What Is The Treatment For An Overactive Bladder
It is important to remember that an overactive bladder is not simply a normal part of ageing, or of having an enlarged prostate, and if you are experiencing symptoms, you should see a doctor, who will take a medical history, and may perform urine tests, physical examinations, and/or neurological tests to determine the cause. There are a number of treatment options, although the first line of treatment is usually behavioural:
- Pelvic floor muscle exercises a doctor or physiotherapist will instruct you on how to do these.
- Scheduling toilet trips can help your body get into a familiar, controlled pattern
- Bladder training this is only possible when you are able to control your pelvic floor muscles. It involves training yourself to hold urine in when you feel the urge, and slowly building up the time you wait before going to the toilet.
- Achieving a healthy weight if you are overweight, losing that weight can help alleviate symptoms
If behavioural treatments are ineffective, or if both doctor and patient decide they are not appropriate for the case, there are other options. Depending on the patient, the doctor may recommend medication, bladder injections, nerve stimulation therapy, or even surgery .
What Is An Overactive Bladder
Overactive bladder, or urgency incontinence, causes a sudden and desperate urge to urinate. Sometimes the urge is so strong, you may not make it to the bathroom in time. This urge can occur even when your bladder is relatively empty.
A problem with your bladder muscles, called detrusor overactivity, is what triggers overactive bladder. Detrusor overactivity causes bladder muscles to misfire and send signals to contract, telling you that you need to urinate before your bladder is full.
Much of the time, its difficult to identify one specific cause of overactive bladder. In some cases, OAB seems to develop for no particular reason at all. Some conditions or risk factors may elevate your chances of developing overactive bladder, including:
- Abnormal nerve activity
- Damage to the brain or declining cognitive function
- Urinary tract infections
- Bladder abnormalities
In addition, certain medications can trigger the symptoms of OAB, as can the hormonal changes associated with menopause.
Overactive bladder can be exacerbated by habits or conditions that contribute to your bladder troubles. These include drinking large amounts of caffeine or alcohol, having difficulty walking, and not being able to empty your bladder fully,
Can Overactive Bladder Be Controlled
Overactive bladder therapy can be challenging to manage. However, many people are very satisfied with the treatment they receive and they often see a dramatic improvement in their quality of life. Your doctor will guide you to the best steps to begin with and give you options for any additional treatments you may need over time.
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Change Your Bathroom Schedule
You can do things to switch up when and how often you pee. If you have trouble fully emptying your bladder, your doctor might suggest double voiding. This is when you pee, wait a few seconds and then try peeing again. Or they might work with you to create a daily urination schedule, setting specific times for you to go every day.
Timed voiding, basically going by the clock and not waiting for your bladder to get full, is the primary action, Dr. Tillem says. The timing may vary from person to person depending on how much liquid you drink.
Are There Treatments For Oab
Treatment for OAB begins with an accurate diagnosis of your condition. At Urology Associates Medical Group, were experienced at identifying OAB so you can get the help you need.
We first review your medical history, paying close attention to any symptoms you describe. If required for diagnosis, we may order lab work or additional testing, such as measuring urine flow rate or a urinalysis.
Once we better understand your condition, we create a customized OAB treatment plan that fits your needs. OAB treatments vary depending on the triggers or contributing factors and the severity of your symptoms and may include:
- Lifestyle changes
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Natural Supplements You Can Take At Home
While there have been very few scientific studies on herbal remedies as an option for overactive bladder treatment, some remedies have shown promising results for some people.
Studies from Japan have shown improvements in urgency, leakage and a reduction in night-time urination using a herbal remedy known as Gosha-jinki-gan. Also, the buchu plant from South Africa is thought to nourish the bladder tissue and fights inflammation which can lead to infections and incontinence.
There are also plenty of common herbs that may help with symptoms, including:
- Ganoderma lucidum
Remember to consult your doctor first before adding any of these herbal remedies into your overactive bladder management plan.
What Are The Specific Symptoms Of Overactive Bladder
Overactive bladder represents a collection of symptoms that can include:
- Urinary urgency: This is a failure to be able to postpone the need to urinate. When you feel you need to urinate, you have a limited amount of time to get to a bathroom.
- Frequency of urination: People who experience this symptom need to urinate very often. Typically its an increase in the number of times you urinate compared to what you previously experienced.
- Urge incontinence: In this case, there can be a leakage of urine when you get the urge to urinate.
- Nocturia: This symptom is characterized by the need to get up and urinate at least two times each night.
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Treatment Options For Overactive Bladder
- Behavioral therapies to help you regain control of their bladder
- Watch the type, quantity and timing of food and drink that you take in
- Avoiding foods and beverages that are likely to cause OAB symptoms
- Regular toileting to prevent the bladder from getting too full
- Weight Loss: Being overweight puts extra pressure on your bladder. Weight loss may help relieve some of the symptoms of OAB.
