What Medications Can I Use For Overactive Bladder
Your doctor may suggest trying behavioral techniques before having you use a medication to treat overactive bladder. However, medications can work very well to return normal function to the bladder. Ask your doctor about the risks and benefits of using the following commonly prescribed medications:
Anticholinergic medications
These medications control muscle spasms in the bladder:
- Oxybutynin , oxybutynin XL , oxybutynin TDDS .
It Doesnt Necessarily Happen When You Cough Sneeze Or Jump
You may think you dont have OAB because you dont leak when you sneeze or coughbut that isnt a symptom of OAB. Instead, stress incontinence is actually a different type of bladder issue caused by a weakening of the pelvic floor muscles, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Leaking a few drops at a time can be a sign of stress urinary incontinence, when moving, coughing, sneezing, standing up, jumping and jogging put stress on the bladder to cause the leakage, Dr. Gregory says. But its possible to have both urgency incontinence, a symptom of OAB, and stress incontinence together. Some women have a disorder called mixed incontinence when leakage occurs with both urge and coughing/straining activity, Dr. Taylor says. It is important to discuss these concerns with a physician to tease out what is going on.
Impact On Quality Of Life
OAB significantly impairs QoL, increases depression scores, and reduces quality of sleep. OAB that involves urgency incontinence is associated with the most severe impairment. Persons with OAB who have poor sleep quality report chronic fatigue and difficulty performing daily activities. An increased number of hip fractures due to falls in elderly persons have been attributed to OAB because of the nocturia component. Many such falls involve the individual tripping or losing balance while getting out of bed.
Individuals with OAB develop coping strategies to manage or hide their problems . These coping strategies, along with the OAB symptoms themselves, commonly affect interactions with friends, colleagues, and families and thereby have an adverse impact on QoL.
Notable psychological effects of OAB and urinary incontinence include fear, shame, and guilt. In elderly people with OAB and incontinence, the need for assistance with toileting, shopping for protective undergarments, and laundry may place an additional burden on family members.
Worries and concerns regarding odor, uncleanliness, and leakage during sexual activity may lead individuals to refrain from intimacy. Frequent urination and the need to interrupt activities may affect the persons work and ability to travel. Studies of the impact of OAB and urinary incontinence demonstrate decreased levels of social and personal activities, increased psychological distress, and an overall decrease in QoL.
References
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Signs Symptoms And Treatments
For most men, one trip to the bathroom will empty the bladder and provide relief for several hours. Men with overactive bladder will regularly feel a powerful urge to urinate throughout the day and night. OAB can be life-altering, affect men of all ages, and wreak havoc on your job, social and active lifestyle, and your sleep. Thankfully, there are a variety of approaches available to ease an overactive bladder and get your life back.
Symptoms Of Overactive Bladder
Are your bathroom needs taking up too much of your attention? Urinating is such a mundane aspect of daily life that is, until your bladder begins to act up. A sudden need to go, lots of nighttime visits to the toilet or an embarrassing leak can be signals that the muscles around your bladder are misfiring and will likely need some help to get back on track. These are all symptoms of overactive bladder to be aware of.
Overactive bladder is not uncommon, but it is also not normal, although it is usually easily treated and often reversed with behavioral strategies or medication. However, since other conditions can mimic the symptoms of OAB, it is important to get these bladder symptoms checked out as soon as you can, in order to rule out more serious problems and get treatment underway.
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Does It Affect Your Life
Does your recognition of needing to urinate frequently and suddenly keep you from lifes normal activities? This is truly another sign of an overactive bladder. Locating a restroom in an unfamiliar place is a good way to cope, but staying home is not.
Likewise, feeling embarrassed about the number of times you need to run to the bathroom may keep you from accepting invitations. There is help.
How Can Nerve Stimulation Help Overactive Bladder
There are several treatments that involve stimulating your nerves to help improve overactive bladder. Your nerves help communicate the message that your bladder needs to be emptied to your brain. By treating the nerves, your healthcare provider can improve your bladder control. Nerve stimulation is a reversible treatment that is considered when conservative treatments have not worked or have not been tolerated. Conservative treatments include behavioral therapies and medications.
There are several types of nerve stimulation treatments. These can include:
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Factors That Contribute To An Overactive Bladder
Once urine is produced, it travels to your bladder and your brain signals that its time to urinate. As a result, your pelvic floor muscles relax, allowing the urine to exit your body. However, an overactive bladder causes your muscles to contract involuntarily. This gives the sensation that your bladder is full even when its not.
While both men and women can suffer from an overactive bladder, this condition most commonly occurs in women. This is due to changes in estrogen and weakened pelvic floor muscles after experiencing menopause, pregnancy, and menstruation. Other factors that can contribute to an overactive bladder include aging, weight gain, poor nutrition, trauma to the pelvis or abdomen region, and neurological diseases that affect nerve signals to the bladder.
