Bladder stones or tumors
  • Declining mental function due to Alzheimer’s disease or aging
  • Hip replacement or other surgeries
  • Reduced mobility, which may keep you from getting to the bathroom as frequently as
    necessary

Some people think OAB is an unavoidable part of getting older or that it’s something that
happens after childbirth. However, there are treatments many people find helpful, so OAB isn’t
something you have to live with.

Symptoms of Overactive Bladder

OAB can interfere with your job, your sleep, your fitness regimen, even your relationships.
Symptoms might make you refrain from activities you enjoy because you worry you might not
be able to find a bathroom when you need one urgently. As a result, you might start to feel
quarantined by your symptoms.

  • If OAB keeps you from getting a good night’s sleep, you’ll lack energy for the day’s activities
    and may begin to feel depressed. Leaking urine can irritate skin. If you have an overactive
    bladder, you may experience the following symptoms:
  • A sudden, intense urge to urinate
  • Accidental urine loss that comes immediately after you feel the need to empty your
    bladder
  • Frequent urination, often having to go more than eight times in a 24-hour period
  • Waking up more than twice a night with the urge to go to the bathroom

Who Is at Risk for Overactive Bladder?

One study found a higher incidence of OAB in African American and Hispanic populations, but
other studies reached inconclusive results. No matter what your gender or ethnicity, some factors
increase your risk.

Bladder muscles and nerve signals can deteriorate with age. Smoking and being overweight also
increase your risk. Chronic conditions like gestational diabetes, recurring urinary tract infections
and prolonged constipation can make you more likely to develop symptoms. Many medications
also can increase your urine output or make you feel the need to drink more fluids.

Treatment and Prevention

For many people, lifestyle changes can help manage symptoms of OAB or reduce the risk of
developing it in the first place. Making healthier choices will benefit you whether you already
experience symptoms or simply have some of the factors that put you at risk.

Maintain a healthy body weight with a healthy diet and regular exercise. Stay hydrated, but keep
your caffeine and alcohol consumption within healthy limits for your gender and body weight. If
you smoke, stop.

Salty, spicy, and acidic foods can irritate your bladder, making you feel like you need to go more
frequently. Avoid excessive consumption of acidic juices, vinegar-based products, and foods
containing MSG or artificial sweeteners.

Consistently manage conditions like diabetes to prevent deterioration caused by blood sugar
fluctuations. Strengthen your pelvic floor muscles with pelvic floor muscle therapy that involves
Kegel and other exercises. Repeated pelvic floor muscle contraction may reduce involuntary
detrusor muscle contractions, so you don’t have to go as often.

Bladder training involves keeping track of fluid intake and urination, gradually lengthening the
time between bathroom visits. It can help improve bladder capacity and reduce urinary
incontinence.

Medications for overactive bladder help the detrusor muscle stay relaxed. Newer therapies even
include Botox injections to the detrusor. When medication and lifestyle changes aren’t enough,
surgery is often effective in reducing OAB symptoms.

Overactive bladder isn’t something you just have to live with. The Charlotte Center for Pelvic
Health works with men and women to create individual treatment plans that let them live without
the need for frequent urination. Contact us to schedule an appointment today.

Sources:
https://medlineplus.gov/ency/article/003425.htm
https://www.livescience.com/27012-urinary- system.html
https://www.urologyhealth.org/urologic-conditions/overactive- bladder-(oab)
https://www.emedicinehealth.com/overactive_bladder/page6_em.htm
https://www.mayoclinic.org/diseases-conditions/overactive- bladder/symptoms-causes/syc-
20355715

ABOUT AUTHOR

Dr. John Hettiarachchi, FACS FPMRS

Dr. John Hettiarachchi, FACS FPMRS