- Urinate on a Schedule: Sometimes, the message that the bladder is full comes without warning and often too late. In these cases, women find that they lose urine on the way to the bathroom. There isn’t enough time between the message and their ability to get to the bathroom before they start to leak. Voiding on a schedule, also referred to as “Timed Voids” may help prevent urgency and urgency incontinence.
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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How We Made Our Recommendation
Our evaluation is primarily based on an independent scientific review of the evidence on the effectiveness, safety, and side effects of overactive bladder medications. A team of physicians and researchers at the Pacific Northwest Evidence-Based Practice Center conducted the analysis.
A synopsis of that forms the basis for this report. A consultant to Consumer Reports Best Buy Drugs is also a member of the Pacific Northwest EPC research team, which has no financial interest in any pharmaceutical company or product. The full Pacific Northwest EPC review of overactive bladder drugs is available here. . We also relied on research conducted by the Agency for Healthcare Research and Quality and the Cochrane Collaboration.
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Evaluation Of Patients With The Oab Syndrome
There are usually no clinical signs on examination, so a careful history is essential. Table Table11 presents the questions a clinician should ask a patient presumed to have OAB. The primary care physician should take a focused history and perform a primary evaluation for urinary tract disorders, such as recurrent urinary tract infections, urinary bladder calculi, and bladder tumors. Such an evaluation is necessary to rule out general conditions and risk factors that cause incontinence such as diabetes mellitus, stroke, lumbar disc disease or spinal cord injury, Parkinson’s disease, multiple sclerosis, pelvic surgery, multiple vaginal deliveries and obstetric history, immobility, dementia, and psychiatric disease.
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What Tests Will Be Done To Diagnose Overactive Bladder
A healthcare provider may order tests to help diagnose overactive bladder. These tests may include:
- Urinalysis. A urinalysis examines the visual, chemical and microscopic aspects of your pee. A provider will look for red blood cells, white blood cells and bacteria. If you have any of them in your pee sample, you may have an infection that causes OAB.
- Urodynamic testing. Urodynamic tests measure how much pee remains in your bladder after you go to the bathroom, how much you pee, how fast you pee and how much pressure is on your bladder as it fills with pee.
- Ultrasound. An ultrasound is a noninvasive imaging test that allows a healthcare provider to take a detailed look at your bladder.
- Computed tomography scan. A CT scan is a noninvasive imaging test that produces 3D images of your bladder.
- Cystoscopy. A healthcare provider will use a special instrument to look inside your bladder from your urethra. The provider typically uses a numbing gel so you dont feel pain in your urethra. In rare cases, they may use general anesthesia, so you arent awake, wont move and wont feel any pain.
Overactive Bladder Treatment Options
Research indicates that most people believe the symptoms of an overactive bladder are an inevitable and normal part of growing older, rather than a treatable medical problem. This couldnt be further from the truth.
In fact, fewer than half of individuals with incontinence actually consult a healthcare provider about their problem. This is unfortunate, since there are many treatments available to combat symptoms of OAB.
Even though it may feel embarrassing to talk about your condition, its important to talk to your doctor about your incontinence symptoms. Watch our short film below about the importance of speaking up about bladder leakage.
NAFC is excited to debut a short film about coming to terms with overactive bladder and incontinence. About just how challenging it can be to admit that there’s a problem. And also about how facing up to that reality can be an important first step towards drier days. Watch this short video about OAB, and about how not speaking up can create more problems than staying silent.
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Pelvic Floor Exercises Can Help Immensely
You cant see your pelvic floor muscles however, just like other muscles in your body they lose their strength if they are not put to use.
Pelvic floor exercises help strengthen the pelvic floor when done consistently at least twice a day. How are they done?
- Imagine you are holding back gas or urine.
- Squeeze and lift the rectal area without tightening your buttocks or belly. Try and hold it for a count of three before relaxing. Repeat this cycle 10 times. Do 10 sets of Kegel exercises, at least 3 times a day.
- Increase your contractions as your doctor recommends.
- Do not hold your breath when you do Kegel exercises. Keep your stomach, back, and leg muscles relaxed.
- Donât use Kegel exercises to start and stop your urine stream which can lead to incomplete emptying of the bladder and an increased risk of a urinary tract infection.
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Debunking Myths About Overactive Bladder
Perhaps because overactive bladder isn’t a commonly discussed topic, myths and assumptions abound about who gets the condition, what causes it, and how you can minimize the problem. Let’s get the truth directly from the experts.
Myth: OAB is just part of getting older. Nope. Toss that one out the window, although the truth isn’t overly comforting either . OAB affects about 17% of women between the ages of 18 and 40. And while OAB becomes more common as you get older, it’s not a normal part of aging. Here’s another myth: Limiting fluids will help the problem. Wrong again. Less urine can irritate your bladder and lead to bacterial growth. And concentrated urine can actually increase your need to urinate.
