Doctor's Notes on Overactive Bladder
Overactive bladder (OAB) is a bladder disorder that results in an abnormal urge to urinate, urinary frequency, and nighttime urination (nocturia). In some cases, involuntary loss of bladder control (urinary incontinence) may occur. Causes of overactive bladder include abnormal contractions of the muscles of the urinary bladder resulting in a sudden and uncontrollable urge to urinate, urinary tract infection, diabetes, medications such as diuretics (water pills), prostate disease, bladder tumors, or interstitial cystitis.
Symptoms of overactive bladder include urinary urgency, which is a sudden urge to urinate that may be difficult to control. Incontinence is not a defining symptom of an overactive bladder, but it can happen as a result of urgency. Other symptoms of overactive bladder include urinary frequency (urinating more than eight times in 24 hours without any other reason, such as taking diuretics) and nighttime urination (waking up at least twice in the middle of the night to void).
What are the treatments for overactive bladder?
Treatment for overactive bladder usually is done by combining two or more therapies. The following treatments are used:
- Behavioral/exercise
- Pelvic floor muscle exercises (Kegel)
- Biofeedback
- If overweight, weight loss
- Schedule trips to the toilet
- Bladder training – practice short delays when the urge to urinate
- Absorbent pads
- Intermittent catheterization
- Medications
- Vaginal estrogen therapy for muscle strength
- Medications to reduce urge incontinence (for example, Detrol)
- Bladder injections – for example, Botox for urge incontinence
- Nerve stimulation – electrical stimulation of nerves to regulate bladder activity
- Surgery
- Procedure to use pieces of the bowel to increase bladder volume
- Bladder removal – done to construct a place for a replacement bladder or a place for a stoma, an area where a bag can attach to collect urine
You and your doctor can decide which combination of treatments will best fit your problem.
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REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.