What Causes Neurogenic Bladder
Neurogenic bladder can be congenital . Birth defects that can cause neurogenic bladder include:
- Spina bifida : This disorder occurs when the spine doesnt completely develop during the first month of pregnancy. Babies born with myelomeningocele often have paralysis or weakness that affects how their bladder works.
- Sacral agenesis: This is a condition in which parts of the lower spine are missing.
- Cerebral palsy: Cerebral palsy refers to a group of chronic disorders that weaken a person’s ability to control body movement and posture. These disorders result from injury to the motor areas of their brain. The problem causing cerebral palsy may occur while during development or after birth. Cerebral palsy isnt always found during a child’s first year of life.
Medical conditions that involve the nervous system can cause neurogenic bladder. Common causes include:
- Trauma/accidents.
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Treatment Of Overactive Bladder
Overactive bladder is a chronic medical condition that requires continuous treatments. There are several treatment options to treat overactive bladder. Nonetheless, the selected treatment option is primarily determined by patients symptoms, disease severity and complications as well as underlying conditions. Treatments include:
What Complications Are Related To Neurogenic Bladder
People who have neurogenic bladder are at higher risk for other urological problems, including repeated infections, kidney damage, vesicoureteral reflux and stones that form in the urinary tract.
People with bladder control conditions such as neurogenic bladder may experience quality of life issues. Its important to recognize these issues and get help with them.
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What Causes Overactive Bladder
An overactive bladder can be caused by several things, or even a combination of causes. Some possible causes can include:
- Weak pelvic muscles: Pregnancy and childbirth can cause your pelvic muscles to stretch and weaken. This can cause the bladder to sag out of its normal position. All of these factors can cause leakage.
- Nerve damage: Sometimes signals are sent to the brain and bladder to empty at the wrong time. Trauma and diseases can cause this to happen. These can include:
- Pelvic or back surgery.
Often, there may be no specific explanation for why this is occurring.
What Is An Overactive Bladder
The simplest definition of an overactive bladder is a recurring feeling of the need to urinate beyond ones normal needs. This often includes rather sudden urges that can be difficult to control. In more than 40% of cases, this urge to urinate is accompanied by an actual loss of control, which is referred to as urge incontinence.
While an overactive bladder is not a serious or life-threatening condition, it nevertheless can negatively affect a persons daily life. In cases where the person has urge incontinence, the sudden loss of control can happen in public places, leading to embarrassment or confusion. But even without loss of bladder control, the ongoing urge to urinate can cause the kind of anxiety that leads to a person rearranging their lives just to avoid an incident.
In addition to ongoing urinary urgency, a feeling that can send someone running to the bathroom at a moments notice, symptoms of an overactive bladder also include actually urinating more frequently than normal. Another symptom that is often the concern is nocturia, an urge to urinate in the middle of the night that usually involves being awoken from sleep.
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Overactive Bladder At Night
If you find that you wake up to urinate more than one time per night, you may have a condition called nocturia, or overactive bladder at night. Nocturia isnt the same as overactive bladder. In fact, some people who experience no OAB symptoms during the day can still have nocturia.
Nocturia is more common in people over age 60, but one in three adults over 30 need two or more trips to the bathroom each night. Most adults can sleep six to eight hours without waking up. Others may only need to wake up once.
If you require more bathrooms breaks during your slumber, you may be experiencing overactive bladder at night.
Overactive Bladder And Botox
Botox may be best known as a great wrinkle reducer for the face. But this injection has actually shown great promise as a treatment for many medical conditions.
Most overactive bladder medications aim to calm muscles and nerves in the urinary tract. If these medicines arent effective, your doctor may consider injecting Botox into your bladder muscles. This can help calm the muscles and reduce symptoms of OAB.
Botox injections for overactive bladder are well-tolerated with few side effects. The injections effects typically last six to eight months. After that time, your doctor may want to use another round of injections to control symptoms.
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Overactive Bladder In Men At A Glance
- Overactive bladder is the result of malfunctioning bladder muscles and nerves that send sensations to the brain, causing involuntary and unnecessary contraction of the bladder muscles.
- The primary symptom of OAB is a sudden, uncontrollable urge to urinate, often resulting in leakage of urine, which is incontinence.
- OAB, also called urge incontinence, affects up to 30 percent of males, preventing them from controlling when and how much they urinate.
- Nearly two-thirds of cases of OAB in men are caused by an enlarged prostate.
Certain Foods And Drinks Trigger Symptoms
Spicy or acidic foods, sugar, alcohol, and caffeine can all be irritants, so you might notice your overactive bladder symptoms getting worse after you consume them. Alcohol acts as a diuretic, causing more urine to be filtered through the kidneys, increasing subsequent urine production and the feeling of OAB, Dr. Taylor explains. Caffeine acts as both a diuretic and also makes the bladder more sensitive by lowering the threshold at which a bladder contraction will occur. Dr. Gregory says that some people just have a lower tolerance for certain foods that irritate the bladders lining. If you have that type of sensitivity, then a good strategy is to identify and avoid your trigger foods, he says. Culprits often include hot peppers, tomato sauce, wasabi, and even cranberry juice.