And how about this myth: OAB requires a surgical solution. Actually, there are numerous ways to improve overactive bladder, and surgery is often saved as a last resort for severe cases. And this one: Stopping at the bathroom extra times, just in case, is helpful. You’re already weary of going to the toilet all the time, says Healthgrades. Why add extra trips? Besides, the goal is to get your bladder accustomed to holding urine longer, if possible, and needing fewer bathroom stops. No need to head in the opposite direction.
Myth: Only women have this problem. Men are less likely to get medical help for overactive bladder, but starting around age 60, more men have the condition than women.
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Cautions With Other Medicines
Mirabegron may affect the way other medicines work, and other medicines may affect how mirabegron works.
Tell your pharmacist or doctor if you’re taking:
- digoxin, a medicine for heart failure or abnormal heart rhythm
- imipramine or desipramine, medicines for urinary incontinence or nerve pain
- dabigatran, a blood thinner
- ketoconazole or itraconazole, medicines used to treat fungal infections
- ritonavir, a medicine used to treat HIV
Symptoms That Aren’t Signs Of Overactive Bladder
Leaking urine when you sneeze, cough, or laugh, or even when you stand up, walk, or bend over, are symptoms of stress urinary incontinence , not OAB, according to Medical News Today. SUI is not associated with an urgency to urinate, or frequency of urination, and people with SUI usually only leak a small amount of urine at a time.
A urinary tract infection is a different condition too . This one is especially confusing though, because both conditions can cause a frequent and urgent need to urinate. In fact, a study published in Current Urology Report found that OAB is often misdiagnosed as a UTI, and that a urine culture is needed to differentiate the two.
Onset of symptoms also may help you tell the difference, because UTIs generally develop quickly, with acute symptoms, while OAB is more ongoing and chronic. Pain is another tipoff, continues Advanced Gynecology. A burning sensation or pain while urinating is common with a UTI, but not with OAB. And a UTI can cause bloody or cloudy urine, while an OAB does not.
Another condition with similar symptoms is benign prostatic hyperplasia , or prostate gland enlargement . Differences include difficulty starting the flow of urine, or a flow that is weak or intermittent. Dribbling as you finish urinating can also be a symptom of BPH.
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What Behavioral Changes Can I Make To Help With Overactive Bladder
There are many techniques and changes to your typical behavior that you can try to help with an overactive bladder. These can include:
Keeping a log: During a typical day, write down your fluid intake, the number of times you urinate, the number of accidents and when they occur. Make a note about what happened when the accident happened, like when you:
- Were unable to reach the bathroom in time.
Monitoring your diet: Eliminate or decrease foods or beverages that may worsen your bladder symptoms. These could include:
- Spicy and acidic foods and drinks.
- Foods and drinks that contain artificial sweeteners.
Maintaining bowel regularity: Constipation can place added pressure on the bladder and have a negative effect on your bladder function. By keeping healthy bowel habits, you may be able to avoid constipation and help to lessen bladder symptoms. The following are some suggestions for maintaining bowel regularity:
- Increase your fiber intake by eating foods like beans, pasta, oatmeal, bran cereal, whole wheat bread, and fresh fruit and vegetables.
- Every morning, take 2 tablespoons of this mixture: 1 cup apple sauce, 1 cup unprocessed wheat bran, and ¾ cup prune juice.
- Exercise regularly to maintain regular bowel movements.
Maintaining a healthy weight: Being overweight can add pressure on your bladder, which may contribute to bladder control problems. If you are overweight, weight loss can reduce the pressure on your bladder.
- Drinks that contain artificial sweeteners.
Preparing For An Appointment
For overactive bladder, you’re likely to start by seeing your primary doctor. After your initial appointment, you may be referred to a specialist in urinary disorders in men and women , a specialist in urinary disorders in women , or a specialist in physical therapy for diagnosis and treatment.
Here’s some information to help you get ready for your appointment, and what to expect from your doctor.
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Weight Loss & Health Improvements To Reduce Your Symptoms
Studies suggest that losing excess weight can reduce the symptoms of stress incontinence and an overactive bladder.
What does this mean exactly? If you can lose about 8 percent of your body weight thats typically around 15 to 20 pounds you will likely see remarkable results. In fact, even just a few pounds of weight loss can reduce incontinence episodes by over 25%.
Aside from all the other health benefits, by losing weight the abdomen will alleviate pressure on all the organs in the area, including the bladder.
As well as weight loss, getting regular exercise can reduce overactive bowel symptoms. Exercise can help to reduce the strain on your bladder which ultimately means less urine leaks.
Stopping smoking can also help with OAB problems since the smoke from cigarettes can irritate your bladder. Smoking can also lead to hacking cough a loud, dry cough which can cause further leaks.