Overactive bladder (OAB) is a condition in which people have a sudden, urgent need to urinate. Some people may lose bladder control before reaching a toilet and leak urine, called incontinence. Overactive bladder also causes increased frequency of urinating--more than 8 times a day or 2 or more times at night. In OAB, the body inappropriately senses the volume of urine in the bladder and a key muscle in the bladder malfunctions, contracting and relaxing sporadically.
Treatment for OAB includes behavioral therapy, pharmacotherapy (medications), and surgery. It is rare to cure OAB, but patients can have satisfactory outcomes.
WHAT ARE THE SYMPTOMS?
The most important symptom of OAB is urgency--the sudden need to urinate. Incontinence may come with or right after this urgent need. People might leak small amounts or completely empty their bladder. People with OAB also often have frequency, feeling the need to urinate more often than usual--8 or more times in 24 hours.
CAUSES AND RISK FACTORS
Some cases of OAB are caused by neurological diseases like multiple sclerosis, Parkinson's disease, or stroke. Experts do not know the cause of the rest of OAB cases. Some possible causes include:
- Side effects of certain medications;
- Bladder stones; and
- Nerve damage caused by abdominal trauma or surgery.
A person's risk for OAB rises with age and the higher the body mass index. Other possible risk factors include diabetes and enlarged prostate.
For a diagnosis of OAB, a person must experience 2 to 3 of the main symptoms: urgency, incontinence, and frequency. Since these symptoms can also indicate a urinary tract infection or bladder cancer, the physician will need to rule those out. The physician will make a general assessment of the patient's weight and mobility and will ask about medications the patient takes that could make urinary symptoms worse.
A variety of tests may be done to diagnose OAB. These include:
- Bladder profilimetry;
- Pad test;
- Post-void residual urine volume;
- Urethral pressure profile tests;
- Urine cytology;
- Uroflowmetry; and
The standard treatment for OAB is behavioral therapy and/or medications. Medications for the condition work better when combined with behavioral changes than on their own. Other treatment options are observation, pads/diapers, sacral nerve stimulation, and surgery. For a patient who cannot completely empty their bladder, intermittent catheterization (inserting a tube into the bladder to drain it) might be used.