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You Often Go Only A Little Bit
With an overactive bladder, even though you may feel the urge to hit the bathroom all the time, not much comes out. Sudden urge to urinate occurs because the muscles of the bladder start to contract involuntarily, even when the amount of urine in the bladder is low, Dr. Taylor says. This involuntary contraction makes women feel an urgent need to urinate, which signals OAB, as the bladder lining becomes hypersensitive to the smallest volumes of urine. Note: this particular symptom could also be a symptom of a urinary tract infection . The only way to truly tell the difference between a UTI and OAB is to obtain a urine culture to see if bacteria is growing in the urine, Dr. Taylor says. A urine culture is a very easy test that can be done in most labs.
What Can I Do If I Have An Overactive Bladder
For women who suffer from incontinence due to the menopausal transition, they will first be encouraged to take measures to resolve the hormonal imbalance.
Elementary steps begin by making simple lifestyle changes, which includes optimizing your diet with phytoestrogens as well as maintaining a healthy weight with regular exercise, which simultaneously helps those suffering from stress urinary incontinence. Also, consider the use of alternative medicines, like phytoestrogenic herbs and hormone-regulating supplements. If you have leakage problems, check out some more successful incontinence treatments to keep you out of the restroom for longer.
Women who suffer from an overactive bladder due to other causes will have to personalize treatment plans with their doctors, which may include medications that relax the bladder, thus alleviating the symptoms and reducing episodes of urge incontinence.
For all women, management practices include using absorbent pads, scheduling toilet trips, performing pelvic floor muscle exercises, and training your bladder to hold urine for longer.
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Sexual Differences In Incidence
In the NOBLE study, the prevalence of OAB was similar in women and men . However, the prevalence of incontinence associated with OAB differed. Among women, 9.3% reported having OAB with incontinence 7.6% reported having OAB without incontinence. In contrast, more men reported having OAB without incontinence than with incontinence . In women, the prevalence of OAB with urgency urinary incontinence increased with increasing body mass index , whereas in men, no difference was found.
Milsom et al, in a population-based survey of 16,776 men and women aged 40 years or older from the general population in Europe, found the overall prevalence of OAB symptoms to be 16.6%. The main outcome measures included the prevalence of urinary frequency , urinary urgency, and urgency incontinence.
Frequency was the most common symptom , followed by urgency and urgency incontinence . The prevalence of OAB increased with age, and rates in men and women were similar. Symptoms of urinary urgency and frequency were similar between both sexes, but urgency incontinence was more prevalent in women than in men.
OAB in men is often related to obstruction therefore, it may be important to differentiate between obstruction and irritative symptoms before the initiation of treatment.
What Are The Treatment Options For An Overactive Bladder
Overactive bladder is actually a fairly common condition, but the good news is that doctors have numerous treatment methods at their disposal to improve the lives of those who are struggling with it. There are actually several categories of treatment options available:
Lifestyle Modification: Doctors usually turn to these methods first since they are often effective and have essentially no side effects. By modifying behavior or lifestyle habits, many patients see a great improvement in symptoms:
- Maintain a healthy weight: Since obesity is one of the main factors, losing weight and maintaining a healthy weight is one of the easiest ways to treat an overactive bladder.
- Pelvic floor muscle exercises: A doctor or physical therapist can help provide guidance in doing exercises, referred to as Kegel exercises, that can strengthen the muscles of the pelvic floor or urinary sphincter.
- Toilet schedule: Rather than waiting for the urge to urinate, which can be unreliable with an overactive bladder, scheduling trips to the toilet every 2-4 hours can help maintain regularity.
- Bladder training: This method involves purposely delaying urination when the urge happens in order to train ones bladder to regain control of the urges.
- Absorbent pads: In cases where urge incontinence is prevalent, absorbent pads may be necessary as a backup in case other methods arent effective.
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How Is Overactive Bladder Diagnosed
In most cases OAB can be diagnosed by history and physical exam and a urine analysis to rule out infection or blood in the urine. An abnormal urine analysis may prompt treatment or further testing . Sometime you doctor will check to see if your bladder is emptying well. This can be done with a small ultrasound or with a catheter). Many times, treatment can be recommended based on the information obtained from these simple things.
In some cases, a bladder diary may be recommended to help understand the severity of the condition. A bladder diary is a record kept by the patient that includes fluid intake, number or urinations, and the amount of urine with each urination.
In more complex cases further testing may be done to get a better understanding of the function and anatomy of the lower urinary tract. These tests may include: