Overactive bladder : Causes, Symptoms and Treatment
Overactive bladder is a chronic condition which causes a sudden need to urinate or leakage of urine when the muscles of the bladder contract involuntarily pushing the urine out of the bladder. This contraction may occur due to damaged nerves of the bladder, the nervous system (spinal cord and brain), and muscles themselves. It can also disrupt the physical functioning, strength, and social life of a person. Overactive bladder is a common problem in elderly people, especially in women after menopause and men with prostate problems.
Symptoms of Overactive bladder
The symptoms of an overactive bladder include:
- Sudden and uncontrollable need to urinate
- Unintentional leakage of urine
- Frequent urination (> 8 times in 24 hours)
- Nocturia (sleep interruption to urinate more than two times at night)
Causes of Overactive bladder
The condition of overactive bladder is caused by various factors which include:
- Nerve damage: The damaged nerve signals send information to empty the bladder at the wrong time
- Weak pelvic muscles: The weak muscles due to pregnancy and childbirth causes stretching of the urethra opening that results in leakage of urine
- Infection: Urinary tract infection disrupts the nerves of the bladder and causes leakage of urine without indication
- Neurological conditions: Stroke, Parkinson’s disease, and multiple sclerosis can disturb the signals from the brain to the bladder.
- Overweight: Excess weight creates pressure on the bladder and causes unintentional leakage of urine
- Medicines: Drugs like diuretics and caffeine speed up the flow of urine to fill in the bladder that may cause leakage.
The possible complications of overactive bladder include
- urinary tract infections
- bladder stone
- skin infection and irritation
- disrupt sleep
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The tests used to diagnose overactive bladder include:
- Physical examination: A doctor checks for inflammation around the abdomen and kidneys or detect for an enlarged prostate.
- Urinalysis: A sample of urine is collected by the urologist to detect urinary tract infections or any urine related problems.
- Uroflowmetry: This test is used to measure the speed and volume of urination.
- Cystoscopy: Doctor inserts a thin tube with a camera to examine the urethra and the bladder internally.
- Bladder scan: Scans and ultrasounds are used to measure the amount of urine in the bladder before and after urination.
- Electromyography: This is used to record the nerve impulses coordination in the urinary sphincter and bladder muscles by using sensors.
The following behavioral interventions or lifestyle changes can prevent or reduce the risk of overactive bladder:
- Bladder control exercises or techniques
- Wear absorbent pads to protect clothes and avoid embarrassing incidents
- Maintain weight
- Avoid drinking fluids before sleeping
- Eat food that helps to make bladder stronger (fiber, beans, apples, whole-grains, and peas)
- Avoid acidic fruits, smoking (to reduce coughing), caffeine, and alcohol
The various treatments to treat overactive bladder include:
- Medications: Drugs like tolterodine, fesoterodine, oxybutynin, solifenacin, etc are used to relax the bladder and reduce leakage of urine.
- Bladder injections: Botox injection is used to stop contracting muscles of the bladder.
- Nerve stimulation: Mild electric current is given to the muscles of the pelvis and lower back that are involved in urination to regulate the nerve impulses.
- Surgery: Surgery to increase bladder capacity is performed by using bowel pieces to replace a portion of the bladder. It is performed only in patients with severe urge incontinence. Surgery to remove the bladder is the last option in which a surgeon removes the bladder and constructs a replacement bladder or a hole in the body to attach a bag for urine collection.